Expanding the Communication Skills Toolbox: The Addition of Spiritual Care to the Medical Student Repertoire

It has been argued that spirituality should be seen as a fundamental, vital component of being human; however, curriculum coverage is limited in Australian medical schools. In our study, we wanted to explore how medical students might recognise the gap in their knowledge about spiritual care and how that would impact their perceived need for learning. This included assessment of the impact on their understanding of spiritual care and their confidence in providing it. We developed a spiritual care training workshop and piloted it with four groups of medical students who were on placement in a rural clinical teaching site; before and after the workshop they were tasked with taking a spiritual history form a simulated patient (SP). A qualitative grounded theory approach was taken to explore the experience of 32 participants. Qualitative data from the students' reflections following each of their two SP interactions were analysed separately. Initial codes were allocated by two researchers; a coding tree was built. Differences were resolved through negotiation until consensus was reached; the process ensured that rigour and reflexivity in the analysis were both achieved. Overarching themes were agreed along with the grouping of the sub-themes in the write-up of the results. Three themes were identified in the data: (1) realising the importance of understanding a patient's world view in healthcare, (2) becoming aware of need for new skills and (3) using the spiritual care toolbox. A gradual process of enlightenment was demonstrated whereby the students became aware of their own world view and also identified their need to incorporate spiritual care into their communication skills repertoire. The students also realised the importance of the value of spirituality for the patient in healthcare.