Religion, Spirituality and Medicine: Impact of an Educational Intervention for Medical Students and Physicians
Andrew Abboud, BS, Third year medical student, University of Pittsburgh
Laura McNamara, BS, Third year medical student, University of Pittsburgh School of Medicine
Christine Glaser, MD, University of Pittsburgh School of Medicine
Lisa Podgurski MD, University of Pittsburgh School of Medicine
Dena Hofkosh, MD, University of Pittsburgh School of Medicine
Scott Maurer, MD, University of Pittsburgh School of Medicine
Krissy K. Moehling, PhD, MPH, University of Pittsburgh Graduate School of Public Health
Introduction - Training physicians in the recognition and support of religious and spiritual (R/S) dimensions of illness (R/S informed care) is predictive of subsequent provision of R/S informed care to patients. We evaluated the impact of an educational workshop for medical students and physicians addressing the importance of attention to R/S issues in the healthcare setting and approaches to providing R/S informed care.
Methods –The 2-hour workshop provided learners with evidence-based support for R/S informed care, instruction for making a spiritual assessment, and discussion regarding the value of and barriers to providing R/S informed care. Learning methods included didactic lecture, role-play, and interactive discussion. Participants were evaluated via subject-matched pre- and post-workshop surveys that assessed knowledge, skills, and attitudes pertaining to R/S care using Likert scales (range 1(low) to 5(high)) and open-ended questions. The primary outcome was the change in response tested using the Sign test. Secondary outcomes included differences in responses by demographic variables using Wilcoxon signed-rank test and written comments.
Results – Forty participants (63% female), were comprised of medical students (n=26), physicians (n=12), and other healthcare providers (n=2). Thirty-seven participants (90%) completed both surveys. Pre-workshop, 93% (37/40) of the participants rated the provision of R/S care to patients as important to very important (mean±sd: 4.2±1.1) with an increase to 97% (36/37) and a non-significant (P=0.15) mean score increase of 0.40 post-workshop (mean±sd: 4.6±0.90). Regarding whether physicians should be involved in the direct provision of R/S care, 78% (31/40) noted this to be important to very important pre-workshop (mean±sd: 3.1±1.0), with an increase to 94% (35/37) and significant (P <.0001) mean score increase of 1.1 post-workshop (mean±sd: 4.2±1.1). Additionally, 75% (30/40) felt comfortable to very comfortable providing R/S care to patients’ pre-workshop (mean±sd: 3.2±1.2), increasing to 92% (34/37) post-workshop (mean±sd: 3.9±1.0) with a significant (P <.0001) mean score increase of 0.73. Pre-workshop, 48% (19/40) rated their knowledge of R/S resources available to patients as some to extensive knowledge (mean±sd: 2.5±1.2), increasing to 84% (31/37), reflecting a significant (P <.0001) mean score increase of 0.92 (mean±sd: 3.4±1.0) post-workshop.
No differences in these mean score increases were found between respondents who rated R/S “important to very important” in their own life versus those who did not (70%, 28/40 vs. 30%, 13/40; P >.05 for all). Comparing students to physicians, there were no significant differences in mean change scores for any of the survey questions, except that medical students noted a greater increase in knowledge of R/S resources post-workshop (Wilcoxon signed rank mean: 21.7 vs. 13.4, P=0.022). Written comments from participants indicated a heightened awareness of the value of R/S informed care, and practical ways to approach R/S care in clinical encounters.
Conclusions - This brief educational intervention positively impacted self-report of knowledge, skill and attitudes regarding R/S informed care among students and physicians and was equally effective regardless of how important R/S was in the participants’ own lives. This work informs future curriculum-based approaches teaching medical students and physicians to address patients’ R/S needs as a component of effective medical care.
Laura McNamara, BS, Third year medical student, University of Pittsburgh School of Medicine
Christine Glaser, MD, University of Pittsburgh School of Medicine
Lisa Podgurski MD, University of Pittsburgh School of Medicine
Dena Hofkosh, MD, University of Pittsburgh School of Medicine
Scott Maurer, MD, University of Pittsburgh School of Medicine
Krissy K. Moehling, PhD, MPH, University of Pittsburgh Graduate School of Public Health
Introduction - Training physicians in the recognition and support of religious and spiritual (R/S) dimensions of illness (R/S informed care) is predictive of subsequent provision of R/S informed care to patients. We evaluated the impact of an educational workshop for medical students and physicians addressing the importance of attention to R/S issues in the healthcare setting and approaches to providing R/S informed care.
Methods –The 2-hour workshop provided learners with evidence-based support for R/S informed care, instruction for making a spiritual assessment, and discussion regarding the value of and barriers to providing R/S informed care. Learning methods included didactic lecture, role-play, and interactive discussion. Participants were evaluated via subject-matched pre- and post-workshop surveys that assessed knowledge, skills, and attitudes pertaining to R/S care using Likert scales (range 1(low) to 5(high)) and open-ended questions. The primary outcome was the change in response tested using the Sign test. Secondary outcomes included differences in responses by demographic variables using Wilcoxon signed-rank test and written comments.
Results – Forty participants (63% female), were comprised of medical students (n=26), physicians (n=12), and other healthcare providers (n=2). Thirty-seven participants (90%) completed both surveys. Pre-workshop, 93% (37/40) of the participants rated the provision of R/S care to patients as important to very important (mean±sd: 4.2±1.1) with an increase to 97% (36/37) and a non-significant (P=0.15) mean score increase of 0.40 post-workshop (mean±sd: 4.6±0.90). Regarding whether physicians should be involved in the direct provision of R/S care, 78% (31/40) noted this to be important to very important pre-workshop (mean±sd: 3.1±1.0), with an increase to 94% (35/37) and significant (P <.0001) mean score increase of 1.1 post-workshop (mean±sd: 4.2±1.1). Additionally, 75% (30/40) felt comfortable to very comfortable providing R/S care to patients’ pre-workshop (mean±sd: 3.2±1.2), increasing to 92% (34/37) post-workshop (mean±sd: 3.9±1.0) with a significant (P <.0001) mean score increase of 0.73. Pre-workshop, 48% (19/40) rated their knowledge of R/S resources available to patients as some to extensive knowledge (mean±sd: 2.5±1.2), increasing to 84% (31/37), reflecting a significant (P <.0001) mean score increase of 0.92 (mean±sd: 3.4±1.0) post-workshop.
No differences in these mean score increases were found between respondents who rated R/S “important to very important” in their own life versus those who did not (70%, 28/40 vs. 30%, 13/40; P >.05 for all). Comparing students to physicians, there were no significant differences in mean change scores for any of the survey questions, except that medical students noted a greater increase in knowledge of R/S resources post-workshop (Wilcoxon signed rank mean: 21.7 vs. 13.4, P=0.022). Written comments from participants indicated a heightened awareness of the value of R/S informed care, and practical ways to approach R/S care in clinical encounters.
Conclusions - This brief educational intervention positively impacted self-report of knowledge, skill and attitudes regarding R/S informed care among students and physicians and was equally effective regardless of how important R/S was in the participants’ own lives. This work informs future curriculum-based approaches teaching medical students and physicians to address patients’ R/S needs as a component of effective medical care.