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Spirituality and Health: The Development of a Field

Puchalski, Christina M. MD; Blatt, Benjamin MD; Kogan, Mikhail MD; Butler, Amy PhD

doi: 10.1097/ACM.0000000000000083

Spirituality has played a role in health care for centuries, but by the early 20th century, technological advances in diagnosis and treatment overshadowed the more human element of medicine. In response, a core group of medical academics and practitioners launched a movement to reclaim medicine’s spiritual roots, defining spirituality broadly as a search for meaning, purpose, and connectedness. This commentary describes the history of the field of spirituality and health—its origins, its furtherance through the Medical School Objectives Project, and its ultimate incorporation into the curricula of over 75% of U.S. medical schools. The diverse efforts in developing this field within medical education and in national and international organizations created a need for a cohesive framework. The National Competencies in Spirituality and Health—created at a consensus conference of faculty from seven medical schools and reported here for the first time—answered that need.

Also reported are some of the first applications of these competencies—competency-linked curricular projects. This issue of Academic Medicine features articles from three of the participating medical schools as well as one from an additional medical school. This commentary also describes another competency application: the George Washington Institute of Spirituality and Health–Templeton Reflection Rounds initiative, known as G-TRR, which has provided clerkship students with the opportunity, through reflection on their patient encounters, to develop their own inner resources to address the suffering of others. This commentary concludes with the authors’ proposals for future directions for the field.

Supplemental Digital Content is available in the text.

Dr. Puchalski is professor, Medicine and Health Sciences, George Washington School of Medicine, and director, George Washington Institute for Spirituality and Health, Washington, DC.

Dr. Blatt is professor of medicine, and medical director, The Clinical Learning and Simulation Skills (CLASS) Center, George Washington School of Medicine, Washington, DC.

Dr. Kogan is medical director, George Washington Center for Integrative Medicine, Washington, DC.

Dr. Butler is executive director, Foundation Relations, George Washington University, Washington, DC.

Funding/Support: John Templeton Foundation and the FISH (Funding Individual Spiritual Health) Foundation.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Supplemental digital content for this article is available at

Correspondence should be addressed to Dr. Puchalski, 2030 M St. NW, Suite 4014, Washington, DC 20036; telephone: (202) 994-6220; e-mail:

© 2014 by the Association of American Medical Colleges