Journal of General Internal Medicine

, Volume 21, Issue 5, pp 481–485 | Cite as

Spirituality and medicine

A workshop for medical students and residents
  • Katherine Gergen Barnett
  • Auguste H. FortinEmail author
Original Articles


INTRODUCTION: Governing bodies for medical education recommend that spirituality and medicine be incorporated into training.

AIM: To pilot a workshop on spirituality and medicine on a convenience sample of preclinical medical students and internal medicine residents and determine whether content was relevant to learners at different levels, whether preliminary evaluation was promising, and to generate hypotheses for future research.

SETTING: Private medical school and university primary care internal medicine residency program, both in the Northeast.

CURRICULUM DESCRIPTION: The authors designed and implemented a required 2-hour workshop for all second-year medical students and a separate required 1.5-hour workshop for all primary care internal medicine house staff. The workshops used multiple educational strategies including lecture, discussion, and role-play to address educational objectives.

PROGRAM EVALUATION: Learners completed optional, anonymous pre and postworkshop surveys with six 5-point Likert-rated statements and space to cite the most useful part of the curriculum and their remaining questions. One hundred and thirty-seven learners participated and 100 completed both surveys. Medical students and residents had increased (all P≤.002): agreement regarding the appropriateness of inquiring about spiritual and religious beliefs in the medical encounter, their perceived competence in taking a spiritual history, and their perceived knowledge of available pastoral care resources. Medical students, but not residents, had an increase in their perceived comfort in working with hospital chaplains.

DISCUSSION: A brief pilot workshop on spirituality and medicine had a modest effect in improving attitudes and perceived competence of both medical students and residents.

Key words

spirituality curriculum medical education 


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  1. 1.
    Carballo M. Gallup International Millennium Survey. Available at: Scholar
  2. 2.
    McNichol T. The new faith in medicine. USA Today. April 7, 1996:4.Google Scholar
  3. 3.
    King DE, Bushwick B. Beliefs and attitudes of hospital inpatients about faith healing and prayer. J Fam Prac. 1994;39:349–52.Google Scholar
  4. 4.
    Daaleman TP, Nease DE. Patient attitudes regarding physician inquiry into spiritual and religious issues [see comments]. J Fam Prac. 1994;39:564–8.Google Scholar
  5. 5.
    Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med. 1999;159:1803–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Ellis MR, Vinson DC, Ewigman B. Addressing spiritual concerns of patients: family physicians’ attitudes and practices [see comments]. J Fam Prac. 1999;48:105–9.Google Scholar
  7. 7.
    Chibnall JT, Brooks CA. Religion in the clinic: the role of physician beliefs. South Med J. 2001;94:374–9.PubMedGoogle Scholar
  8. 8.
    Kristeller JL, Zumbrun CS, Schilling RF. “I would if I could”: how oncologists and oncology nurses address spiritual distress in cancer patients. Psychooncology. 1999;8:451–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Jones AW. A survey of general practitioners’ attitudes to the involvement of clergy in patient care. Br J General Prac. 1990;40:280–3.Google Scholar
  10. 10.
    Association of American Medical Colleges. Report III of the medical school objectives project. Contemporary issues in medicine: communication in medicine; 1999.Google Scholar
  11. 11.
    Puchalski C. Spirituality in health: the role of spirituality in critical care. Crit Care Clin. 2004;20:487–504.PubMedCrossRefGoogle Scholar
  12. 12.
    Puchalski CM, Larson DB. Developing curricula in spirituality and medicine. [erratum appears in Acad Med 1998;73:1038]. Acad Med. 1998;73:970–4.PubMedCrossRefGoogle Scholar
  13. 13.
    Barnard D, Dayringer R, Cassel CK. Toward a person-centered medicine: religious studies in the medical curriculum. Acad Med. 1995;70:806–13.PubMedCrossRefGoogle Scholar
  14. 14.
    Silverman HD. Creating a spirituality curriculum for family practice residents. Altern Ther Health Med. 1997;3:54–61.PubMedGoogle Scholar
  15. 15.
    Fortin AH VI, Gergen Barnett K. Medical school curricula in spirituality and medicine. JAMA. 2004;291:2883.PubMedCrossRefGoogle Scholar
  16. 16.
    Kern DE. Curriculum Development for Medical education: A Six Step Approach. Baltimore: Johns Hopkins University Press; 1998.Google Scholar
  17. 17.
    Deloney LA, Graham CJ, Erwin DO. Presenting cultural diversity and spirituality to first-year medical students. Acad Med. 2000;75:513–4.PubMedCrossRefGoogle Scholar
  18. 18.
    Smith RC. Patient Centered Interviewing. 2nd edn. Philadelphia: Lippincott Williams & Wilkins; 2002.Google Scholar
  19. 19.
    McKee DD, Chappel JN. Spirtuality and medical practice. [see comments]. J Fam Prac. 1992;35:201.Google Scholar
  20. 20.
    Anandarajah G, Hight E. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician. 2001;63:81–9.PubMedGoogle Scholar
  21. 21.
    Hunter RJ. Dictionary of Pastoral Care and Counseling. Nashville: Abingdon Press; 1990.Google Scholar
  22. 22.
    Matthews DA, Classen DC, Willms JL, Cotton JP. A program to help interns cope with stresses in an internal medicine residency. J Med Educ. 1988;63:539–47.PubMedGoogle Scholar
  23. 23.
    Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: implications for clinical practice. [see comments]. Mayo Clinic Proc. 2001;76:1225–35.CrossRefGoogle Scholar
  24. 24.
    Gallup G Princeton Religion Research Center. Religion in America 1990. Princeton, NJ: Princeton Religion Research Center, 1990.Google Scholar
  25. 25.
    Daaleman TP, Frey B. Spiritual and religious beliefs and practices of family physicians: a national survey. [see comments]. J Fam Prac. 1999;48:98–104.Google Scholar
  26. 26.
    Levin JS. How religion influences morbidity and health: reflections on natural history, salutogenesis and host resistance. Soc Sci Med. 1996;43:849–64.PubMedCrossRefGoogle Scholar
  27. 27.
    Koenig HG, Hays JC, Larson DB, et al. Does religious attendance prolong survival? A six-year follow-up study of 3,968 older adults. J Gerontol Series A—Biol Sci Med Sci. 1999;54:M370–6.Google Scholar
  28. 28.
    Matthews DA, McCullough ME, Larson DB, Koenig HG, Swyers JP, Milano MG. Religious commitment and health status: a review of the research and implications for family medicine. Arch Fam Med. 1998;7:118–24.PubMedCrossRefGoogle Scholar
  29. 29.
    McBride JL, Arthur G, Brooks R, Pilkington L. The relationship between a patient’s spirituality and health experiences. Fam Med. 1998;30:122–6.PubMedGoogle Scholar
  30. 30.
    Kaldjian LC, Jekel JF, Friedland G. End-of-life decisions in HIV-positive patients: the role of spiritual beliefs. AIDS. 1998;12:103–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Sloan RP, Bagiella E, Powell T. Religion, spirituality, and medicine. [see comments]. Lancet. 1999;353:664–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Post SG, Puchalski CM, Larson DB. Physicians and patient spirituality: professional boundaries, competency, and ethics. Ann Intern Med. 2000;132:578–83.PubMedGoogle Scholar
  33. 33.
    Asser SM, Swan R. Child fatalities from religion-motivated medical neglect. Pediatrics. 1998;101(part 1):625–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Pargament KI, Koenig HG, Tarakeshwar N, Hahn J. Religious struggle as a predictor of mortality among medically ill elderly patients: a 2-year longitudinal study. Arch Intern Med. 2001;161:1881–5.PubMedCrossRefGoogle Scholar
  35. 35.
    Koenig HG. Religion and medicine I: historical background and reasons for separation [see comments]. Int J Psychiatry Med. 2000;30:385–98.PubMedCrossRefGoogle Scholar
  36. 36.
    Sloan RP, Bagiella E, VandeCreek L, et al. Should physicians prescribe religious activities? N Engl J Med. 2000;342:1913–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Astrow AB, Puchalski CM, Sulmasy DP. Religion, spirituality, and health care: social, ethical, and practical considerations. Am J Med. 2001;110:283–7.PubMedCrossRefGoogle Scholar
  38. 38.
    Rutherford JF, Bergman J. Jehovah’s Witnesses I: The Early Writings of J.F. Rutherford. New York: Garland Publication; 1990 (Cults and new religions; 8).Google Scholar
  39. 39.
    Bergman J. Jehovah’s Witnesses II: Controversial and Polemical Pamphlets. New York: Garland Publication; 1990 (Cults and new religions; 9).Google Scholar
  40. 40.
    Puchalski C, Romer AL. Taking a spiritual history allows clinicians to understand patients more fully. J Palliat Med. 2000;3:129–37.PubMedCrossRefGoogle Scholar
  41. 41.
    Crabtree BF, Miller WL. Doing Qualitative Research. Newbury Park, CA: Sage Publications; 1992 (Research methods for primary care; v. 3.).Google Scholar
  42. 42.
    Graves DL, Shue CK, Arnold L. The role of spirituality in patient care: incorporating spirituality training into medical school curriculum. Acad Med. 2002;77:1167.PubMedCrossRefGoogle Scholar
  43. 43.
    Chibnall JT, Duckro PN. Does exposure to issues of spirituality predict medical students’ attitudes toward spirituality in medicine? Acad Med. 2000;75:661.PubMedCrossRefGoogle Scholar
  44. 44.
    Curlin FA, Hall DE. Strangers or friends? A proposal for a new spirituality-in-medicine ethic. J Gen Intern Med. 2005;20:370–4.PubMedCrossRefGoogle Scholar
  45. 45.
    Scheurich N. Spirituality, medicine, and the possibility of wisdom. J Gen Intern Med. 2005;20:379–80.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Katherine Gergen Barnett
    • 1
  • Auguste H. Fortin
    • 2
    • 3
    Email author
  1. 1.Yale University School of MedicineNew HavenUSA
  2. 2.Department of MedicineYale University School of MedicineNew HavenUSA
  3. 3.Waterbury HospitalWaterburyUSA

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