NUS Yong Loo Lin School of Medicine, Singapore.
Research Division, Institute of Mental Health, Singapore.
BMJ Open. 2021 May 28;11(5):e044321. doi: 10.1136/bmjopen-2020-044321.
With the increased emphasis on personalised, patient-centred care, there is now greater acceptance and expectation for the physician to address issues related to spirituality and religion (SR) during clinical consultations with patients. In light of the clinical need to improve SR-related training in residency, this review sought to examine the extant literature on the attitudes of residents regarding SR during residency training, impact on clinical care and psychological well-being of residents and SR-related curriculum implemented within various residency programmes.
A scoping review was conducted on studies examining the topic of SR within residency training up until July 2020 on PubMed/Medline and Web of Science databases. Keywords for the literature search included: (Spirituality OR Religion) AND (Residen* OR "Postgraduate Medicine" OR "Post-graduate Medicine" OR "Graduate Medical Education").
Overall, 44 studies were included. The majority were conducted in North America (95.5%) predominantly within family medicine (29.5%), psychiatry (29.5%) and internal medicine (25%) residency programmes. While residents held positive attitudes about the role of SR and impact on patient care (such as better therapeutic relationship, treatment adherence and coping with illness), they often lacked the knowledge and skills to address these issues. Better spiritual well-being of residents was associated with greater sense of work accomplishment, overall self-rated health, decreased burnout and depressive symptoms. SR-related curricula varied from standalone workshops to continuous modules across the training years.
These findings suggest a need to better integrate appropriate SR-related education within residency training. Better engagement of the residents through different pedagogical strategies with supervision, feedback, reflective practice and ongoing faculty and peer support can enhance learning about SR in clinical care. Future studies should identify barriers to SR-related training and evaluate the outcomes of these SR-related curriculum including how they impact the well-being of patients and residents over time.
随着对个性化、以患者为中心的护理的重视日益增加，现在医生在与患者进行临床会诊时，更多地接受并期望解决与精神信仰和宗教相关的问题。鉴于住院医师培训中需要改善与精神信仰和宗教相关的培训，本综述旨在检查现有文献中关于住院医师在住院医师培训期间对精神信仰和宗教相关问题的态度、对临床护理和住院医师心理健康的影响，以及在各种住院医师培训计划中实施的与精神信仰和宗教相关的课程。
对截至 2020 年 7 月在 PubMed/Medline 和 Web of Science 数据库中研究精神信仰和宗教在住院医师培训中的主题的研究进行了范围界定综述。文献检索的关键词包括：（精神信仰或宗教）和（住院医师或“研究生医学”或“研究生医学”或“研究生医学教育”）。
共有 44 项研究被纳入。其中大部分研究（95.5%）来自北美，主要集中在家庭医学（29.5%）、精神病学（29.5%）和内科（25%）住院医师培训项目中。尽管住院医师对精神信仰和宗教的作用及其对患者护理的影响持有积极态度（如更好的治疗关系、治疗依从性和应对疾病），但他们往往缺乏解决这些问题的知识和技能。住院医师的精神健康状况较好与更高的工作成就感、总体自我评估健康状况、降低的倦怠感和抑郁症状有关。与精神信仰和宗教相关的课程从单独的研讨会到整个培训年限的连续模块各不相同。
这些发现表明需要更好地将适当的与精神信仰和宗教相关的教育纳入住院医师培训中。通过监督、反馈、反思实践以及持续的教师和同行支持，通过不同的教学策略更好地吸引住院医师，可以增强他们在临床护理中对精神信仰和宗教的了解。未来的研究应确定与精神信仰和宗教相关的培训障碍，并评估这些与精神信仰和宗教相关的课程的结果，包括它们如何随时间推移影响患者和住院医师的健康。
