Implementation and Assessment of a Spiritual History Taking Curriculum in the First Year of Medical School
Abstract
BACKGROUND: The Association of American Medical Colleges has recommended addressing spirituality in the medical curriculum. DESCRIPTION: To evaluate the impact of a spiritual history-taking curriculum on the skills, knowledge, and attitudes of 1st year medical students. The study implemented a spiritual history-taking curriculum in the 1st year of medical school that included reading assignments, practice history taking, and standardized patient (SP) scenarios with spiritual content. It assessed students' performance in three ways: (a) using a videotaped SP interview, (b) a survey of students' attitudes regarding incorporating patients' religious and cultural views into medical decision making, and (c) a written test question on their first examination. EVALUATION: Students (146) took part in the medical school's spirituality curriculum, which included participation in videotaped interviews; 98% completed the initial survey, and 75% completed the follow-up survey. On the final videotaped SP interview, 65% of students were able to recognize the patient's spiritual concern according to trained faculty observers. On the attitude survey, there was an increased desire to accommodate patients' beliefs, although the magnitude of the increase was generally quite small. Ninety-four percent of students answered the test question correctly. CONCLUSION: Spiritual history taking can be integrated effectively into the existing history-taking curriculum in 1st year medical training.
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Another study examined the effectiveness of SH training among 1st-year medical students.
“Another study examined the effectiveness of SH training among 1st-year medical students.38”
Of the 146 students included in that study, 65% could recognize the patient's spiritual concerns, demonstrating skills and knowledge in taking a SH 1 to 3 months after the initial learning period.
“Of the 146 students included in the study, 65% could recognize the patient’s spiritual concerns, demonstrating skills and knowledge in taking a SH 1 to 3 months after the initial learning period.”
The results suggest that 1st-year medical students can effectively learn about spirituality and medicine as an integrated part of their clinical training, without the need for separate courses to address spiritual issues.
“The results suggest that 1st-year medical students can effectively learn about spirituality and medicine as an integrated part of their clinical training, without the need for separate courses to address spiritual issues.38”
Cites
Handbook of Religion and Health
Koenig, H., McCullough, M., & Larson, D. (2001) · doi:10.1093/acprof:oso/9780195118667.001.0001 · Cited by 2,581 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A prescription for cultural competence in medical education
Kripalani, S., Bussey-Jones, J., Katz, M. G., & Genao, I. (2006) · Journal of general internal medicine · doi:10.1111/j.1525-1497.2006.00557.x · Cited by 262 · see citing works
Humanities in Undergraduate Medical Education: A Literature Review
Ousager, J., & Johannessen, H. (2010) · Academic medicine : journal of the Association of American Medical Colleges · doi:10.1097/acm.0b013e3181dd226b · Cited by 237 · see citing works
Spiritual issues in the care of dying patients: ". . . it's okay between me and god".
Sulmasy, D. (2006) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.296.11.1385 · Cited by 194 · see citing works
Spiritual Care Training Provided to Healthcare Professionals: A Systematic Review
Paal, P., Helo, Y., & Frick, E. (2015) · Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications · doi:10.1177/1542305015572955 · Cited by 158 · see citing works
“, 2004) or Spiritual Life Map (Thompson & MacNeil, 2006; Bushfield, 2010), was part of the process (Wallace et al., 2008; Sierpina & Boisaubin, 2001; Todres et al., 2005; Musick et al., 2003; King et al., 2004).”
BackgroundMethodInfluentialTrends in Medical Education Research
Regehr, G. (2004) · Academic medicine : journal of the Association of American Medical Colleges · doi:10.1097/00001888-200410000-00008 · Cited by 127 · see citing works
Chi, F. W., Kaskutas, L. A., Sterling, S., Campbell, C. I., & Weisner, C. M. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02524.x · Cited by 114 · see citing works
“Religiosity and spirituality are closely related constructs [72,73], yet there is little agreement among researchers about the theoretical and operational definitions of religiosity and spirituality [42,72,74,75], especially among adolescents.”
BackgroundMedical School Curricula in Spirituality and Medicine
Fortin, A., & Barnett, K. (2004) · JAMA · doi:10.1001/jama.291.23.2883 · Cited by 98 · see citing works
Spirituality in Medical Education: Global Reality?
Lucchetti, G., Lucchetti, A., & Puchalski, C. (2012) · Journal of religion and health · doi:10.1007/s10943-011-9557-6 · Cited by 96 · see citing works
“In 2004, King et al. (2004) from University of South Carolina, USA, implemented a spiritual history-taking curriculum in the 1st year of medical school that included reading articles and scientific literature, spiritual history taking and a scenario (dealing with spirituality) in a standardized…”
A review on cultural competency in medical education
Rukadikar, C., Mali, S., Bajpai, R., Rukadikar, A., & Singh, A. (2022) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_2503_21 · Cited by 66 · see citing works
“A clinic preceptor, for example, might offer comment on the student’s ability to do one of the skills, like eliciting the patient’s grasp of the disease aetiology.[86,87]”
BackgroundTeaching Health Care Providers To Provide Spiritual Care: A Pilot Study
Zollfrank, A. A., Trevino, K., Cadge, W., Balboni, M., Thiel, M., Fitchett, G., Gallivan, K., VanderWeele, T., & Balboni, T. (2015) · Journal of Palliative Medicine · doi:10.1089/jpm.2014.0306 · Cited by 59 · see citing works
Osório, I. H. S., Gonçalves, L. M., Pozzobon, P. M., Gaspar Júnior, J. J., Miranda, F. M., Lucchetti, A. L. G., & Lucchetti, G. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1337878 · Cited by 45 · see citing works
“King et al. (2004) evaluated the impact of a spiritual history-taking curriculum on first year medical students’ skills, knowledge, and attitudes.”
BackgroundInfluentialSpirituality Training for Palliative Care Fellows
Marr, L., Billings, J. A., & Weissman, D. E. (2007) · Journal of Palliative Medicine · doi:10.1089/jpm.2006.0076.r1 · Cited by 42
“…Self-care 14,28,35 Taking a spiritual history and addressing spiritual needs, including the skills of compassion, presence and listening 7,10,11,14,18,21,24,26,27,29,30,32,34 Spiritual considerations in bereavement care 14 Understand how your (the trainee’s) spiritual beliefs affect patient care…”
Integration of Spirituality in Medical Education in Iran: A Qualitative Exploration of Requirements
Memaryan, N., Rassouli, M., Nahardani, S. Z., & Amiri, P. (2015) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2015/793085 · Cited by 32 · see citing works
“Thus, providing such training appears essential [10].”
Anandarajah, G., Roseman, J., Lee, D.-Y., & Dhandhania, N. (2016) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2016.06.006 · Cited by 31 · see citing works
Introduction: Spiritual Assessment and Intervention: Current Directions and Applications
Brennan, M., & Heiser, D. (2004) · Journal of Religion Spirituality & Aging · doi:10.1300/j496v17n01_01 · Cited by 25 · see citing works
Teaching spirituality to medical students: a systematic review
Crozier, D., Greene, A., Schleicher, M., & Goldfarb, J. (2021) · Journal of Health Care Chaplaincy · doi:10.1080/08854726.2021.1916332 · Cited by 23 · see citing works
“Similarly, King and colleagues reported that during the end-of-year standardized patient exam, 65% of students recognized the patient’s spiritual concern, with only 57% of these students asking at least one follow-up question (King et al., 2004).”
BackgroundMcClain, E., McClain, R., Desai, G., & Pyle, S. A. (2008) · The Journal of the American Osteopathic Association · doi:10.7556/jaoa.2008.108.4.197 · Cited by 19
The Role of Spirituality in Medical School and Psychiatry Residency Education
Loboprabhu, S., & Lomax, J. (2010) · doi:10.1002/aps.241 · Cited by 17
Sleeth, G., Gottlieb, P., Srinivasan, A., Thaddeus, U., Mennillo, M. R., & Anandarajah, G. (2025) · BMC Palliative Care · doi:10.1186/s12904-025-01809-z · Cited by 13 · see citing works
Gonçalves, L. M., Osório, I. H. S., Oliveira, L. L., Simonetti, L. R., dos Reis, E., & Lucchetti, G. (2015) · Journal of Religion and Health · doi:10.1007/s10943-015-0146-y · Cited by 22 · see citing works
“King et al. (2004) evaluated a training program developed during the first year of medical school (King et al. 2004).”
BackgroundMosqueiro, B. P., Costa, M. D. A., Caribé, A. C., Oliveira e Oliveira, F. H. A., Pizutti, L., Zimpel, R. R., Baldaçara, L., da Silva, A. G., & Moreira-Almeida, A. (2023) · Brazilian Journal of Psychiatry · doi:10.47626/1516-4446-2023-3056 · Cited by 12 · see citing works
McEvoy, M., Schlair, S., Sidló, Z., Burton, W., & Milan, F. (2014) · Academic medicine : journal of the Association of American Medical Colleges · doi:10.1097/acm.0000000000000061 · Cited by 12 · see citing works
McEvoy, M., Gorski, V. A., Swiderski, D., & Alderman, E. (2013) · Journal of religion and health · doi:10.1007/s10943-013-9716-z · Cited by 11
van Rensburg, B. J., Szabo, C. P., Poggenpoel, M., & Myburgh, C. (2013) · International Journal of Psychiatry in Medicine · doi:10.2190/pm.45.2.f · Cited by 11 · see citing works
Hays, J., Wood, L., Steinhauser, K., Olson, M., Lindquist, J., & Tulsky, J. (2011) · Palliative & Supportive Care · doi:10.1017/s1478951511000228 · Cited by 10 · see citing works
“Physicians and nurses are encouraged to assess the religious and spiritual histories of patients (Kemp, 2001; King et al., 2004; Tulsky, 2005).”
BackgroundEnhancing Objectivity in Pastoral Education: Use of Standardized Patients in Video Simulation
Tartaglia, A., & Dodd‐McCue, D. (2010) · Journal of Pastoral Care & Counseling · doi:10.1177/154230501006400202 · Cited by 10
Matthews, J. A., Lianov, L., Anandarajah, G., Puchalski, C., Jones, N. M., Miller, C., Suhie, M. M., Frates, E. P., Kaufmann, M. G., Ito, S., et al. (2026) · American Journal of Lifestyle Medicine · doi:10.1177/15598276261421064 · Cited by 8
Developing The Spiritual Health Curriculum Approach Based on Tyler's Model in Iran
Nahardani, S. Z., Arabshahi, K. S., & Pashmdarfard, M. (2022) · Medical Journal of The Islamic Republic of Iran · doi:10.47176/mjiri.36.133 · Cited by 7 · see citing works
“To apply spiritual health in health services, it is necessary to begin the necessary education (6).”
BackgroundOriginalia. Evaluation einer Fortbildung zur Spirituellen Anamnese SPIR in Klinik und Praxis
Elhardt, E., Riedner, C., Paal, P., Roser, T., & Frick, E. (2013) · doi:10.1515/spircare-2013-0007 · Cited by 6
“Im englischsprachigen Raum konnte gezeigt werden, dass Schulungen im Umgang mit Spiritualität/Religiosität dem Problem entgegen wirken können (Campbell et al. 2011, King et al. 2004).”
BackgroundBorragini-Abuchaim, S., Alonso, L. G., & Tárcia, R. M. L. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.787340 · Cited by 6 · see citing works
“There are different ways of including Spirituality in academic activities of medical schools, such as: elective courses; lectures; standardized patient interviews; chaplains’ follow-ups; reading scientific articles on Spirituality/Religiosity in clinical practice and related subjects; discussions in small groups; asse…”
The Spirituality Integration in Iranian Health Education: Best Lessons for Development
Mehrabi, M., Memaryan, N., Mohaghegh, N., & Abbasi, M. (2017) · doi:10.22037/bhl.v1i2.17834 · Cited by 4
“(2004) applied the triangulation technique as a powerful method with combination of a videotaped interview, a survey of students' attitudes and a written test on their first examination and the final videotaped interview.(45) 4.”
MethodLucchetti, G., Gonçalves, L. M., Ferreira, A. G. D. C., Daher, J. C., & Lucchetti, A. L. G. (2019) · Religion, spirituality and health: a social scientific approach · doi:10.1007/978-3-030-21221-6_15 · Cited by 6 · see citing works
Spirituality, health, and medical care of adults.
King, D. (2006) · Southern medical journal (Birmingham, Ala. Print) · doi:10.1097/01.smj.0000242809.99420.e0 · Cited by 3 · see citing works
Self-citationWenham, J., Best, M., & Ac, D. W. K. (2026) · Journal of religion and health · doi:10.1007/s10943-025-02545-7 · Cited by 2 · see citing works
“Finally, there is good evidence from the USA of how to enable undergraduate medical students to address patients’ spiritual needs (King et al., 2004).”
Kumar, P. V., Chitnis, S., Lawrence, L., Langasco, N., & McGowan, N. (2020) · Journal of Medical Education · doi:10.5812/jme.110406 · Cited by 2
Development of a Spiritual Health Curriculum: An Applied Study in Iran
Nahardani, S. Z., Memaryan, N., Keshavarzi, M., Hadi, F., Koenig, H., & Pashmdarfard, M. (2023) · Shiraz E Medical Journal · doi:10.5812/semj-130784 · Cited by 1 · see citing works
Applied Education of Spiritual Health in Iranian Medical Sciences
Nahardani, S. Z. (2020) · Journal of Medical Education Development · doi:10.18502/jmed.v15i1.3325 · Cited by 1
“Holistic nursing practice 2006; 20(6): 288-”
Manjra, H., Cho, J., Yeung, A. M., Okamuro, L., Liu, C., Gray, M. S. F., Turner, J. B., & Cipta, A. (2026) · The Permanente Journal · doi:10.7812/tpp/26.019
“27,28 On the other hand, HOPE may be better suited for residency and fellowship training, where health care practitioners are honing their interview skills and building longitudinal relationships with patients.”
- Authors
- King, D. E., Blue, A., Mallin, R., & Thiedke, C.
- Affiliations
- Medical University of South Carolina (US)
- Venue
- Teaching and Learning in Medicine
- Publisher
- Informa UK Limited
- Published
- 2004-01
- Volume
- 16
- Issue
- 1
- Pages
- 64-68
- ISSN
- 1040-1334 (ISSN-L)
- 1532-8015
- OpenAlex
- W2017125138
- Cited by
- 38
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 1
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Teaching and Learning in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- spiritual history taking, spirituality in medicine, medical curriculum, first-year medical students, standardized patients, attitudes toward spirituality, history-taking skills
- MeSH terms
- Curriculum, Education, Medical, Undergraduate, Humans, Medical History Taking, Physician-Patient Relations, Spirituality
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