Spirituality in Serious Illness Education: A Narrative Review of Medical School Curricula From 2000 to 2024

Spirituality is increasingly recognized as an integral component of patient-centered care in serious illness. Despite substantial evidence supporting its benefits, the integration of spiritual care into medical education remains inconsistent. This narrative review examines how spiritual care is incorporated into serious illness curricula in medical schools and evaluates its impact on student learning.

Articles published between 2000 and 2024 describing medical school curricula addressing spiritual care in palliative care, serious illness, hospice, or end-of-life care were reviewed. Studies were categorized using the Kirkpatrick 4-tier framework to evaluate educational outcomes.

Among the 1974 studies screened, 85 met the inclusion criteria. Of these, 31 (36.5%) explicitly mentioned spirituality as part of the curricula. Only 16 studies (18.8%) assessed student growth in spiritual care competencies, focusing primarily on student reactions (n = 9), followed by changes in self-reported efficacy (n = 5), knowledge gains (n = 2), and skill gains (n = 1).

Despite evidence linking spirituality to improved health outcomes in serious illness, spiritual care remains underrepresented in medical school curricula. Substantial variability in teaching methods and assessment strategies highlights the need for structured, evidence-informed frameworks to better prepare future physicians to address the spiritual needs of patients facing serious illness.