Sacred Encounters in Clinical Training: Medical Student Reflections After Shadowing a Board-Certified Chaplain
Tiffany Racataian, Ja Tsun, Amy Hayton, MD, and Paige Stevens, MD, Loma Linda University School of Medicine
Background
Spirituality has been linked to improved health outcomes and patient satisfaction, and thus the clinical importance of spiritual care has been more widely recognized by both secular and religious healthcare organizations.1,2 Chaplains serve an integral role in healthcare teams in their ability to provide spiritual care for patients from diverse religious backgrounds.
Trained to address all aspects of spirituality within patients, chaplains have grown in their role in addressing patients’ spiritual needs within multidisciplinary teams.3 Despite patient benefit, studies have shown that chaplain referrals are least likely to be made by physicians as opposed to other members of the healthcare team.4 The integration of chaplains into multidisciplinary holistic care requires improved team understanding of chaplain skills and training as well as indications for chaplain referral.4, 5
Growing recognition of spirituality’s role in medicine has prompted improvements in clinical education on spiritual care and the role of chaplaincy, though formal curricula on this topic remain rare.6 Previous reflections on pre-clinical medical students’ shadowing of chaplains suggest improved understanding of the role of chaplains in the clinical setting and the importance of spiritual care.7 Fourth year medical students at Loma Linda University School of Medicine (LLUSM) are required to participate in a new curriculum designed to teach students about the role of chaplains and the spiritual care they provide. This study aims to explore themes that emerge from senior medical student reflections after these required experiences.
Methods
As of June 2025, all senior medical students at LLUSM are required to participate in a 2-week clinical clerkship called “Whole Person Care.” During this clerkship, students participate in didactic training on the role of chaplains and spend one half-day shadowing a Board-Certified Chaplain in the hospital. All students submit a required reflective writing assignment after participating in the didactic session and can also submit an optional post-chaplain shadowing experience survey. To date, 46 students have participated in the Whole Person Care Clerkship. Students’ written reflections were analyzed using thematic analysis by three independent reviewers to generate initial codes, achieve consensus, and then identify overarching themes.
Results
Qualitative analysis of 46 student reflections demonstrated the following 5 themes as represented by these respective illustrative quotes: 1) Chaplain Training and Their Multidisciplinary Role in Clinical Practice: “I had absolutely no idea how much training actually goes into the education for a chaplain… BA + MS + additional clinical training.” “It was encouraging to know that there are people available to help both the patient and the team when there are difficult questions related to faith." 2) How Chaplains Promote Patient-Centered Care: “Chaplains do not walk into a patient room with a specific agenda.” “[They] try to find out what is important to the patient rather than going in with an agenda.” 3) How Chaplains Approach Spiritual Care: "one of the central goals of a chaplain is to connect with patients by being invited into their sacred space, learning who they are, their story, and what they need at that moment. This requires deep, compassionate, and empathetic listening." “Just listening, sitting with them, and connecting as a person can build trust in ways medicine alone cannot.” 4) The Role of Prayer in Spiritual Care: “Prayer is essential but not the only tool—connection and affirmation are equally important.” 5) Students’ Plans for Integration of Spiritual Care into Their Future Practice: “I will integrate connecting, listening, curiosity, and compassion into my future practice.” “I will remember the importance of slowing down and being fully present with patients. I will listen not just to their medical concerns but to what truly matters to them. I will try to create space for their stories and struggles which can help foster healing in ways that go beyond physical treatment."
Conclusion
This pilot study supports that structured chaplain shadowing experiences effectively enhance medical students' understanding of the multidisciplinary role of chaplains and how they provide spiritual care. The experiences deepened students' awareness of spirituality's clinical relevance and highlighted spiritual care as a vital dimension of whole-person healing. It also fostered their intent to integrate compassionate, reflective, and collaborative practices into their future medical careers. Continued data collection and qualitative analysis is needed to further understand medical student insights regarding chaplains and the spiritual care they provide.
Spirituality has been linked to improved health outcomes and patient satisfaction, and thus the clinical importance of spiritual care has been more widely recognized by both secular and religious healthcare organizations.1,2 Chaplains serve an integral role in healthcare teams in their ability to provide spiritual care for patients from diverse religious backgrounds.
Trained to address all aspects of spirituality within patients, chaplains have grown in their role in addressing patients’ spiritual needs within multidisciplinary teams.3 Despite patient benefit, studies have shown that chaplain referrals are least likely to be made by physicians as opposed to other members of the healthcare team.4 The integration of chaplains into multidisciplinary holistic care requires improved team understanding of chaplain skills and training as well as indications for chaplain referral.4, 5
Growing recognition of spirituality’s role in medicine has prompted improvements in clinical education on spiritual care and the role of chaplaincy, though formal curricula on this topic remain rare.6 Previous reflections on pre-clinical medical students’ shadowing of chaplains suggest improved understanding of the role of chaplains in the clinical setting and the importance of spiritual care.7 Fourth year medical students at Loma Linda University School of Medicine (LLUSM) are required to participate in a new curriculum designed to teach students about the role of chaplains and the spiritual care they provide. This study aims to explore themes that emerge from senior medical student reflections after these required experiences.
Methods
As of June 2025, all senior medical students at LLUSM are required to participate in a 2-week clinical clerkship called “Whole Person Care.” During this clerkship, students participate in didactic training on the role of chaplains and spend one half-day shadowing a Board-Certified Chaplain in the hospital. All students submit a required reflective writing assignment after participating in the didactic session and can also submit an optional post-chaplain shadowing experience survey. To date, 46 students have participated in the Whole Person Care Clerkship. Students’ written reflections were analyzed using thematic analysis by three independent reviewers to generate initial codes, achieve consensus, and then identify overarching themes.
Results
Qualitative analysis of 46 student reflections demonstrated the following 5 themes as represented by these respective illustrative quotes: 1) Chaplain Training and Their Multidisciplinary Role in Clinical Practice: “I had absolutely no idea how much training actually goes into the education for a chaplain… BA + MS + additional clinical training.” “It was encouraging to know that there are people available to help both the patient and the team when there are difficult questions related to faith." 2) How Chaplains Promote Patient-Centered Care: “Chaplains do not walk into a patient room with a specific agenda.” “[They] try to find out what is important to the patient rather than going in with an agenda.” 3) How Chaplains Approach Spiritual Care: "one of the central goals of a chaplain is to connect with patients by being invited into their sacred space, learning who they are, their story, and what they need at that moment. This requires deep, compassionate, and empathetic listening." “Just listening, sitting with them, and connecting as a person can build trust in ways medicine alone cannot.” 4) The Role of Prayer in Spiritual Care: “Prayer is essential but not the only tool—connection and affirmation are equally important.” 5) Students’ Plans for Integration of Spiritual Care into Their Future Practice: “I will integrate connecting, listening, curiosity, and compassion into my future practice.” “I will remember the importance of slowing down and being fully present with patients. I will listen not just to their medical concerns but to what truly matters to them. I will try to create space for their stories and struggles which can help foster healing in ways that go beyond physical treatment."
Conclusion
This pilot study supports that structured chaplain shadowing experiences effectively enhance medical students' understanding of the multidisciplinary role of chaplains and how they provide spiritual care. The experiences deepened students' awareness of spirituality's clinical relevance and highlighted spiritual care as a vital dimension of whole-person healing. It also fostered their intent to integrate compassionate, reflective, and collaborative practices into their future medical careers. Continued data collection and qualitative analysis is needed to further understand medical student insights regarding chaplains and the spiritual care they provide.