Medical students' Names for the Transcendent First Name Cindy Last Name Schmidt Terminal Degree(s) PHD Institution/Organization Kansas City University of Medicine and Biosciences
Introduction Many Americans identify as religious and/or spiritual and want their physicians to integrate their religion and/or their spirituality into their medical care. This integration occurs less often than patients would like. Teaching medical students how to facilitate this conversation is a necessary step toward this more patient-centered approach to care. This poster looks at a key component of this conversation – how medical students refer to a Transcendent force or entity in which they may believe, specifically the referent Name they prefer.
Methods First year medical students engaged in a self-reflection activity as part of a Standardized Patient (SP) encounter of a case with a religious concern. Of the 237 students experiencing this SP encounter, 157 students provided a Name for the Transcendent. We did a qualitative content analysis of the Names they provided. To enhance the validity of the analysis, we triangulated analysts, including one Catholic and one atheist qualitative coder. We began by individually coding each Name, then discussing and negotiating the codes and categories until we achieved consensus. This process produced four thematic categories: Dogmatic (Name refers to a world beyond the here and now and is well-defined, e.g., God, swami, holy, immaculate), Mystical (Name refers to a world beyond the here and now and is more flexible/open, e.g., transcendent, higher power, energy), Pragmatic (Name refers to the here and now and is well-defined, e.g., physics, universal law, agnostic), and Humanistic (Name refers to the here and now and is more flexible/open, e.g., peace, humanity, reflection). For the next step, we sought to validate this classification by asking a panel of religious research experts to categorize each Name (from the set of Names given by the students), applying one of the four broad categories we created. Thirty-three of 41 experts completed the categorization activity. To minimize bias, we used A, B, C, and D instead of the category labels we had created, providing the experts with the same definitions as above.
Results The expert raters showed strong disagreement among each other on labelling the Names using the four categories we had created. Next, we looked to identify a subset among our expert raters who agreed with each other, even if they did not agree with our original categorization. Nineteen experts agreed with each other at a rate of > 75% on a subset of 10 Names: Dogmatic (God, Allah, God/Allah); Mystical (Higher Power, Transcendent, Supernatural, Higher being); Pragmatic (Physics, Religion, Belief-system). Conclusion Using all of the necessary measures to reduce bias stemming from our own religious perspectives eventually led to a set of categories that we believe has low utility because they are already widely in use. Perhaps embracing the plethora of our diversity works better than looking for our commonality. Knowing there is a multitude of interpretations and usage of Names for the Transcendent may help physicians communicate better in a medical interview by not leading, but instead allowing the patient to be first to declare their preferred Name for the Transcendent.