Free
Medical Education  |   April 2008
Spirituality and Medicine: Prevalence of Spirituality-in-Medicine Instruction at Osteopathic Medical Schools
Author Notes
  • From the Department of Family Medicine (Ms E.K. McClain and Drs R.L. McClain and Pyle) and the Department of Medical Affairs (Dr Desai) at the Kansas City (Mo) University of Medicine and Biosciences College of Osteopathic Medicine. 
  • Address correspondence to Rance L. McClain, DO, Assistant Professor of Family Medicine, Kansas City University of Medicine and Biosciences College of Osteopathic Medicine, 1750 Independence Ave, SEP 358, Kansas City, MO 64106-1453. E-mail: rmcclain@kcumb.edu 
Article Information
Medical Education / Curriculum
Medical Education   |   April 2008
Spirituality and Medicine: Prevalence of Spirituality-in-Medicine Instruction at Osteopathic Medical Schools
The Journal of the American Osteopathic Association, April 2008, Vol. 108, 197-202. doi:10.7556/jaoa.2008.108.4.197
The Journal of the American Osteopathic Association, April 2008, Vol. 108, 197-202. doi:10.7556/jaoa.2008.108.4.197
Abstract

Context: Since the 1990s, there has been a heightened awareness of the value of teaching medical students about how aspects of spirituality and religion may affect patient care.

Objective: To determine the prevalence of spirituality-in-medicine instruction at colleges of osteopathic medicine (COMs) in the United States.

Methods: Prescreened subjects at 20 COMs were contacted by electronic mail and asked to complete a 25-item Web-based survey. The survey instrument consisted of questions about spirituality-in-medicine instruction at their institutions. If an institution was not represented in our survey results through subject response, we reviewed that institution's Web site to locate material suggestive of an extant spirituality-in-medicine curricula (eg, prospective student information).

Results: Surveys were submitted to investigators by representatives of 12 COMs for a response rate of 60%. Subjects from 8 COMs reported a structured spirituality-in-medicine curriculum currently in place at their institutions. Osteopathic medical students generally receive a total of 2 to 20 hours of instruction on spirituality and religion. Of the 10 unrepresented institutions, 4 COMs had material available on their Web sites that suggested spirituality-in-medicine topics were embedded in their curricula. Therefore, approximately 55% of all COMs have some form of spirituality-in-medicine program in place.

Conclusion: Some form of spirituality-in-medicine instruction is available at slightly more than half the COMs in the United States. As the need for spirituality-in-medicine curricula is increasingly recognized, improved methods of documenting ongoing curricular development and student competency will be required.

Spirituality is of growing interest in the medical profession. Studies1,2 suggest that personal religious and spiritual beliefs influence the medical decisions of physicians, such as their use of palliative care versus aggressive treatment or experimental protocols for patients with cancer. However, the topic of spirituality as it relates to medicine—as well as the impact of spirituality on medical decision-making—can be uncomfortable for physicians to discuss.3-5 This discomfort can be attributed to the limited amount of professional training available in medical schools on the relationship between spirituality and medicine.1 
To address this problem, many medical schools have begun increasing the number of course offerings and curriculum programs on spirituality. In 1994, only 17 out of 126 accredited medical schools in the United States offered courses on spirituality in medicine.1 By 2004, this number had increased to 84 medical schools.6 
Information regarding education topics and programs related to spirituality-in-medicine instruction at colleges of osteopathic medicine (COMs) is limited. Two studies7,8 compared complimentary alternative medicine offerings, including topics related to spirituality, between osteopathic and allopathic medical schools. Both investigations found that fewer than 20 contact hours of spirituality-in-medicine topics were taught in the first 2 years of medical school, with coursework being similar at osteopathic and allopathic institutions.7,8 Other studies have discussed the scarcity of information on curriculum development and evaluation for such programs in medical education, including at COMs.5,6 The present survey-based study explores the spirituality-in-medicine curriculum currently available at COMs and addresses curriculum development and requirements as well as teaching and student-evaluation methods. 
Methods
When the present study was initiated in mid-2006, there were 22 COMs accredited by the American Osteopathic Association's Commission on Osteopathic College Accreditation.9 Administrators at each institution were asked to identify the most appropriate faculty members at that COM for study participation—specifically any instructors who were currently teaching spirituality-in-medicine curricula or indicated an interest in doing so. 
Administrators at 2 of the 22 COMs contacted reported that no spirituality-in-medicine programs currently existed at their schools. Faculty members at these 2 institutions were therefore excluded from further participation in the survey. 
A participation request and a hyperlink (uniform resource locator) to the Web-based survey were sent to the identified individuals using a Web-based survey service. All correspondence was sent through university electronic mail (e-mail). 
For the purposes of the survey, “spirituality in medicine” was defined as “material covering any topics in the following areas: faith, prayer, religious beliefs—and the effects of the same on healthcare, from both a patient and physician perspective.” 
Participants were given 12 weeks to complete the survey. Six weeks after the initial participation request was sent to potential subjects, a follow-up e-mail was sent to instructors who had not yet responded to the survey. A hyperlink to the online survey was included in this follow-up attempt. 
Survey Instrument
The Web survey (zPro for Education; Zoomerang, San Francisco, Calif)10 used in the present study consisted of 25 questions structured in either multiple-choice or fill-in-the-blank format. A space was provided at the end of the survey for participants to enter additional questions or comments. The survey design allowed completion in 10 minutes or less. For participants with extant spirituality-in-medicine programs at their institutions, the survey inquired as to the following: 
  • availability of spirituality-in-medicine instruction by training year (ie, during academic and residency training)
  • course focus and topics addressed
  • course location (ie, on or off campus)
  • teaching methods used
  • institutional guidelines or recommendations for course selection (ie, required courses versus electives, number of credit hours)
  • time commitments required (eg, per academic year, off-campus time, total during academic training years, other associated time commitments)
  • methods for assessing student competency
  • year program was established
  • program funding sources
  • total number of program participants
  • academic and other training or preparation requirements for course instructors
  • methodology used for curriculum development
  • sources for ongoing curriculum development and expansion
Results
We contacted 23 instructors at 20 COMs via e-mail and asked them to participate in an online survey. A total of 20 subjects visited the survey Web site. 
Data were gathered from representatives of 12 COMs (Table 1). Respondents represented 60% of the 20 COMs surveyed. Representatives of 8 COMs reported current spirituality-in-medicine instruction at their institutions. All 8 programs were initiated during the previous 8 years (ie, 1998-2004). Four respondents reported that their institutions did not have formal spirituality-in-medicine instruction for medical students, neither did these COMs have plans to initiate such programs in the next 5 years. Two respondents noted the availability of nonrequired lectures on these topics through family medicine and community health courses—in addition to ready access through outside venues. 
Table 1
Prevalence of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=12)

Survey Question and Responses

No.
Does your university currently have coursework covering spirituality in medicine?
□ Yes 8
□ No4
Are there any plans to implement a spirituality curriculum in the next 5 years?
□ Yes0
□ No 4
□ No response8
Are there any plans to write a grant in the next 6 months to pursue the development of a spirituality curriculum?
□ Yes1
□ No 10
□ No response
1
Table 1
Prevalence of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=12)

Survey Question and Responses

No.
Does your university currently have coursework covering spirituality in medicine?
□ Yes 8
□ No4
Are there any plans to implement a spirituality curriculum in the next 5 years?
□ Yes0
□ No 4
□ No response8
Are there any plans to write a grant in the next 6 months to pursue the development of a spirituality curriculum?
□ Yes1
□ No 10
□ No response
1
×
Characteristics of the spirituality-in-medicine curricula at the 8 COMs with extant programs are reported in Table 2. Data reflect the fact that the number of responses received varied for each survey question. Some subjects chose not to answer selected survey items; others chose multiple responses as applicable. 
Table 2
Characteristics of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=8)

Characteristic

No.*
Academic year(s) of course instruction
□ First 7
□ Second6
□ Third and fourth (ie, clinicals) 2
□ No response1
Instruction available for residents
□ Yes2
□ No 3
□ No response3
Courses or credit hours required
□ Yes7
□ No (elective) 1
Course selection
□ All courses required 7
□ Students can elect ≥ 1 course1
□ Other 2
Total instruction hours per academic year
□ <5 1
□ 5-90
□ 10-15 3
□ 16-202
□ Unable to determine 2
Curriculum development
□ Created internally 7
□ Created by outside consultants1
□ Modeled on existing program 1
□ No response1
Teaching methods used
□ Lectures8
□ Small group discussions 8
□ Reading assignments7
□ Shadowing hospital chaplain 4
□ Standardized patient encounters4
□ Community work 1
□ Other2
Sources for curriculum updates
□ Current literature 6
□ Conferences4
□ Other 4
□ No response2
Instructor academic degree(s)
□ PhD4
□ DO 3
□ MD2
□ MDiv 2
□ RN1
□ No response 2
Other instructor training and course preparation
□ Precourse meetings 5
□ Self-taught3
□ Outside training or seminars 1
□ No special training1
□ Other 1
□ No response2
Assessment of student competence
□ Self-report (changes in knowledge)5
□ Written examination 4
□ Written or oral presentation3
□ Standardized patient case studies 3
□ Self-report (changes in attitude)2
□ Other 1
□ No response2
 Abbreviation: MDiv, master of divinity.
 *Totals for each survey item may not equal 8 because of nonresponse, as indicated, and because subjects were invited to select multiple options as appropriate for several survey questions.
Table 2
Characteristics of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=8)

Characteristic

No.*
Academic year(s) of course instruction
□ First 7
□ Second6
□ Third and fourth (ie, clinicals) 2
□ No response1
Instruction available for residents
□ Yes2
□ No 3
□ No response3
Courses or credit hours required
□ Yes7
□ No (elective) 1
Course selection
□ All courses required 7
□ Students can elect ≥ 1 course1
□ Other 2
Total instruction hours per academic year
□ <5 1
□ 5-90
□ 10-15 3
□ 16-202
□ Unable to determine 2
Curriculum development
□ Created internally 7
□ Created by outside consultants1
□ Modeled on existing program 1
□ No response1
Teaching methods used
□ Lectures8
□ Small group discussions 8
□ Reading assignments7
□ Shadowing hospital chaplain 4
□ Standardized patient encounters4
□ Community work 1
□ Other2
Sources for curriculum updates
□ Current literature 6
□ Conferences4
□ Other 4
□ No response2
Instructor academic degree(s)
□ PhD4
□ DO 3
□ MD2
□ MDiv 2
□ RN1
□ No response 2
Other instructor training and course preparation
□ Precourse meetings 5
□ Self-taught3
□ Outside training or seminars 1
□ No special training1
□ Other 1
□ No response2
Assessment of student competence
□ Self-report (changes in knowledge)5
□ Written examination 4
□ Written or oral presentation3
□ Standardized patient case studies 3
□ Self-report (changes in attitude)2
□ Other 1
□ No response2
 Abbreviation: MDiv, master of divinity.
 *Totals for each survey item may not equal 8 because of nonresponse, as indicated, and because subjects were invited to select multiple options as appropriate for several survey questions.
×
Spirituality-in-medicine coursework was most often presented during the first 2 years of osteopathic medical school. Only 1 COM limited its spirituality-in-medicine program to the first year of osteopathic medical school. Two COMs offered spirituality-in-medicine instruction during students' final 2 years of osteopathic medical school. These schools also offered this training through their residency programs. 
Seven COMs required that students study the spirituality-in-medicine curricula by taking all courses available in that area. One COM offered these courses as electives that would satisfy a 3-credit hour requirement for ethics coursework. 
Respondents noted that spirituality-in-medicine topics were integrated into the schools' overall medical curricula. Therefore, it was difficult for respondents to determine the total credit hour commitment made by their institutions to these topics, especially when spirituality-in-medicine topics were compared with other topics covered in COM curricula. Estimates as to instruction time devoted to these topics varied between a total of 2 and 20 hours of coursework at the COMs, with 2 respondents unable to determine the amount of lecture time dedicated specifically to these topics. 
Similarly, data regarding meeting frequency for spirituality-in-medicine courses indicate that instruction may occur at various intervals, from once weekly to once during every 6-week section. Many respondents found it difficult to determine these times because of the high level of integration for spirituality-in-medicine material within the general medical school curriculum. 
Although all spirituality-in-medicine programs at COMs included on-campus instruction, half of the programs documented also required off-campus experiences. In addition, several programs used hospitals and physicians' offices as instructional sites. One of the most integrated COM programs required a 3-hour experience with a hospital chaplain. Of survey-represented COMs, half offered spirituality-in-medicine courses in the hospital setting. Two institutions offered instruction in alternate clinical settings (ie, physicians' offices). 
Each COM spirituality-in-medicine program was created internally and used current literature to keep teaching topics up to date. In most cases, faculty with DO, MD, RN, or PhD degrees taught the spirituality-in-medicine courses at COMs—though 2 COMs incorporated hospital chaplains with master of divinity degrees into their programs. The most common training or preparation for COM faculty who facilitated spirituality-in-medicine instruction was precourse meetings. 
Spirituality-in-medicine instruction was most often provided in lecture and small group discussion format. Respondents reported that a majority of COMs rely heavily on student reading assignments to provide spirituality-in-medicine training. Community service work was the least common method of instruction reported, with only 1 institution responding affirmatively. This particular program also incorporated lectures, student reading assignments, shadowing, small group discussions, and standardized patient encounters. In fact, half of extant programs used shadowing or standardized patient encounters. Panel discussions on spirituality and medicine were used at some institutions. 
Student competency in COM spirituality-in-medicine curricula was most frequently assessed through student self-report and written examinations. Among survey responses received, approximately half of the COM programs also used written and oral student presentations and case studies with standardized patient encounters to assess student competency. 
As noted in Table 3, common areas of focus in the COM spirituality-in-medicine curricula for all COMs represented by results of the present survey were end-of-life care, the effects of spirituality on healing and health, and cultivating student awareness of various religious beliefs. Only slightly less prominent in spirituality-in-medicine training at COMs was the topic “religion/faith and prayer” and the recording of a patient's spiritual history. The least common area of focus for these educational efforts were topics related to the hospice movement and the impact of spiritual perspectives on healing. This last topic addressed how an individual's religious or spiritual beliefs about the nature of an illness might help or hinder the healing process (eg, viewing illness as a punishment). 
Table 3
Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States: Course Offerings and Focus Areas (n=8)

Instruction Topics

No.*
Awareness of various religious beliefs7
Effects of spirituality on healing and health 7
End-of-life issues7
Religion/faith and prayer 6
Recording patient spiritual history alongside medical history6
Hospice movement 1
Patients' spiritual perspectives on illness1
No response
1
 *Subjects were invited to select multiple options for this survey question, as applicable. One individual chose not to respond to this survey item.
 Patients' spiritual perspectives on illness addressed the impact of an individual's spiritual perspectives on healing. Specifically, this instruction topic addressed how an individual's religious or spiritual beliefs about the nature of an illness might help or hinder the healing process (eg, viewing illness as a punishment).
Table 3
Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States: Course Offerings and Focus Areas (n=8)

Instruction Topics

No.*
Awareness of various religious beliefs7
Effects of spirituality on healing and health 7
End-of-life issues7
Religion/faith and prayer 6
Recording patient spiritual history alongside medical history6
Hospice movement 1
Patients' spiritual perspectives on illness1
No response
1
 *Subjects were invited to select multiple options for this survey question, as applicable. One individual chose not to respond to this survey item.
 Patients' spiritual perspectives on illness addressed the impact of an individual's spiritual perspectives on healing. Specifically, this instruction topic addressed how an individual's religious or spiritual beliefs about the nature of an illness might help or hinder the healing process (eg, viewing illness as a punishment).
×
If an institution was not represented in our survey results through subject response, we reviewed the school Web site to locate material suggestive of an extant spirituality-in-medicine curriculum (eg, prospective student information). Of the 10 COMs not represented by survey responses, 4 schools had material available on their Web sites that suggested spirituality-in-medicine topics were embedded in their curricula. Two of these 4 COMs offered courses that addressed the spirituality of health and illness, while the other 2 schools addressed end-of-life issues in their coursework. 
Therefore, of the 22 COMs in existence during this investigation, 8 COMs (36%) have formal spirituality-in-medicine programs, as confirmed by the results of the present study. In addition, 4 COMs (18%) have these topics integrated in their curricula on a more informal basis. Therefore, when these numbers are combined, there is an overall COM participation rate of 55% for spirituality-in-medicine programs. 
Comment
The objective of the present investigation was to determine the prevalence of spirituality-in-medicine instruction at COMs in the United States. Our survey results focus on data gathered from prescreened representatives of 12 COMs who responded to our Web-based questionnaire. Our data provide an overview of how issues related to spirituality and religion are being addressed at the nation's COMs. Because of the study's small sample size, however, there are certain limitations to the conclusions we may draw. 
Most respondents reported that their respective COMs had formal spirituality-in-medicine programs and that students were required to take such courses as part of the overall medical curriculum. 
Consistent with the findings of previous researchers,7,8 our data reveal that spirituality-in-medicine programs were commonly offered during the first 2 years of osteopathic medical school. Such a program schedule is a practical approach to medical education because students are primarily on campus during this time. A few programs at COMs offered spirituality-in-medicine curricula during all 4 years of medical school training. This schedule poses a greater challenge to program administrators because some portions of the curriculum would need to occur off campus to accommodate students' clinical training. 
Providing multiple educational settings for students is an important factor in establishing a functional knowledge base regarding spirituality in medicine. Multiple educational settings facilitate learning by challenging students to transfer learned skills from one environment to another.11 Different learning environments also foster the use of varied teaching philosophies, encouraging in students a critical analysis of differing views and the ability to link those views to create a functional knowledge base. Such an approach supports the structure of problem-based learning and evidence-based medicine—also facilitating unique learning experiences for students in the classroom and in clinical settings.12 
One limitation to the survey instrument used in the present investigation was the lack of opportunity for respondents to provide additional information regarding the breadth and depth of the topics addressed at their home institutions. Although it is important for COMs to have diversity among spirituality-in-medicine programs, it is also important for COMs to monitor the depth of their educational programs to ensure that students are taking away the intended educational outcomes.13 
Our results were also consistent with previous researchers7,14-17 in regard to the use of varied educational methods. By providing multiple educational environments and topic exposures, this particular program had a very effective approach to strengthening students' ability to link functional knowledge and clinical application. 
The development of spirituality-in-medicine curricula at medical schools has received limited attention by researchers.7,14 However, as with information on these topics, the methods used in curricular development for these programs remain somewhat vague in the published literature. This lack of detailed published descriptions of existing spirituality-in-medicine curricula makes it difficult for COMs to either improve existing programs or develop new ones.7 This difficulty is supported by the finding that most respondents in the present survey stated that their programs were created internally. Many respondents commented that it was difficult to find material to use as models for their programs. One COM representative reported a spirituality-in-medicine program that was modeled after an existing program. This program was developed with the assistance of outside consultants—a resource that is unavailable at many institutions. 
Questions about updating spirituality-in-medicine coursework were answered by most of the respondents in the present investigation. All respondents reported using current literature to update their spirituality-in-medicine curricula, and many noted their reliance on relevant conferences for this purpose. In addition, some COMs used personal clinical experiences and team planning in updating curricula. Only one respondent reported using other spirituality-in-medicine programs for updating purposes. These findings support the need to clearly identify common components and methodologies used in curriculum development. Identifying the key components in spirituality-in-medicine programs will enable this curricular model to become more firmly established. This, in turn, will facilitate the growth of new programs at COMs and encourage existing programs to improve their effectiveness. 
Many COMs are moving toward problem-based learning models, evidence-based medicine, and integrated curricula.14,16 As previously noted, the present investigation could not provide firm findings on total hours of spirituality-related instruction because respondents reported that these topics were integrated into other lectures. 
Similarly, as many respondents found it difficult to determine meeting-frequency times because of the high level of integration for spirituality-in-medicine material within the general medical school curriculum, we recommend that future surveys modify the approach used for time-related questions. New instruments should attempt to accommodate the problem-based learning model of instruction. 
Future Directions
Trends in medicine in the United States suggest that the increasing diversity of our culture and the increasing interest in understanding how spiritual beliefs influence health will continue to fuel the growth of spirituality-in-medicine curricula. Collaboration among programs at different COMs is important to strengthen such programs and encourage further multidisciplinary innovation in osteopathic medical education. 
One challenge facing osteopathic medical education is the need to integrate components of spirituality and religion effectively into the overall medical school curriculum. This challenge includes administrative support to aid faculty in developing and maintaining updated curricular material through conferences and collaboration with other COM programs. 
Successful programs are the result of collaborative action among all stakeholders, including administration, faculty, students, alumni, and the community.11 Possible future trends in this regard may involve incorporating in-depth spirituality-in-medicine instruction with clinical skills and standardizing how these topics are approached during patient encounters. Such approaches are formally assessed as part of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX–USA) Levels 1 and 2.18 
A variety of learning experiences could also be integrated into medical simulation scenarios or interactive computer sessions. Yet another future trend may be to increase student exposure to clinical settings with the guidance of both osteopathic physicians and hospital chaplains. 
If training using spirituality-in-medicine models were extended beyond the first 2 years of osteopathic medical school, the result could be a beneficial blend of skill acquisition for students, incorporating multiple clinical and classroom experiences. These types of integrated learning experiences provide hands-on application of medical skills and factual knowledge. 
It is also important to fully document curricular development for spirituality-in-medicine programs, including evaluation methods that address effective clinical practice and an increased emphasis on publication for these topics. Such contributions to the medical literature would serve as valuable resources for COM administrators and instructors, supporting the continued growth and strength of spirituality-in-medicine curricula at our institutions. 
Conclusion
The results of the present investigation suggest that the percentage of COMs with spirituality-in-medicine curricula is similar to that indicated in previous studies.7 Courses in this model are commonly taught in the first 2 years of osteopathic medical school. All spirituality-in-medicine programs at COMs have been created internally. Primary methods of topic presentation are lectures, small group interactions, and student reading assignments. Spirituality-in-medicine curricula are updated primarily through reviews of current literature. Spirituality-in-medicine instructors are from a variety of educational backgrounds, and the training and preparation for these programs was handled mainly through precourse meetings. Student competency is evaluated through multiple methods—most frequently through self-reported changes in knowledge and written examinations. 
As spirituality-in-medicine programs become more prevalent in medical schools across the United States, it is important that more information regarding successful methods of curricular development and program evaluation become available. This information will serve as a valuable resource to promote the continued growth, quality, and effectiveness of spirituality-in-medicine curricula. 
We acknowledge the efforts of Sandra Kay Willsie, DO; V. James Guillory, DO, MPH; and Patrick Clay, PharmD, in the preparation of this research project and manuscript. 
Koenig HG. Religion, spirituality, and medicine: research findings and implications for clinical practice. South Med J. 2004;97:1194-1200.
Puchalski CM, Larson DB. Developing curricula in spirituality and medicine [published correction appears in Acad Med. 1998;73:1038]. Acad Med. 1998;73:970-974.
Spirituality and health (2002-2006) page. John Templeton Foundation Web site. Available at: http://www.templeton.org/funding_areas/core_themes/spirituality_and_health/. Accessed September 29, 2007.
Rufsvold RM, Remen RN. Finding meaning in medicine: reclaiming the soul of practice. San Francisco Med. May 2002;28-30. Available at: http://www.meaninginmedicine.org/download/SF_Medicine_article.pdf. Accessed September 29, 2007.
Brokaw JJ, Tunnicliff G, Raess BU, Saxon DW. The teaching of complementary and alternative medicine in US medical schools: a survey of course directors. Acad Med. 2002;77:876-881.
Ghosh AK. The role of religion/spirituality in the medical curriculum. Minn Med. 2003;86:5 .
Fortin AH VI, Barnett KG. Medical school curricula in spirituality and medicine. JAMA. 2004;291:2883 .
Saxon DW, Tunnicliff G, Brokaw JJ, Raess BU. Status of complementary and alternative medicine in the osteopathic medical school curriculum. JAm Osteopath Assoc. 2004;104:121-126. Available at: http://www.jaoa.org/cgi/content/full/104/3/121. Accessed September 29, 2007.
Osteopathic medical schools page. American Association of Colleges of Osteopathic Medicine Web site. Available at: http://www.aacom.org/colleges/index.asp. Accessed September 29, 2007.
Survey software: online surveys page. Zoomerang: A MarketTools Inc Co Web site. Available at: http://www.zoomerang.com/login/index.zgi. Accessed September 29, 2007.
American Association for Higher Education, American College Personnel Association, National Association of Student Personnel Administrators. Powerful Partnerships, A Shared Responsibility for Learning: A Joint Report. Washington, DC: American Association for Higher Education; June 2, 1998. Available at: http://www.myacpa.org/pub/documents/taskforce.pdf. Accessed September 29, 2007.
Zayas LE, James PA, Shipengrover JA, Schwartz DG, Osborne JW, Graham RP. Exploring instructional quality indicators in ambulatory medical settings: an ethnographic approach. Fam Med. 1999;31:635-640.
Mentowski M. Thinking through a curriculum that lasts. In: Lattuca LR, Haworth JG, Conrad CF, eds. ASHE College and University Curriculum: Developing and Cultivating Programs of Study That Enhance Student Learning. Boston, Mass: Pearson Custom Publishing;2000 : 336-351.
Fenwick P. Science and spirituality: a challenge for the 21st century. Paper presented at: Annual Conference of International Association for Near-Death Studies; 2004; Evanston, Ill. Available at: http://www.iands.org/research/important_studies/dr._peter_fenwick_m.d._science_and_spirituality.html. Accessed September 29, 2007.
Graves DL, Shue CK, Arnold L. The role of spirituality in patient care: incorporating spirituality training into medical school curriculum. Acad Med. 2002;77:1167 .
King DE, Blue A, Mallin R, Thiedke C. Implementation and assessment of a spiritual history taking curriculum in the first year of medical school. Teach Learn Med. 2004;16:64-68.
McPartland JM, Pruit PL. Opinions of MDs, RNs, allied health practitioners toward osteopathic medicine and alternative therapies: results from a Vermont survey. J Am Osteopath Assoc. 1999;99:101-108.
Baker HH, Cope MK, Adelman MD, Schuler S, Foster RW, Gimpel JR. Relationships between scores on the COMLEX-USA level 2-performance evaluation and selected school-based performance measures. J Am Osteopath Assoc. 2006;106:290-295. Available at: http://www.jaoa.org/cgi/content/full/106/5/290. Accessed September 29, 2007.
Table 1
Prevalence of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=12)

Survey Question and Responses

No.
Does your university currently have coursework covering spirituality in medicine?
□ Yes 8
□ No4
Are there any plans to implement a spirituality curriculum in the next 5 years?
□ Yes0
□ No 4
□ No response8
Are there any plans to write a grant in the next 6 months to pursue the development of a spirituality curriculum?
□ Yes1
□ No 10
□ No response
1
Table 1
Prevalence of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=12)

Survey Question and Responses

No.
Does your university currently have coursework covering spirituality in medicine?
□ Yes 8
□ No4
Are there any plans to implement a spirituality curriculum in the next 5 years?
□ Yes0
□ No 4
□ No response8
Are there any plans to write a grant in the next 6 months to pursue the development of a spirituality curriculum?
□ Yes1
□ No 10
□ No response
1
×
Table 2
Characteristics of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=8)

Characteristic

No.*
Academic year(s) of course instruction
□ First 7
□ Second6
□ Third and fourth (ie, clinicals) 2
□ No response1
Instruction available for residents
□ Yes2
□ No 3
□ No response3
Courses or credit hours required
□ Yes7
□ No (elective) 1
Course selection
□ All courses required 7
□ Students can elect ≥ 1 course1
□ Other 2
Total instruction hours per academic year
□ <5 1
□ 5-90
□ 10-15 3
□ 16-202
□ Unable to determine 2
Curriculum development
□ Created internally 7
□ Created by outside consultants1
□ Modeled on existing program 1
□ No response1
Teaching methods used
□ Lectures8
□ Small group discussions 8
□ Reading assignments7
□ Shadowing hospital chaplain 4
□ Standardized patient encounters4
□ Community work 1
□ Other2
Sources for curriculum updates
□ Current literature 6
□ Conferences4
□ Other 4
□ No response2
Instructor academic degree(s)
□ PhD4
□ DO 3
□ MD2
□ MDiv 2
□ RN1
□ No response 2
Other instructor training and course preparation
□ Precourse meetings 5
□ Self-taught3
□ Outside training or seminars 1
□ No special training1
□ Other 1
□ No response2
Assessment of student competence
□ Self-report (changes in knowledge)5
□ Written examination 4
□ Written or oral presentation3
□ Standardized patient case studies 3
□ Self-report (changes in attitude)2
□ Other 1
□ No response2
 Abbreviation: MDiv, master of divinity.
 *Totals for each survey item may not equal 8 because of nonresponse, as indicated, and because subjects were invited to select multiple options as appropriate for several survey questions.
Table 2
Characteristics of Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States (n=8)

Characteristic

No.*
Academic year(s) of course instruction
□ First 7
□ Second6
□ Third and fourth (ie, clinicals) 2
□ No response1
Instruction available for residents
□ Yes2
□ No 3
□ No response3
Courses or credit hours required
□ Yes7
□ No (elective) 1
Course selection
□ All courses required 7
□ Students can elect ≥ 1 course1
□ Other 2
Total instruction hours per academic year
□ <5 1
□ 5-90
□ 10-15 3
□ 16-202
□ Unable to determine 2
Curriculum development
□ Created internally 7
□ Created by outside consultants1
□ Modeled on existing program 1
□ No response1
Teaching methods used
□ Lectures8
□ Small group discussions 8
□ Reading assignments7
□ Shadowing hospital chaplain 4
□ Standardized patient encounters4
□ Community work 1
□ Other2
Sources for curriculum updates
□ Current literature 6
□ Conferences4
□ Other 4
□ No response2
Instructor academic degree(s)
□ PhD4
□ DO 3
□ MD2
□ MDiv 2
□ RN1
□ No response 2
Other instructor training and course preparation
□ Precourse meetings 5
□ Self-taught3
□ Outside training or seminars 1
□ No special training1
□ Other 1
□ No response2
Assessment of student competence
□ Self-report (changes in knowledge)5
□ Written examination 4
□ Written or oral presentation3
□ Standardized patient case studies 3
□ Self-report (changes in attitude)2
□ Other 1
□ No response2
 Abbreviation: MDiv, master of divinity.
 *Totals for each survey item may not equal 8 because of nonresponse, as indicated, and because subjects were invited to select multiple options as appropriate for several survey questions.
×
Table 3
Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States: Course Offerings and Focus Areas (n=8)

Instruction Topics

No.*
Awareness of various religious beliefs7
Effects of spirituality on healing and health 7
End-of-life issues7
Religion/faith and prayer 6
Recording patient spiritual history alongside medical history6
Hospice movement 1
Patients' spiritual perspectives on illness1
No response
1
 *Subjects were invited to select multiple options for this survey question, as applicable. One individual chose not to respond to this survey item.
 Patients' spiritual perspectives on illness addressed the impact of an individual's spiritual perspectives on healing. Specifically, this instruction topic addressed how an individual's religious or spiritual beliefs about the nature of an illness might help or hinder the healing process (eg, viewing illness as a punishment).
Table 3
Spirituality-in-Medicine Programs at Colleges of Osteopathic Medicine in the United States: Course Offerings and Focus Areas (n=8)

Instruction Topics

No.*
Awareness of various religious beliefs7
Effects of spirituality on healing and health 7
End-of-life issues7
Religion/faith and prayer 6
Recording patient spiritual history alongside medical history6
Hospice movement 1
Patients' spiritual perspectives on illness1
No response
1
 *Subjects were invited to select multiple options for this survey question, as applicable. One individual chose not to respond to this survey item.
 Patients' spiritual perspectives on illness addressed the impact of an individual's spiritual perspectives on healing. Specifically, this instruction topic addressed how an individual's religious or spiritual beliefs about the nature of an illness might help or hinder the healing process (eg, viewing illness as a punishment).
×