November 13, 1998

New curriculum to stress patients’ spiritual needs

New curriculum to stress patients' spiritual needs

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Dr. John Tarpley is implementing a program to incorporate patients' spiritual needs into VUSM's curriculum. (Photo by Donna Jones Bailey)

Vanderbilt University School of Medicine has been chosen to receive a $25,000, four-year award to implement a curriculum introducing the connection between spirituality and health in patient care.

The new program will be implemented as soon as possible in various parts of the curriculum. It is designed to encourage both students and faculty to be aware of ‹ and sensitive to ‹ the spiritual needs of patients and their families as they deal with disease, disability and decreasing independence.

VUSM, along with several other of the nation's leading academic medical centers, was recently presented with The John Templeton Spirituality and Medicine Curricular Award by the National Institute for Healthcare Research at the National Press Club in Washington, D.C.

Dr. John L. Tarpley, professor of Surgery, will serve as the course director. He and Dr. Gerald S. Gotterer, associate dean of the School of Medicine, designed the curriculum.

Throughout his medical career, Tarpley has been interested in the spiritual needs of patients and their families. In 1995 a patient, near death, underwent an emergency operation with little chance of surviving. The man developed multi-system organ failur, but survived.

"I never take all hope away from patients but I basically told his family, Œshort of a miracle, he¹s not going to survive.¹ We¹ve done everything we can do medically.¹"

But over the next few weeks, Tarpley, who is also a Baptist deacon, other members of the man¹s health care team, Tarpley¹s church, Sunday School class and choir prayed for the man and his family. When the man walked out of the hospital, Tarpley pondered the connection between prayer and recovery.

"This whole area leaves a lot for interpretation," Tarpley said. "Two people can look at the same event and come to diametrically opposed interpretations or explanations for that event. This whole area of the spirit and prayer has a very high kook factor. There¹s a lot of stuff that¹s been written. Some is very kooky. Some is restrained. It¹s an area that very few people in academics are willing to look into."

It is nearly impossible to conduct scientific experiments that will prove whether or not prayer is helpful in a patient¹s recovery, he said.

"It¹s not like you need 500 prayers in 15 minutes. It¹s not the number and volume and length of prayers. I maintain there is no group in American society who isn¹t being prayed for, but making the connection is just too complex."

Other recipients of the award are Howard University, Harvard University, Medical University of South Carolina, St. Louis University, University of Health Sciences in Kansas City, University of Texas at Galveston, and the University of Virginia.

The course format will be integrated with existing components of the medical school curriculum over the next four years. In the first year, the impact of religious practices and spirituality on health and disease will be introduced in the Human Behavior course as part of the psychological consequences of illness.

In the second year, spiritual and religious history will be incorporated into the Physical Diagnosis course as part of the social history. In the third and fourth year, students will have the opportunity to participate with attending physicians who already incorporate the belief systems of their patients in their day-to-day care.

"A key factor of the Vanderbilt program over the next four years will be to create the environment and culture where it is acceptable to talk to patients at their deepest levels, to treat them in a more integrated manner, and to be less organ-specific. Hence the faculty development portion of the program is a top priority," Tarpley said.

Patients often get divided into their composite parts when they see a health care provider, he said.

"I maintain that the whole is greater than its constituent parts," he said. "Sometimes our patients come here and many of their unspoken worries, fears and concerns are not addressed. They want a physician who can sit down and talk about their fears."

Tarpley, paraphrasing noted author Scott Peck, said if physicians don¹t address their patients' belief systems, they are taking an incomplete history.

"We as individuals are biological, social, psychological and spiritual beings. We are not just molecules, enzymes and synapses. There are things about us that can¹t be readily measured.

"I think the time has come for us all to tell our medical students and our physicians that it may be okay to recognize that our patients are not only physical beings, but also psychological, social and spiritual beings. If we, as health care providers, limit ourselves to only what we can see, touch or feel, then we might be excluding a very important part of our patients."

Gotterer agrees.

"The curriculum recognizes the pluralistic nature of patient views and associations with religion and spirituality and the autonomy of patients to make decision in this realm and does not allow proselytization," he said.