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Incorporating and Teaching Spirituality into Medical Education: An Overview of the Field and Possible Educational Strategies

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Spirituality, Religiousness and Health

Abstract

Resulting from the increasing scientific evidence on the correlations between spirituality and health (S/H), important institutions such as the World Health Organization, American College of Physicians and Association of American Medical Colleges have already formally recommended the approach of spirituality in clinical practice. In addition, most US and UK medical schools have already included S/H contents in their curriculum, students and medical teachers believe this issue is important to clinical practice and there are several studies showing promising results on the incorporation of S/H courses or strategies to medical students. This chapter will provide a brief panorama on the S/H field, aiming to bring an update overview of the development of the field, the current scientific evidence, the most common educational strategies and initiatives used, the S/H curriculum goals, objectives and general competences. Future challenges of this field are to create an international consensus including the minimum required competences that a medical student should learn concerning S/H, to increase the number of S/H content worldwide and to provide high-quality and continuing training for teachers and students.

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References

  • AAMC (1999). Contemporary issues in medicine: Communication in medicine. Washington, D.C: Association of American Medical Colleges.

    Google Scholar 

  • Anandarajah, G., & Mitchell, M. (2007). A spirituality and medicine elective for senior medical students: 4 years’ experience, evaluation, and expansion to the family medicine residency. Family Medicine, 39, 313–315.

    Google Scholar 

  • Anandarajah, G., Roseman, J., Lee, D., & Dhandhania, N. (2016). A 10-year longitudinal study of effects of a multifaceted residency spiritual care curriculum: Clinical ability, professional formation, end of life, and culture. Journal of Pain and Symptom Management, 52, 859–872. https://doi.org/10.1016/j.jpainsymman.2016.06.006. e851.

    Article  Google Scholar 

  • Balboni, M. J., et al. (2015). Religion, spirituality, and the hidden curriculum: Medical student and faculty reflections. Journal of Pain and Symptom Management, 50, 507–515. https://doi.org/10.1016/j.jpainsymman.2015.04.020.

    Article  Google Scholar 

  • Banin, L. B., Suzart, N. B., Banin, V. B., Guimaraes, F. G., Mariotti, L. L., & Lucchetti, G. (2013). Spirituality: Do teachers and students hold the same opinion? The Clinical Teacher, 10, 3–8. https://doi.org/10.1111/j.1743-498X.2012.00576.x.

    Article  Google Scholar 

  • Barnett, K. G., & Fortin, A. H. (2006). Spirituality and medicine. A workshop for medical students and residents. Journal of General Internal Medicine, 21, 481–485. https://doi.org/10.1111/j.1525-1497.2006.00431.x.

    Article  Google Scholar 

  • Bell, D., Harbinson, M., Toman, G., Crawford, V., & Cunningham, H. (2010). Wholeness of healing: An innovative student-selected component introducing United Kingdom medical students to the spiritual dimension in healthcare. Southern Medical Journal, 103, 1204–1209. https://doi.org/10.1097/SMJ.0b013e3181f968ce.

    Article  Google Scholar 

  • Best, M., Butow, P., & Olver, I. (2015). Do patients want doctors to talk about spirituality? A systematic literature review. Patient Education and Counseling, 98, 1320–1328. https://doi.org/10.1016/j.pec.2015.04.017.

    Article  Google Scholar 

  • Best, M., Butow, P., & Olver, I. (2016). Doctors discussing religion and spirituality: A systematic literature review. Palliative Medicine, 30, 327–337. https://doi.org/10.1177/0269216315600912.

    Article  Google Scholar 

  • Calman, K. (2008). Spirituality and medical education. Medical Education, 42, 123–125.

    Article  Google Scholar 

  • Culliford, L. (2009). Teaching spirituality and health care to third-year medical students. The Clinical Teacher, 6, 22–27.

    Article  Google Scholar 

  • Curlin, F. A., Lawrence, R. E., Odell, S., Chin, M. H., Lantos, J. D., Koenig, H. G., & Meador, K. G. (2007). Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. American Journal of Psychiatry, 164, 1825–1831.

    Article  Google Scholar 

  • de Carvalho Ferreira, A. G., de Oliveira, J. A. C., & Jordán, A. P. W. (2016). Educação em saúde e espiritualidade: uma proposta de transversalidade na perspectiva do estudante. IJHE-Interdisciplinary Journal of Health Education, 1, 3–12.

    Article  Google Scholar 

  • Ehman, J. W., Ott, B. B., Short, T. H., Ciampa, R. C., & Hansen-Flaschen, J. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159, 1803–1806.

    Article  Google Scholar 

  • Ellman, M. S., Schulman-Green, D., Blatt, L., Asher, S., Viveiros, D., Clark, J., & Bia, M. (2012). Using online learning and interactive simulation to teach spiritual and cultural aspects of palliative care to interprofessional students. Journal of Palliative Medicine, 15, 1240–1247. https://doi.org/10.1089/jpm.2012.0038.

    Article  Google Scholar 

  • Frazier, M., Schnell, K., Baillie, S., & Stuber, M. L. (2015). Chaplain rounds: A chance for medical students to reflect on spirituality in patient-centered care. Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 39, 320–323. https://doi.org/10.1007/s40596-015-0292-2.

    Article  Google Scholar 

  • Gonçalves, L. M., Osório, I. H. S., Oliveira, L. L., Simonetti, L. R., dos Reis, E., & Lucchetti, G. (2016). Learning from listening: Helping healthcare students to understand spiritual assessment in clinical practice. Journal of Religion and Health, 55, 986–999. https://doi.org/10.1007/s10943-015-0146-y.

    Article  Google Scholar 

  • Graves, D. L., Shue, C. K., & Arnold, L. (2002). The role of spirituality in patient care: Incorporating spirituality training into medical school curriculum. Academic Medicine: Journal of the Association of American Medical Colleges, 77, 1167.

    Article  Google Scholar 

  • Group, W. S. (2006). A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life. Social Science & Medicine, 62, 1486–1497.

    Article  Google Scholar 

  • Guck, T. P., & Kavan, M. G. (2006). Medical student beliefs: Spirituality’s relationship to health and place in the medical school curriculum. Medical Teacher, 28, 702–707. https://doi.org/10.1080/01421590601047680.

    Article  Google Scholar 

  • Harbinson, M. T., & Bell, D. (2015). How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum in the United Kingdom? BMC Medical Education, 15, 96. https://doi.org/10.1186/s12909-015-0378-2.

    Article  Google Scholar 

  • Kaufman, Y., Anaki, D., Binns, M., & Freedman, M. (2007). Cognitive decline in Alzheimer disease impact of spirituality, religiosity, and QOL. Neurology, 68, 1509–1514.

    Article  Google Scholar 

  • King, D. E., Arch, G., Mainous, I., Steyer, T. E., & Pearson, W. (2001). The relationship between attendance at religious services and cardiovascular inflammatory markers. The International Journal of Psychiatry in Medicine, 31, 415–425. https://doi.org/10.2190/F4MP-KLYE-VED4-3LDD.

    Article  Google Scholar 

  • King, D. E., Blue, A., Mallin, R., & Thiedke, C. (2004). Implementation and assessment of a spiritual history taking curriculum in the first year of medical school. Teaching and Learning in Medicine, 16, 64–68. https://doi.org/10.1207/s15328015tlm1601_13.

    Article  Google Scholar 

  • Koenig, H. G. (1998). Religious attitudes and practices of hospitalized medically ill older adults. International Journal of Geriatric Psychiatry, 13, 213–224.

    Article  Google Scholar 

  • Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, 278730. https://doi.org/10.5402/2012/278730.

    Article  Google Scholar 

  • Koenig, H. G., Hooten, E. G., Lindsay-Calkins, E., & Meador, K. G. (2010). Spirituality in medical school curricula: Findings from a national survey. International Journal of Psychiatry in Medicine, 40, 391–398. https://doi.org/10.2190/PM.40.4.c.

    Article  Google Scholar 

  • Ledford, C. J., Seehusen, D. A., Canzona, M. R., & Cafferty, L. A. (2014). Using a teaching OSCE to prompt learners to engage with patients who talk about religion and/or spirituality. Academic Medicine: Journal of the Association of American Medical Colleges, 89, 60–65. https://doi.org/10.1097/acm.0000000000000062.

    Article  Google Scholar 

  • Lennon-Dearing, R., Florence, J. A., Halvorson, H., & Pollard, J. T. (2012). An interprofessional educational approach to teaching spiritual assessment. Journal of Health Care Chaplaincy, 18, 121–132. https://doi.org/10.1080/08854726.2012.720546.

    Article  Google Scholar 

  • Lucchetti, G., & Lucchetti, A. L. (2014). Spirituality, religion, and health: Over the last 15 years of field research (1999–2013). International Journal of Psychiatry in Medicine, 48, 199–215. https://doi.org/10.2190/PM.48.3.e.

    Article  Google Scholar 

  • Lucchetti, G., Lucchetti, A. L., & Koenig, H. G. (2011a). Impact of spirituality/religiosity on mortality: Comparison with other health interventions. Explore: The Journal of Science and Healing, 7, 234–238.

    Article  Google Scholar 

  • Lucchetti, G., Lucchetti, A. L. G., & Avezum, Á., Jr. (2011b). Religiosidade, espiritualidade e doenças cardiovasculares. Rev Bras Cardiol, 24, 55–57.

    Google Scholar 

  • Lucchetti, G., Lucchetti, A. L., & Puchalski, C. M. (2012a). Spirituality in medical education: Global reality? Journal of Religion and Health, 51, 3–19. https://doi.org/10.1007/s10943-011-9557-6.

    Article  Google Scholar 

  • Lucchetti, G., Lucchetti, A. L. G., Espinha, D. C. M., de Oliveira, L. R., Leite, J. R., & Koenig, H. G. (2012b). Spirituality and health in the curricula of medical schools in Brazil. BMC Medical Education, 12, 78.

    Article  Google Scholar 

  • Lucchetti, G., de Oliveira, L. R., Koenig, H. G., Leite, J. R., & Lucchetti, A. L. (2013). Medical students, spirituality and religiosity – results from the multicenter study SBRAME. BMC Medical Education, 13, 162. https://doi.org/10.1186/1472-6920-13-162.

    Article  Google Scholar 

  • Mariotti, L. G., Lucchetti, G., Dantas, M. F., Banin, V. B., Fumelli, F., & Padula, N. A. (2011). Spirituality and medicine: Views and opinions of teachers in a Brazilian medical school. Medical Teacher, 33, 339–340.

    Google Scholar 

  • Mccauley, J., Jenckes, M. W., Tarpley, M. J., Koenig, H. G., Yanek, L. R., & Becker, D. M. (2005). Spiritual beliefs and barriers among managed care practitioners. Journal of Religion and Health, 44, 137–146.

    Article  Google Scholar 

  • McEvoy, M., Schlair, S., Sidlo, Z., Burton, W., & Milan, F. (2014). Assessing third-year medical students’ ability to address a patient’s spiritual distress using an OSCE case. Academic Medicine: Journal of the Association of American Medical Colleges, 89, 66–70. https://doi.org/10.1097/acm.0000000000000061.

    Article  Google Scholar 

  • Michaelsen, L. K., & Sweet, M. (2011). Team-based learning. New Directions for Teaching and Learning, 2011, 41–51.

    Article  Google Scholar 

  • Moreira-Almeida, A., Koenig, H. G., & Lucchetti, G. (2014). Clinical implications of spirituality to mental health: Review of evidence and practical guidelines. Revista Brasileira de Psiquiatria, 36, 176–182.

    Article  Google Scholar 

  • Musick, D. W., Cheever, T. R., Quinlivan, S., & Nora, L. M. (2003). Spirituality in medicine: A comparison of medical students’ attitudes and clinical performance. Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 27, 67–73. https://doi.org/10.1176/appi.ap.27.2.67.

    Article  Google Scholar 

  • Neely, D., & Minford, E. J. (2008). Current status of teaching on spirituality in UK medical schools. Medical Education, 42, 176–182.

    Article  Google Scholar 

  • Onyon, C. (2012). Problem-based learning: A review of the educational and psychological theory. The Clinical Teacher, 9, 22–26. https://doi.org/10.1111/j.1743-498X.2011.00501.x.

    Article  Google Scholar 

  • Osorio, I. H. S., Goncalves, L. M., Pozzobon, P. M., Gaspar Junior, J. J., Miranda, F. M., Lucchetti, A. L. G., & Lucchetti, G. (2017). Effect of an educational intervention in “spirituality and health” on knowledge, attitudes, and skills of students in health-related areas: A controlled randomized trial. Medical Teacher, 1–8. https://doi.org/10.1080/0142159x.2017.1337878.

    Article  Google Scholar 

  • Panzini, R. G., & Bandeira, D. R. (2007). Spiritual/religious coping. Archives of Clinical Psychiatry (São Paulo), 34, 126–135.

    Article  Google Scholar 

  • Perechocky, A., DeLisser, H., Ciampa, R., Browning, J., Shea, J. A., & Corcoran, A. M. (2014). Piloting a medical student observational experience with hospital-based trauma chaplains. Journal of Surgical Education, 71, 91–95. https://doi.org/10.1016/j.jsurg.2013.07.001.

    Article  Google Scholar 

  • Pettus, M. C. (2002). Implementing a medicine-spirituality curriculum in a community-based internal medicine residency program. Academic Medicine: Journal of the Association of American Medical Colleges, 77, 745.

    Article  Google Scholar 

  • Prober, C. G., & Heath, C. (2012). Lecture halls without lectures – a proposal for medical education. The New England Journal of Medicine, 366, 1657–1659. https://doi.org/10.1056/NEJMp1202451.

    Article  Google Scholar 

  • Puchalski, C. M., & Larson, D. B. (1998). Developing curricula in spirituality and medicine. Academic Medicine, 73, 970–974.

    Article  Google Scholar 

  • Puchalski, C., & Romer, A. L. (2000). Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Medicine, 3. https://doi.org/10.1089/jpm.2000.3.129.

    Article  Google Scholar 

  • Puchalski, C., et al. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine, 12, 885–904. https://doi.org/10.1089/jpm.2009.0142.

    Article  Google Scholar 

  • Puchalski, C. M., Blatt, B., Kogan, M., & Butler, A. (2014a). Spirituality and health: The development of a field. Academic Medicine: Journal of the Association of American Medical Colleges, 89, 10–16. https://doi.org/10.1097/acm.0000000000000083.

    Article  Google Scholar 

  • Puchalski, C. M., Vitillo, R., Hull, S. K., & Reller, N. (2014b). Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine, 17, 642–656. https://doi.org/10.1089/jpm.2014.9427.

    Article  Google Scholar 

  • Ramakrishnan, P., et al. (2014). Perspectives of Indian traditional and allopathic professionals on religion/spirituality and its role in medicine: Basis for developing an integrative medicine program. Journal of Religion and Health, 53, 1161–1175. https://doi.org/10.1007/s10943-013-9721-2.

    Article  Google Scholar 

  • Rassoulian, A., Seidman, C., & Loffler-Stastka, H. (2016). Transcendence, religion and spirituality in medicine: Medical students’ point of view. Medicine, 95, e4953. https://doi.org/10.1097/md.0000000000004953.

    Article  Google Scholar 

  • Sandor, M. K., Sierpina, V. S., Vanderpool, H. V., & Owen, S. V. (2006). Spirituality and clinical care: Exploring developmental changes in nursing and medical students. Explore (New York, NY), 2, 37–42. https://doi.org/10.1016/j.explore.2005.10.009.

    Article  Google Scholar 

  • Schonfeld, T. L., Schmid, K. K., & Boucher-Payne, D. (2016). Incorporating spirituality into health sciences education. Journal of Religion and Health, 55, 85–96. https://doi.org/10.1007/s10943-014-9972-6.

    Article  Google Scholar 

  • Talley, J. A., & Magie, R. (2014). The integration of the “spirituality in medicine” curriculum into the osteopathic communication curriculum at Kansas City University of Medicine and Biosciences. Academic Medicine: Journal of the Association of American Medical Colleges, 89, 43–47. https://doi.org/10.1097/acm.0000000000000078.

    Article  Google Scholar 

  • Tomasso, C. S., Beltrame, I. L., & Lucchetti, G. (2011). Knowledge and attitudes of nursing professors and students concerning the interface between spirituality, religiosity and health. Revista Latino-Americana de Enfermagem, 19, 1205–1213.

    Article  Google Scholar 

  • Tosteson, D. C. (1990). New pathways in general medical education. The New England Journal of Medicine, 322, 234–238. https://doi.org/10.1056/nejm199001253220405.

    Article  Google Scholar 

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Lucchetti, G., Gonçalves, L.M., de Carvalho Ferreira, A.G., Daher, J.C., Lucchetti, A.L.G. (2019). Incorporating and Teaching Spirituality into Medical Education: An Overview of the Field and Possible Educational Strategies. In: Lucchetti, G., Prieto Peres, M.F., Damiano, R.F. (eds) Spirituality, Religiousness and Health. Religion, Spirituality and Health: A Social Scientific Approach, vol 4. Springer, Cham. https://doi.org/10.1007/978-3-030-21221-6_15

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