Reclaiming Tradition: A Proposal for Theological Training in Medical Education
Peter Gunderman, BA, MD student, MTS student, Theology, Medicine, and Culture Fellow, Duke Divinity School
Spirituality is becoming widely recognized as an important part of patient care. The benefits of addressing the spiritual needs of patients and the desire among patients for spiritual care are well documented. In recognition of this fact, in 2010, 90% of U.S. medical schools had courses or content on spirituality and health. While the number of medical schools devoting time to spirituality has increased, this change has not translated into clinical care. Consider that in 2013, in one study, more than 90% of patients with advanced cancer reported that they had never received any form of spiritual care from their physician.
Considering that the vast majority of medical schools are now providing courses on spirituality and health, why are physicians not providing spiritual care to patients? One possible reason for this disjunction is that the training provided by medical schools is currently inadequate. This hypothesis is supported by the fact that multiple studies have identified the chief barrier to physicians and nurses addressing patients’ spiritual needs as lack of training. One study found that nearly two-thirds of physicians list inadequate training as a barrier to providing spiritual care.
Though the time allotted to spirituality curricula in medical schools will always be compressed, these curricula would likely be more effective if they equipped clinicians to engage the particular religious traditions in which most patients are formed, rather than remaining with generic accounts of spirituality. In this presentation I describe a novel proposed curriculum that presumes no religious faith on the part of those who participate in it, but that centers on “theology” rather than “spirituality.” While seemingly just a slight change in words, this change marks a radical transition in how “spiritual” care is understood, taught, and practiced. Prior curricula and research studies have incorporated religion into medicine’s long-standing mechanical model by reducing religion to spirituality, which can be isolated and measured. Theology, however, is organic and system-based and cannot be abstracted from the whole. Theology, unlike spirituality, is a discipline that studies religiously “traditioned,” not necessarily traditional, modes of thought. By drawing on histories, particularities, and relationships that are characteristic of theology rather than spiritual abstractions and individualism, a curriculum on theology and medicine has the potential to develop a depth of understanding that spirituality lacks.
The proposed curriculum draws heavily on specific religious traditions – primarily Judaism, Islam, and Christianity – to help physicians think theologically and appreciate patients’ religious beliefs and needs. The proposed curriculum is designed to be implemented in three parts. The first section, titled “Diagnosing Medicine,” focuses on raising questions about modern medicine and the role of the physician. Texts include Richard Lischer’s Stations of the Heart and Albert Camus’ The Plague. The second section, “Thinking Theologically,” provides an overview of Jewish, Muslim, and Christian theology. Students will read core texts of each of the three traditions. The final section, “Integrating Medicine and Theology,” attempts to address the questions of the first section using theological discourse by challenging students to develop their own theological perspective on medicine.
Spirituality is becoming widely recognized as an important part of patient care. The benefits of addressing the spiritual needs of patients and the desire among patients for spiritual care are well documented. In recognition of this fact, in 2010, 90% of U.S. medical schools had courses or content on spirituality and health. While the number of medical schools devoting time to spirituality has increased, this change has not translated into clinical care. Consider that in 2013, in one study, more than 90% of patients with advanced cancer reported that they had never received any form of spiritual care from their physician.
Considering that the vast majority of medical schools are now providing courses on spirituality and health, why are physicians not providing spiritual care to patients? One possible reason for this disjunction is that the training provided by medical schools is currently inadequate. This hypothesis is supported by the fact that multiple studies have identified the chief barrier to physicians and nurses addressing patients’ spiritual needs as lack of training. One study found that nearly two-thirds of physicians list inadequate training as a barrier to providing spiritual care.
Though the time allotted to spirituality curricula in medical schools will always be compressed, these curricula would likely be more effective if they equipped clinicians to engage the particular religious traditions in which most patients are formed, rather than remaining with generic accounts of spirituality. In this presentation I describe a novel proposed curriculum that presumes no religious faith on the part of those who participate in it, but that centers on “theology” rather than “spirituality.” While seemingly just a slight change in words, this change marks a radical transition in how “spiritual” care is understood, taught, and practiced. Prior curricula and research studies have incorporated religion into medicine’s long-standing mechanical model by reducing religion to spirituality, which can be isolated and measured. Theology, however, is organic and system-based and cannot be abstracted from the whole. Theology, unlike spirituality, is a discipline that studies religiously “traditioned,” not necessarily traditional, modes of thought. By drawing on histories, particularities, and relationships that are characteristic of theology rather than spiritual abstractions and individualism, a curriculum on theology and medicine has the potential to develop a depth of understanding that spirituality lacks.
The proposed curriculum draws heavily on specific religious traditions – primarily Judaism, Islam, and Christianity – to help physicians think theologically and appreciate patients’ religious beliefs and needs. The proposed curriculum is designed to be implemented in three parts. The first section, titled “Diagnosing Medicine,” focuses on raising questions about modern medicine and the role of the physician. Texts include Richard Lischer’s Stations of the Heart and Albert Camus’ The Plague. The second section, “Thinking Theologically,” provides an overview of Jewish, Muslim, and Christian theology. Students will read core texts of each of the three traditions. The final section, “Integrating Medicine and Theology,” attempts to address the questions of the first section using theological discourse by challenging students to develop their own theological perspective on medicine.