Teaching Spiritual and Religious Competencies to Psychiatry Residents: A Scoping and Systematic Review.

Abstract

PURPOSE\nFor many persons worldwide, mental health is inseparably linked with spirituality or religion, yet psychiatrists have repeatedly expressed doubts regarding their preparedness to address patients spirituality or religion appropriately. In recent decades, medical educators have developed and implemented curricula for teaching spiritual and religious (S&R) competencies to psychiatry residents. The authors reviewed the literature to understand the scope and effectiveness of these educational initiatives.\n\n\nMETHOD\nThe authors searched eight databases to identify studies for a scoping review and a systematic review. The scoping review explored educational approaches (topics, methods) used in psychiatry residency training programs to teach S&R competencies. The systematic review examined changes in psychiatry trainees competencies and/or in patient outcomes following exposure to these educational interventions.\n\n\nRESULTS\nTwelve studies met criteria for inclusion in the scoping review. All reported providing residents with both (1) a general overview of the intersections between mental health and S&R and (2) training in relevant interviewing and assessment skills. Seven of these studies - representing an estimated 218 postgraduate psychiatry trainees and at least 84 patients - were included in the systematic review. Residents generally rated themselves as being more competent in addressing patients spirituality or religious concerns following the trainings. One randomized controlled trial found that patients with severe mental illness who were treated by residents trained in S&R competencies attended more appointments than control patients.\n\n\nCONCLUSIONS\nS&R educational interventions appeared generally well-tolerated and appreciated by psychiatry trainees and their patients; however, some topics (e.g., Alcoholics Anonymous) received infrequent emphasis, and some experiential teaching methodologies (e.g., attending chaplaincy rounds) were less frequently used for psychiatry residents than for medical students. The positive association between teaching S&R competencies to psychiatry residents and patient appointment attendance merits further study. Future trainings should supplement classroom learning with experiential approaches and incorporate objective measures of resident competence.