Seminar Aims to Help Students Understand Role of Faith, Religion in Patient Care

Today, there is a general recognition that faith and religion can be an important part of patient care. The Joint Commission, the accreditation body for hospitals, requires hospitals and health care organizations to include spiritual assessments as part of routine patient care.

But educating physicians about why it’s important and figuring out how to work that into conversations with patients can be a challenge.

On Jan. 8, for the 17th year in a row, the Jacobs School of Medicine and Biomedical Sciences held its annual Spirituality in Medicine seminar, required for third-year students. This seminar is part of Intersession, a two-week course for students in their third year who are about halfway through their clinical rotations. 

“We cover a variety of topics to help our students better care for their patients, themselves, and to prepare for their next steps in training,” said Samantha Bordonaro, MD, assistant dean for student and academic affairs in the Jacobs School. 

“This session is included because, as physicians, we take care of patients from various backgrounds and beliefs, many of which are different from our own,” she explained. “If we can add tools to our toolkit that allow us to meaningfully engage with patients about beliefs that affect their health and wellness, we can better treat their illness and improve their experience with the health care system.”

The seminar exposes students to the spiritual backgrounds they will encounter with their patients and to help them understand how to be more spiritually and culturally sensitive.

“I believe in the importance of whole-person health care, not just caring for physical bodies,” said David M. Holmes, MD, clinical associate professor and director of global health education in the Department of Family Medicine, who developed the seminar with his colleagues. “Research shows that health outcomes are affected by biological, psychological, social and spiritual factors. We know how to address the first three, but it’s also important to address spiritual issues with patients who want them addressed.”

Each year, Holmes and colleagues work with Rev. Dr. G. Stanford Bratton, director of the Network of Religious Communities, to design the curriculum and recruit local faith leaders to participate. During the half-day seminar, leaders from 17 faith groups met with students in small groups to share key tenets of their faiths, answer questions and discuss patient case studies.

Students heard from Scott Anderson, now a fourth-year Jacobs School student, who spoke about how he benefitted from the seminar last year. He acknowledged that in addition to the fact that spirituality and religion aren’t typically part of the formal medical curriculum, it’s just not a topic people are used to discussing.

“Throughout your life, you’re taught not to ask people about their religion,” he said. “So it can be uncomfortable to talk about these things. But you will become more comfortable the more you do it.”

Sandra Kamel, MD, a UB medical resident in family medicine, noted discussions of spirituality and religion become even more relevant during residency. “You don’t do end-of-life talks as a medical student,” she said. “You usually don’t encounter that until you’re a resident.” 

Students heard numerous examples of how spiritual and religious practices and medicine intersect. In the session with the Muslim leader, students inquired about women patients requesting to be examined only by female providers. Several faith leaders discussed how to deal with fasting, especially with diabetic patients who may be on insulin. Darrel Ivy, a Jehovah’s Witness, said students were interested in some alternative strategies to transfusions.

Manjit Leo F. Singh, who led the group on Sikhism, said that when the provider has taken the time to discuss spiritual issues with patients, it is important to make others on the care team aware of those needs as well.

Lou Bergner of the Bahai faith was grateful for the chance to share information about his faith, which he said most people know little or nothing about. And Ethel Baker, a Christian Science teacher who was attending the seminar for the 14th year, said that “People believe we’re against doctors. This was an opportunity to clear that up.”

Faith leaders emphasized that people in the same faith may practice differently. “There’s diversity within the same community,” noted Karlin Bacher, a nurse from the Amish/Mennonite faith. “We like to say, ‘When you’ve met one Mennonite, you’ve probably just met one Mennonite.’”

“It was eye-opening,” Hannah Granger, a third-year student, said of the seminar. “I found out that while a Mennonite may be OK using a cell phone, you can’t assume that they’re OK with all kinds of technology. You have to ask, ‘What lifesaving measures are you OK with?’”

“It was great to hear the different perspectives,” agreed Rachel Yerden, another student. “I had thought that religion is based on adherence to certain common tenets, but I learned that depends on the community you’re in. There are different ways that people adhere, even within the same religion.”

Granger’s interest in primary care is another reason why she thinks spiritual beliefs are relevant. “I want to develop personal relationships with my patients,” she said. “So I want to learn what they value as I build relationships with them.”

The students learned that a broad view of spirituality is necessary. “It can be a barrier to think only of religion,” Anderson said. “Spiritual needs don’t just happen in terms of Christianity or Judaism or Islam. It’s really about coping and about questions like, what decisions should I make?”

And while students were free to discuss their own feelings about spirituality, Holmes made it clear that wasn’t the point.

“It’s not about what we as doctors or students believe,” he said. “It’s about what the patient believes. It’s about putting ‘patient-centered care’ into practice.”