Religion, Spirituality, and the Hidden Curriculum: Medical Student and Faculty Reflections

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• 作者：Michael J. Balboni ; MDiv ; ThM ; PhD^a ; ^d ; ^{Michael_Balboni@dfci.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; Julia Bandini ; BS^e ; Christine Mitchell ; MDiv^f ; Zachary D. Epstein-Peterson ; MD^g ; Ada Amobi ; MPH^d ; Jonathan Cahill ; MA^h ; Andrea C. Enzinger ; MD^b ; ^d ; John Peteet ; MD^a ; ^d ; Tracy Balboni ; MD ; MPH^c ; ^d
• 关键词：Professionalism ; hidden curriculum ; religion ; spirituality ; medical education
• 刊名：Journal of Pain and Symptom Management
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：50
• 期：4
• 页码：507-515
• 全文大小：255 K

文摘

Religion and spirituality play an important role in physicians’ medical practice, but little research has examined their influence within the socialization of medical trainees and the hidden curriculum.

Objectives

The objective is to explore the role of religion and spirituality as they intersect with aspects of medicine's hidden curriculum.

Methods

Semiscripted, one-on-one interviews and focus groups (n = 33 respondents) were conducted to assess Harvard Medical School student and faculty experiences of religion/spirituality and the professionalization process during medical training. Using grounded theory, theme extraction was performed with interdisciplinary input (medicine, sociology, and theology), yielding a high inter-rater reliability score (kappa = 0.75).

Results

Three domains emerged where religion and spirituality appear as a factor in medical training. First, religion/spirituality may present unique challenges and benefits in relation to the hidden curriculum. Religious/spiritual respondents more often reported to struggle with issues of personal identity, increased self-doubt, and perceived medical knowledge inadequacy. However, religious/spiritual participants less often described relationship conflicts within the medical team, work-life imbalance, and emotional stress arising from patient suffering. Second, religion/spirituality may influence coping strategies during encounters with patient suffering. Religious/spiritual trainees described using prayer, faith, and compassion as means for coping whereas nonreligious/nonspiritual trainees discussed compartmentalization and emotional repression. Third, levels of religion/spirituality appear to fluctuate in relation to medical training, with many trainees experiencing an increase in religiousness/spirituality during training.

Conclusion

Religion/spirituality has a largely unstudied but possibly influential role in medical student socialization. Future study is needed to characterize its function within the hidden curriculum.