spirituality and medicine:
curriculum development project


Communication skills


At their beginning of their clinical exposure many medical schools run intensive courses introducing students to the basics of history taking. There may also be other courses run during the clinical years addressing more specific aspects of communication skills, such as breaking bad news or dealing with angry patients.

Since the essence of addressing patients' spiritual needs lies in good communication, and establishing a close therapeutic relationship between doctor and patient, it is important that spiritual issues are addressed thoroughly in communication skills training. In particular, the basic 'clerking' history should be expanded to routinely include a spiritual history, where simple questions are asked about the impact of a patient's illness on them as people.

Several models have been designed to help doctors explore spiritual issues with patients in open and non-threatening ways. Two that have risen to particular prominence are the FICA and HOPE models, which allow a brief exploration of the patients spiritual beliefs and ask how the patient would like them to be addressed by the healthcare team.


» FICA model for spiritual history taking

» HOPE model for spiritual screening

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The Spirituality and Medicine Curriculum Development Project is funded by the Centre for Excellence in Teaching and Learning at Barts and the London School of Medicine and Dentistry.