Abstract: Objectives To explore the impact of the three-stage clinical practice approach on medical students' cognition of narrative medicine. Methods A self-designed questionnaire was used to compare the cognition degree of narrative medicine among the students of clinical medicine from grade 2019, 2018, 2017, and 2016 in Shanghai University of Medicine and Health Sciences from April 2000 to May 2000. The three-stage “narrative medicine” teaching was arranged in the third semester in the first, second and third school year. Results With the advancement of three-stage clinical practice, students' understandings of the concept, development, parallel medical records, and the writing skills of narrative medicine gradually deepened (all P<0.001). During the communication between doctors and patients, the percentage of listening time within 10 minutes gradually decreased as the practice progresses (P=0.034). More than 95% of students who have received narrative medical practice in the three grades thought that narrative medical practice was helpful for the cultivation of professionalism, empathy between doctors and patients, and communication capacity between doctors and patients. Conclusions Medical students' cognitions of narrative medicine have been improved by the staged curriculum based clinical practice teaching, and the teaching model has been well recognized by students.

Key words: Three-stage, Clinical practice, Narrative medicine, CognitionFund program: Young Teachers Training Funding Program of Shanghai University in 2020(ZZSHJKYXY20006)