MedEdPORTAL (Feb 2015)
Spiritual Histories: Putting Religio-Cultural Competence into Practice
Abstract
Abstract Introduction Medical education increasingly recognizes that cultural competence is an important component of patient care. However, religion is an aspect of culture that still often goes unaddressed in medical education. Spiritual Histories: Putting Religio-Cultural Competence into Practice is a resource for medical school educators designed to address this gap in medical education. Methods This 90-minute learning module introduces medical students to key tools and strategies for communicating with patients about how their religious beliefs and practices impact their care. The module reviews why taking a spiritual history is important, when and how to ask appropriate questions about a patient's religious beliefs and practices, and what do with the information once obtained. This module also includes two longer case studies and two role play activities that allow students to develop their skills around taking spiritual histories. The facilitator's guide provides detailed instructions and helpful strategies for the facilitator on how to effectively convey the information and facilitate the accompanying activities. Results The Tanenbaum Center for Interreligious Understanding initially developed this learning module for Hofstra North Shore-LIJ School of Medicine. Dr. Judith Brenner, Associate Dean for Curricular Integration noted that the materials were “extremely helpful in planning and idea-generating for their course, Sources of Support, Meaning and Hope.” She added that our curriculum had “molded the session and prompted us to include religion and spirituality as a critical component of our curriculum.” In an evaluation the medical students completed after their course, 60% of students agreed or strongly agreed with the following statement: “Session content enhanced my knowledge and/or skills.” In addition, 70% agreed or strongly agreed that the “session was engaging.” Approximately 2 months following the course, Hofstra faculty also evaluated students' learning through a standardized patient encounter. The results indicated that the majority of students internalized the information on how to take a spiritual history. Thirty-nine students completed standardized patient encounters. The mean score was 78.46 out of 100. Dr. Judith Brenner summarized the outcome of the standardized patient exercise as follows: “Overall performance was very good. Nearly half of students met all expectations for performance on this station, which included checklist items addressing the following competencies: interpersonal and communication skills, patient care and professionalism. Regarding the specific checklist items relevant to spiritual history content, students performed extremely well, with mean scores of nearly 4 or more [on a scale of 1-5] on 75% of critical questions.” Discussion The knowledge and skill sets presented in this course provide instruction for pre-service physicians on how to respectfully ask patients about their religious beliefs as it relates to their health care, as well as how to address the topic of religion when it impacts patient care and/or patient decision-making. Addressing the religious beliefs of patients as it relates to their health care is an essential component of patient centered care and improves patient satisfaction.
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