The George Washington Institute for Spirituality and Health     |     home                                      
1999 Curricular Awards Course Summaries

The John Templeton Spirituality and Medicine Award for
Undergraduate Medical School Curricula



COURSE: Longitudinal Program in Cultural Sensitivity, Spirituality, and End of Life Issues
COURSE DIRECTOR(S): Robert Hatch, M.D., M.P.H. (Lead Director), John Graham-Pole, M.D., Allen Neims, M.D., Ph.D., Louis Ritz, Ph.D., James Wagner, M.Div., Ph.D., University of Florida, College of Medicine, Gainesville, FL
YEAR AWARDED: 1999

We propose to establish at the University of Florida College of Medicine a formal Longitudinal Program in Cultural Sensitivity, Spirituality, and End of Life Issues. Some of these issues already receive limited attention in our four-year medical curriculum, but this proposal seeks to specifically codify and substantially enhance their place in existing required and elective courses in each of the four years. We propose to introduce several activities, which will build upon each other in a stepwise progression, reinforcing and expanding upon material taught in previous years. Students with deeper interest will be provided special opportunities. These include participation in a series of public lectures and workshops sponsored by the University of Florida Spirituality and Health Group, as well as elective research, clinical and educational activities mentored by the Group's multidisciplinary faculty.
This Longitudinal Program is in part an extension from our university-wide UF Spirituality and Health group. The group, which came together two years ago, seeks to heighten awareness of the important relationship between spirituality and health, each broadly defined, within the Health Science Center, the University, our community, and our region. It is our deep purpose to "give permission" to people to acknowledge, embrace and act upon their yearning for Connection, Relationship and Meaning, especially as they seek, give and/or receive health care. The group includes faculty from the Colleges of Liberal Arts and Sciences, Medicine, and Pharmacy. Intended Outcome
The Longitudinal Program in Cultural Sensitivity, Spirituality, and End of Life Issues is designed to:
1.increase students' awareness of the importance of spirituality, professionally and personally, and its relationship to health and to disease;
2. enhance students' sensitivity to, and respect for, diverse beliefs and cultures;
3. provide students with tools that they can use in clinical settings to address spiritual issues with patients, with a special focus on tools useful when helping patients face their death or the death of a loved one;
4. provide students with opportunities to use these tools as they interact with patients. It is hoped that these activities will enhance students' appreciation of these important areas, and provide them with skills and attitudes that will allow them to successfully address these issues with future patients.

Rather than achieving these goals through one discrete course, the material will be integrated into existing required courses and distributed longitudinally through all four years of medical school. Components of the Longitudinal Program will be incorporated into the following required courses: Essentials of patient Care (1st year), Primary Care Preceptorship (1st year), Ethical and Legal Issues in Medical Practice (2nd year), Interdisciplinary Generalist Clerkship (3rd year) and Geriatrics (4th year). Optional activities include a weekend retreat for second year students, End of Life Elective (2nd year), lectures sponsored by the Spirituality and Health Group, research opportunities (summer after 1st year and during 4th year) and three 4th year electives.



COURSE: Spirituality, Culture and Clinical Care
COURSE DIRECTOR(S): Gregory A. Plotnikoff, M.D., M.T.S. (Lead Director), David Berg, M.Div., Mary Catherine Casey, M.Div., John Hatgidakis, M.Div., Edward Ratner, M.D., University of Minnesota Medical School, Center for Spirituality and Healing, Minneapolis, MN
YEAR AWARDED: 1999

At the University of Minnesota Medical School, we believe that students by graduation should demonstrate the ability to:
1. recognize that control of physical symptoms is a necessary but insufficient response to suffering
2. define and understand spirituality as it relates to health and healing
3. interview to identify relevant cultural, spiritual and religious resources for healing
4. recognize and acknowledge issues of fear, guilt, shame, trust, forgiveness, and reconciliation present in patient stories and patient care
5. refer to chaplains, clergy, and/or traditional healers for spiritual care support incorporation of religious rituals and observances meaningful to the patient.
To do so, the University of Minnesota Medical School will integrate spirituality, culture and clinical care into four courses spaced throughout the four years. These are "Professionalism" in Clinical Medicine I,"Patient interviewing" in Clinical Medicine II, "Seniors as Teachers" in Clinical Medicine III, and "Spirituality, Culture and Clinical Care" in Clinical Medicine IV.
"Professionalism" is a required first year course which combines patient and physician presentations with small group reflections using poetry, short stories and essays related to illness and medical care. Questions addressed include: What does it mean to be a doctor? What does it mean to be a patient? What does it mean to suffer? To be healed? To be a healer?  "Patient Interviewing" is a required course in the first year where students learn the fundamentals of this core clinical skill. Specific questions related to a patient's perception of their spirituality are included with standard questions related to signs and symptoms so future doctors can also identify a patient's spiritual strengths, resources and challenges.
"Seniors as Teachers" is a required course in the second year where students make house calls in senior high rises to practice their interviewing skills with real patients. The intent is to increase student confidence and competence in communication skills and geriatric assessment. These competencies include student skills in asking about spiritual strengths, resources and concerns.  "Spirituality, Culture and Clinical Care" is a series of four 2-hour elective workshops in a required course for senior students. Here, chaplains serve as co-facilitators with a physician. These workshops include a general introduction to the topic and also focus on specific issues in chemical dependency, chronic illness and end of life care. Both students and patients are encouraged to reflect and share their experiences with spiritual concerns in the hospital wards. These first-person accounts become the basis for clinically-relevant lessons in humane care.



COURSE:  An Integrated Four-Year Medical School Curriculum in Spirituality, Cultural and End of Life Issues
COURSE DIRECTOR(S): Kevin Dorsey, M.D., Ph.D. Southern Illinois University School of Medicine, Carbondale, IL
YEAR AWARDED: 1999

Starting in August 2000, the Southern Illinois University School of Medicine will implement its revised undergraduate medical curriculum. This four-year curriculum is guided by ten goal statements, one of which is to "prepare students to be physicians who recognize that spirituality and cultural beliefs are important elements of the health and well being of patients." In order to accomplish this goal, a fully integrated, longitudinal, four-year experience has been designed which will strive to change the culture of the medical school community to one that is more responsive to the meaning of patients' stories in the context of their spiritual beliefs and cultural values.
Specifically, students will receive instruction in obtaining a spiritual history and, during their four-year medical school career, be given increasing opportunity and responsibility to demonstrate their ability to do so. In addition, through reflective discussions with fellow students and mentor physicians, using stories taken from literature as well as personal narratives, we hope to increase the medical community's awareness of, and sensitivity to, spiritual, cultural and end of life issues.



COURSE: Spirituality, Care and the Medical Dialogue
COURSE DIRECTOR(S): Rev. Terry Ruth Culbertson (Lead Director), Steve Allen, Jr., M.D., Lynn M. Cleary, M.D., Joel Potash, M.D., Dennis J. Stelzner, Ph.D., Suny Upstate Medical University College of Medicine, Syracuse, NY
YEAR AWARDED: 1999

The instruction in spirituality at the College of Medicine at SUNY Upstate Medical University will be an interdisciplinary theme weaving throughout the four-year curriculum. It will include the introduction of new content within two current required courses, and will introduce two new electives. The overall goals of our curriculum in spirituality include the following:
1. To provide students with a greater understanding of the role of spirituality and sources of meaning in their own lives and in the lives of their patients.
2. To understand spirituality and religion as they relate to health (e.g. diet, contraception, death and dying) and health-related decision (resuscitation, transfusions, treatment, etc.) during and at the end of life.
3. To help students develop the communication skills they need to provide culturally sensitive, patient-centered care, during and at the end of life.
4. To enhance students' understanding of a variety of spiritual beliefs that patients may have.
5. To understand the effect of the predominant religious culture in society on patient care and medical education.
Within two existing courses, there will be new modules. One course is the Medicine and Society course, a longitudinal course spanning years 1 and 2 where students attend a large group session followed by a small group session facilitated by faculty. The course attempts to foster greater appreciation of different cultural backgrounds of students and the patients they treat, to improve students' communication skills, and to enhance an understanding of moral issues that arise in medical care. A new module on spirituality will address how spirituality in the lives of patients and of physicians affects their health, well being, and decision-making. Within the required "Introduction to Clinical Medicine" course, a new segment will be integrated on how to appropriately take a spiritual history from a patient and how to include discussions of spirituality in open dialogue with patients about their health care decision making.
A new elective, "The Meaning of Illness," will be offered to first year students and taught as a combination of small group sessions (with a facilitator from the InterReligious Council of Central New York) as well as hospital rounds. This course hopes to provide students with an appreciation of their patients' spirituality and how their own spirituality will effect the provision of medical care. A new fourth year elective, "End-of-Life and Palliative Care" will be offered through Hospice of Central New York, chaplains from the InterReligious Council of Central New York, and faculty of the College of Medicine. A major goal of this elective will be for students to increase their communication skills in assessment, diagnosis, and treatment as they focus on issues, which affect end-of-life patient care. Students will work with patients and families experiencing death and dying, in the outpatient setting, in home visits, in-group discussions, and in the hospital.
Outcomes expected from this curriculum include:
1.developing cultural awareness of diverse spiritual beliefs and religious traditions;
2.fostering the integration of spiritual and religious issues in the medical dialogue with patient and family (history taking, communication and decision-making); and
3.contributing to each student's own lifelong journey as a competent, compassionate physician.



COURSE: Doctoring 1, 2 and 3
COURSE DIRECTOR(S): Susan Stangl, M.D., M.S.Ed., David Myler, M.Div., University of California, Los Angeles School of Medicine
YEAR AWARDED: 1999

The course at UCLA involves all years of medical students, with a particular focus on the first year. Much of the course is included in our existing Doctoring course. The first year students receive presentations on the mind-body connection and eliciting the relaxation response, the role of spirituality in medical care, research on religion and prayer and their connection with health, two presentations on cultural aspects of health care, including a presentation of Hispanic spiritual healing practices, a session on death and dying, and a session on advance directives. Students complete a survey comparing their beliefs about spiritual issues and prayer with those of the general public. In addition, students interview a standardized patient who has concerns about spirituality. Two other patient cases involve issues regarding the ethics of abortion and the role of faith in cancer care. All students visit an AA meeting and make rounds with the hospital chaplain.
Because the program involving the entire class with chaplain rounds is a new one, selected second year students will also be making chaplain rounds. Some students will make home visits or work with nurses and social workers to experience the support they give to patients. The second year course includes two cases of patients who will receive a cancer diagnosis, including one whose prognosis is very grave.
The third year students work further with cancer patients, the elderly, and a young woman who has been raped and has strong religious convictions. Approximately one-sixth of the fourth year class work as tutors in the Doctoring course, and are thus involved in the educational program of the first three years. Electives are planned for the first and fourth year students involving hospital chaplains and local hospices.  These experiences will give students an appreciation for the role of spiritual issues in patient care, including research that has been done on the subject. Students will learn to respect the beliefs of others and gain an understanding of the power of belief. Regardless of their own convictions, students should learn how to help patients integrate their own spirituality as a tool for healing.



COURSE: Spirituality in Patient Care
COURSE DIRECTOR(S): Mahtab Jafari, PharmD., University of Health Sciences, Pomona, CA
YEAR AWARDED: 1999

The nature of health care has changed rapidly during the past few decades. Health care providers are no longer afforded more than a few minutes to spend with patients during office visits, and counseling for prescriptions is also rushed. The challenge to physicians and pharmacists is also increased by the growing diversity of the population. Health care providers are expected to be sensitive to individual differences, and attend to a wide variety of patient needs including mind, body and soul. Therefore good care requires much more than traditional medical training. Physicians and pharmacists today must also receive training in the behavioral and spiritual aspects of life. Human beings have two dimensions, a spiritual dimension and a physical dimension. To treat a patient as a whole, health care providers should focus on both spiritual and physical dimensions of their patients. Spirituality in Patient Care is a course that teaches students to utilize a mature understanding of spirituality in their interactions with patients.
Upon completion of the Spirituality in Patient Care, students will learn to:
1. Describe the role of spirituality in health care
2. Be aware of the relationship between physical and spiritual aspects of their patients
3. Value the potential that patient and relationship-centered care has towards enhancing patient coping and healing
4. Balance personal, patient, and medical/legal values
To achieve the goals of the Spirituality in Patient Care curriculum, a variety of learning experiences will be offered to osteopathic and pharmacy students over the course of four years. Material in the first two years will be taught through a combination of lectures, readings, case studies, small group discussions, and Internet queries. During the third and fourth year, students will practice what they learned in the classroom in clinical settings. Students will thus have time and occasion to revisit issues as they mature and expand their knowledge and skills as health care providers. The multiple modalities of learning utilized across the four years facilitate more complete learning of concepts and constructs as well as provide reinforcement of lessons learned. At the conclusion of the course, students will demonstrate the ability to help others from varied cultural and religious backgrounds deal with issues surrounding major life events, including birth, illness, suffering, grief, and the end of life.
Attendance estimates are based upon the size of the entering classes for Osteopathy and Pharmacy. Entering students will complete one year each year. Therefore, the first year will have the smallest enrollment, an estimated 182 osteopathic students and 110 pharmacy students. The second year the course is offered, Year 1 enrollment will be approximately 292, and Year 2 enrollment will also be approximately 292. Therefore, once the course has been offered for four years, the enrollment over all four years will be approximately 1168 students. Again, this number will increase for Western University overall, when the curriculum is added for other program.



Return to top of page