Effect of an educational intervention in “spirituality and health” on knowledge, attitudes, and skills of students in health-related areas: A controlled randomized trial

Abstract

Background: To date there have been no randomized studies that assess whether “Spirituality and Health” (S/H) programs are, indeed, effective, or not. We sought to evaluate if an intervention in teaching S/H fosters competence changes in healthcare students.

Methods: A randomized controlled trial was carried out. Students were randomized into two groups: an Intervention Group (a theoretical-practical course in S/H) and a control group (waiting list). Students’ S/H knowledge, attitudes, and skills (through a simulated patient) were assessed.

Results: A total of 49 students were evaluated. Students in the intervention group received higher scores on knowledge tests, felt more comfortable and prepared to talk about religious/spiritual beliefs with patients, more readily recognized importance of hospital chaplains, and more frequently held the opinion that addressing spirituality is important. Furthermore, a breaking down of S/H barriers was identified. Students also demonstrated more ability in obtaining a patient’s spiritual history when compared to the control group.

Conclusions: There were some differences on knowledge, attitudes, and spiritual history skills between students who participated in the S/H teaching strategy and students who have not been exposed to the theme. These results might foster discussion for the development of new educational strategies about the subject.

Disclosure statement

The authors declared no competing interests.

Funding

This work was supported by the AME São Paulo.

Glossary

• Spiritual History: Medical history is defined as a record of information about a person’s health (1). Spiritual history can be defined as a record of information about a person’s spiritual and religious beliefs. The purpose of the spiritual history is to learn about how patients cope with their illnesses, the kinds of support systems available to them in the community, and any strongly held beliefs that might influence medical care (2). The spiritual history taking can be performed by healthcare chaplains, as well as, by health professionals and healthcare students.

•  (1) NCI Dictionary of Cancer Terms. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid =689078.

  (2) Koenig HG. 2004. Taking a spiritual history. JAMA. 291(23):2881–2882.

• Attitude: (1) A settled way of thinking or feeling about something. (2) Attitudes are complex mental processes that are thought to influence the way in which individuals’ process information and to motivate behavior. Attitudes can be inferred by observing an individual’s response to a situation but cannot be directly measured. Responses can be behavioral (actions, intentions to act; cognitive (thoughts and opinions), and affective (feelings, emotions, and autonomic nervous system activity).

•   (1) Oxford Dictionaries. Available from http://www.oxforddictionaries.com/definition/english/attitude (Accessed 2014 Apr 21).

  (2) Adapted from: Martin J, Lloyd M, Dingh S. 2002. Professional attitudes: can they be taught and assessed in medical education? Clinical Medicine. 2(3):217–223.

• Standardized Patient (SP): Individuals who have been trained to reliably reproduce the history and/or physical findings of typical clinical cases. They can be real patients who have been “standardized” or they can be simulated patients, i.e. persons who are not sick but take on a patient’s history and role. Sometimes health care providers or actors are used to accomplish this goal. This tool is designed to make examination and assessment of a student’s clinical skills as objective as possible. To teach a standardized patient to simulate a new clinical problem takes 8–10 h.

• Wojtczak A. 2003. Glossary of Medical Education Terms. AMEE Occasional Paper No 3. Dundee: AMEE.

• Competence: Possession of a satisfactory level of relevant knowledge and acquisition of a range of relevant skills that include interpersonal and technical components at a certain point in the educational process. Such knowledge and skills are necessary to perform the tasks that reflect the scope of professional practices. Competence may differ from “performance”, which denotes actions taken in a real life situation. Competence is therefore not the same as “knowing” on the contrary, it may well be about recognizing one's own limits. The more experienced the professional being tested, the more difficult it is to create a tool to assess their actual understandings and the complex skills of the tasks they undertake. A holistic integration of understandings, abilities and professional judgments, i.e. a “generic” model, is one where competence is not necessarily directly observable, but rather can be inferred from performance.

• Wojtczak A. 2003. Glossary of Medical Education Terms. AMEE Occasional Paper No 3. Dundee: AMEE.

Notes on contributors

Igraíne Helena Scholz Osório is a medical student from the Federal University of Mato Grosso do Sul, Brazil.

Lídia Maria Gonçalves, MD, is a medical doctor from the Federal University of Mato Grosso do Sul, Brazil and currently works as a Family doctor.

Pedro Machry Pozzobon is a medical student from the Federal University of Mato Grosso do Sul, Brazil.

Jair José Gaspar Júnior is a physical therapy student from the Federal University of Mato Grosso do Sul, Brazil.

Filippe Martins Miranda is a medical student from the Federal University of Mato Grosso do Sul, Brazil.

Alessandra L.G. Lucchetti, MD, Ph.D., a medical doctor specialized in the care of the elderly, received her Ph.D. degree in Health from the Federal University of Juiz de Fora, Brazil. She is currently an Assistant Professor of Medicine at the Federal University of Juiz de Fora, Brazil.

Giancarlo Lucchetti, MD, Ph.D., a medical doctor with fellowship training in Geriatrics, and received his PhD in Neurology/Neurosciences from the Federal University of São Paulo. He is an Associate Professor of Medicine at the Federal University of Juiz de Fora, Brazil.