Spiritual and religious beliefs not only play important roles in many people’s lives but, as research has shown, they also have an impact on physical and mental health. A new Certificate in Spirituality and Health at the Perelman School of Medicine at the University of Pennsylvania will help up-and-coming doctors learn how to incorporate patient beliefs into their medical practice – and feel more comfortable in that role.
“Spirituality is a part of people’s identity,” said Horace DeLisser, MD, an associate professor of Medicine, who directs the Certificate program. “Understanding these beliefs helps to better care for patients and form relationships.”
Certificate requirements, which span the four years of medical school, include instruction in mindfulness meditation – providers who can take care of themselves are better able to take care of patients – as well as lectures related to spirituality and health. But the cornerstone of the program is the six-week summer internship. Comprising several elements, two stand out as key to this experience: meeting and learning to engage with patients, and shadowing chaplains.
DeLisser said that the ability to really listen to patients, especially when there is emotional charge, is an essential part of a physician’s repertoire of skills. “A lot of what we mean by spirituality is relationship building, being able to connect with people in more than superficial ways.”
Second-year PSOM student Dominique Bohorquez said these informal talks helped her feel more comfortable around patients. “It got me out of my shell.” But she felt that it was also beneficial for patients. Based on her experiences, “I think the patient population is extremely receptive to talking. Many poured their hearts out.”
Students not only met and talked with patients, but also were asked to create a “verbatim report” in which they tried to reconstruct the conversation word-for-word. The process helps them focus more on the conversation and determine where it was accurate and where they saw it through their own experiences.
Shadowing chaplains opened up a whole new world for many of the Certificate students. They visited patient-care units at the Hospital of the University of Pennsylvania, and Penn Presbyterian Medical Center and Penn’s Trauma Center. In an article about shadowing chaplains in the Summer 2016 issue of Penn Medicine, the alumni publication for the PSOM, DeLisser pointed out that many students arrive at medical schools with an “indifferent, dismissive, or even hostile attitude” toward religion or spirituality. They are surprised by the role faith plays in patients’ decisions. Watching a chaplain in action, he continued, gives students “a little glimpse of how they themselves can do spiritual care.”
Incoming students often have little idea how chaplains fit into the patient-care system. Watching a chaplain engage with patients, “was an intense experience,” Bohorquez said. “I learned they’re vital to the health-care team.”
The shadowing experience also offers students “a greater awareness of what patients and families go through,” added James Browning, director of Pastoral Care at HUP. “When students encounter a spiritual belief, they have to figure out how it fits in with both the patient and family. It helps them look at the whole, not the sum of parts.”
Recognizing their own limitations when it comes to spiritual help is another lesson the program seeks to teach, DeLisser said. Suggesting that a chaplain stop by when the doctor sees that a family is struggling with the impending death of a loved one is part of the training. “It’s learning to think in those terms and appreciate the power of doing something like that.”
The summer internship also offers students field trips to several religious or faith-based programs to help them expand their knowledge – and understanding – of beliefs among people. Last summer students visited a Muslim family, a Buddhist temple, a faith-based health center in North Philadelphia and a Santería, a Cuban religious practice that blends African pagan practices with Catholicism. The visits not only exposed students to different traditions but also showed how it affects their decisions about medical care.
“Being able to engage that spiritual realm as a physician ultimately helps you do your work better,” DeLisser said. “My hope is that 10 years from now, these students will look back on the program and see that it was transformative.”
Photo caption: Chaplain resident Pauline Jennett shows medical student Dominique Bohorquez the Pastoral Care documentation screens in PennChart, completed for every Trauma patient.