Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Acad Med. 2010 Dec;85(12):1897-904. doi: 10.1097/ACM.0b013e3181fa2dd1.
Spiritual care is increasingly recognized as an important component of medical care. Although many primary care residency programs incorporate spiritual care into their curricula, there are currently no consensus guidelines regarding core competencies necessary for primary care training. In 2006, the Society of Teachers of Family Medicine's Interest Group on Spirituality undertook a three-year initiative to address this need. The project leader assembled a diverse panel of eight educators with dual expertise in (1) spirituality and health and (2) family medicine. The multidisciplinary panel members represented different geographic regions and diverse faith traditions and were nationally recognized senior faculty. They underwent three rounds of a modified Delphi technique to achieve initial consensus regarding spiritual care competencies (SCCs) tailored for family medicine residency training, followed by an iterative process of external validation, feedback, and consensus modifications of the SCCs. Panel members identified six knowledge, nine skills, and four attitude core SCCs for use in training and linked these to competencies of the Accreditation Council for Graduate Medical Education. They identified three global competencies for use in promotion and graduation criteria. Defining core competencies in spiritual care clarifies training goals and provides the basis for robust curricula evaluation. Given the breadth of family medicine, these competencies may be adaptable to other primary care fields, to medical and surgical specialties, and to medical student education. Effective training in this area may enhance physicians' ability to attend to the physical, mental, and spiritual needs of patients and better maintain sustainable healing relationships.
精神关怀越来越被认为是医疗保健的一个重要组成部分。尽管许多初级保健住院医师培训计划将精神关怀纳入其课程，但目前尚无关于初级保健培训核心能力的共识指南。2006 年，家庭医学教师学会精神健康兴趣小组开展了一项为期三年的倡议，以满足这一需求。项目负责人组建了一个由八位教育工作者组成的多元化小组，他们在（1）精神与健康和（2）家庭医学方面具有双重专业知识。多学科小组成员代表了不同的地理区域和不同的信仰传统，是全国公认的资深教师。他们经历了三轮修改后的 Delphi 技术，就针对家庭医学住院医师培训量身定制的精神关怀能力（SCC）达成初步共识，然后对 SCC 进行迭代式的外部验证、反馈和共识修改。小组成员确定了六个知识、九个技能和四个态度核心 SCC，用于培训，并将这些与研究生医学教育认证委员会的能力联系起来。他们确定了三个全球能力，用于推广和毕业标准。明确精神关怀的核心能力可以阐明培训目标，并为强大的课程评估提供基础。鉴于家庭医学的广泛性，这些能力可能适用于其他初级保健领域、医疗和外科专业以及医学生教育。在这一领域进行有效的培训可以提高医生满足患者身体、心理和精神需求的能力，并更好地维持可持续的治疗关系。
