Despite the ubiquity of healthcare simulation and the humanities in medical education, the two domains of learning remain unintegrated. The stories suffused within healthcare simulation have thus remained unshaped by the developments of narrative medicine and the health humanities. Healthcare simulation, in turn, has yet to utilize concepts like co-construction and narrative competence to enrich learners’ understanding of patient experience alongside their clinical competencies. To create a conceptual bridge between these two fields (including narrative-based inquiry more broadly), we redescribe narrative competence via Ronald Heifetz’s distinction of “technical” and “adaptive” challenges outlined in his adaptive leadership model. Heifetz, we argue, enriches learners’ self-understanding of the unique demands of cultivating narrative competence, which can be both elucidated on the page and tested within the charged yet supportive simulation environment. We introduce Co-constructive Patient Simulation (CCPS) to demonstrate how working with simulated patients can support narrative work by drawing on the clinical vicissitudes of learners in the formulation and enactment of case studies. The three movements of CCPS—resensing, retelling, and retooling—told through learner experiences, describe the affinities and divergences between narrative medicine’s sequence of attention, representation, and affiliation; Montello’s three forms of narrative competence (departure, performance, change), and Heifetz’s three steps (observe, interpret, and intervene) of adaptive leadership.

尽管医疗保健模拟和医学教育中的人文学科无处不在，但这两个学习领域仍然没有整合。因此，医疗模拟中充斥的故事并未受到叙事医学和健康人文学科发展的影响。反过来，医疗保健模拟尚未利用共建和叙事能力等概念来丰富学习者对患者体验及其临床能力的理解。为了在这两个领域（包括更广泛的基于叙事的探究）之间建立概念桥梁，我们通过罗纳德·海菲茨（Ronald Heifetz）在其适应性领导模型中概述的“技术”和“适应性”挑战的区别来重新描述叙事能力。我们认为，海菲茨丰富了学习者对培养叙事能力的独特要求的自我理解，这些能力既可以在页面上阐明，也可以在充满活力但支持性的模拟环境中进行测试。我们引入共建患者模拟（CCPS）来展示如何通过利用学习者在案例研究的制定和实施中的临床变迁来支持模拟患者的工作，从而支持叙事工作。 CCPS 的三个运动——重新感知、重述和重组——通过学习者的经验讲述，描述了叙事医学的关注、再现和归属序列之间的相似性和分歧；蒙特洛的叙事能力的三种形式（离开、表演、改变）和海菲茨的适应性领导力的三个步骤（观察、解释和干预）。