Original Publication
Open Access

Trigger Topics: Where Religion & Health Care Intersect

Published: February 2, 2015 | 10.15766/mep_2374-8265.10007

Included in this publication:

  • Instructor's Guide.pdf
  • Trigger Topics Facilitator's Guide.pdf
  • Trigger Topics PowerPoint.ppt

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Medical education increasingly recognizes that cultural competence is an important component of patient care. However, religion is an aspect of culture that still often goes unaddressed in medical education. The knowledge and skill sets presented in this course provides instruction for preservice physicians on how to address the topic of religion when it impacts patient care and/or patient decision-making. Addressing the religious beliefs of patients as it relates to their health care is an essential component of patient centered care and improves patient satisfaction. This resource addresses this gap in medical education. The course content examines 15 trigger topics where religion often emerges in a health care setting so that medical students can be prepared and proactive in addressing the topic of religion with their patients. Methods: This 90-minute module includes didactic information for an educator to present to a class of students accompanied by case study discussions and activities that can be used to reinforce learning. The materials comprise two documents: a facilitator’s guide and an accompanying PowerPoint presentation. The PowerPoint is designed to be presented in class and the facilitator’s guide provides detailed instructions and helpful strategies for the facilitator on how to effectively convey the information in addition to providing numerous case study discussion activities to reinforce learning. Two examples and one detailed case study discussion activity are included in this module for each of the trigger topics. Results: A version of this curriculum was incorporated into a course titled End of Life Care at Hofstra North Shore-LIJ School of Medicine. In an evaluation the medical students completed after the course, 60% of students agreed or strongly agreed with the following statement: “Session content enhanced my knowledge and/or skills.” In addition, 70% agreed or strongly agreed that the “session was engaging.” Discussion: This module takes a thematic approach because, given the diversity between and within different faith traditions, it is unrealistic to expect health care providers to be familiar with the diversity of patient religious beliefs and practices that they encounter on a daily basis. Moreover, teaching medical students what all Muslims, Christians, Hindus, etc., believe ignores the diversity within these groups and can lead to false assumptions and stereotyping. A more effective and practical strategy of understanding how a patient’s religious beliefs may impact his/her care is by learning to identify certain themes across faith traditions where religion emerges, along with effective strategies and skills for addressing challenges when they emerge.

Educational Objectives

By the end of this session, the learner will be able to:

  1. Define religion as the intersection of three components: culture, belief, and practice.
  2. Recognize the variability and individuality of each person’s religious beliefs based on his or her own unique manifestation of these three elements.
  3. Identify the 15 elements of health care where religion emerges so as to anticipate and address challenges related to patient care.
  4. Analyze where religious challenges may emerge and determine through discussion and dialogue, how these issues can be respectfully approached and resolved.

Author Information

  • Lynn Stoller, MA: Tanenbaum Center for Interreligious Understanding
  • Eliza Blanchard: Tanenbaum Center for Interreligious Understanding
  • Mark Fowler: Tanenbaum Center for Interreligious Understanding

This module was reviewed by eight individuals working in the field of religion, cultural competence, and medical education. Reviewers included:

  • Judith Jacobson, Dr.PH - Associate Professor of Clinical Epidemiology, Columbia University Mailman School of Public Health
  • Ann-Christine Nyquist, MD – Associate Dean of Diversity and Inclusion and Associate Professor of Pediatrics at the University of Colorado School of Medicine; Associate Professor of Community and Behavioral Health, Colorado School of Public Health
  • Geri-Ann Galanti, PhD – Department of Anthropology at California State University, Doctoring Curriculum at the David Geffen School of Medicine at UCLA and author of Caring for Patients from Different Cultures, currently in its 4th edition.
  • Hilit Surowitz-Israel, PhD – Professor in the Department of Religion at Rutgers University.
  • June Jones, PhD – Senior Lecturer in Biomedical Ethics and College Lead on Religious and Cultural Diversity at University of Birmingham, UK.
  • Edward Poliandro, PhD – Assistant Clinical Professor of Preventive Medicine, Social Work and Behavioral Science, Assistant Clinical Professor of Medical Education at Icahn School of Medicine at Mount Sinai.
  • Rabbi Rafael Goldstein – Director of Spiritual Care and Education, Mount Sinai Hospital
  • Dr. Joseph Truglio – Assistant Professor, Departments of Internal Medicine and Pediatrics, The Mount Sinai Medical Center

The materials were sent out with an evaluation form that, in addition to asking for general comments on the strengths and weaknesses of the curriculum, asked reviewers to rate the curriculum and accompanying case studies based on the following criteria:

  • The learning module demonstrates why clinicians should address the topic of religion with patients.
  • The learning module offers practical strategies for identifying when religion and health care intersect.
  • The learning module includes discussion questions that promote reflection and learning.
  • The content is comprehensive—does not have any gaps in essential knowledge and/or skill sets.
  • The PowerPoints are formatted and organized in a way that is easy for educators to use.
  • The facilitator’s guides include clear and comprehensive instructions for implementing the lessons.
  • This curriculum could be easily integrated into a medical institution’s existing curriculum.

Edits and additions were made to the learning module based on the reviewer evaluation responses. After materials were edited, Tanenbaum submitted the modules to reviewers and other experts in the field to ask for an endorsement. A sample of endorsements received are as follows:

  • “The Tanenbaum Center has produced an excellent and informative educational program that should prove useful in training physicians, residents, medical students, and other health professionals to care for patients from diverse religious and cultural backgrounds. Real world clinical cases and interactive exercises help learners develop the knowledge, skills, and attitudes needed to put 'religio-cultural competence into practice.' This program is highly recommended and relevant for addressing national accreditation requirements and competencies relating to spirituality and health.” - Robert C. Like, MD, MS, Professor and Director, Center for Healthy Families and Cultural Diversity, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School
  • “Designed to support non-clergy educators during the challenging experience of incorporating “soft science” concepts of caregiving into the creation and development of physicians. While developed with medical school curriculum in mind, these volumes provide important curricular content for the education of all health professions.” - Deborah Caputo Rosen, RN, PhD and Amy Wilson-Stronks, MPP, CPHQ

None to report.

The Arnold P. Gold Foundation, The Josiah Macy Jr. Foundation and The Louis and Rachel Rudin Foundation provided funding to support the creation and initial piloting of these materials.


  1. ACP Internist. (2000). Talking about organ procurement when one of your patients dies Retrieved from: http://www.acpinternist.org/archives/2000/02/organ.htm
  2. American Academy of Pediatrics. (2011). Policy statement – Ritual genital cutting of female minors. Pediatrics, 1008-1094.
  3. Berry, G. (2010, July 17). Hospice: Angel of mercy or angel of death: A cautionary tale. aish.com. Retrieved from http://www.aish.com/ci/sam/97788234.html
  4. Campenella, K., Korbin, J.E., & Acheson, L. (1993). Pregnancy and childbirth among the Amish. Social Science Medicine, 36(3), 333-342. http://dx.doi.org/10.1016/0277-9536(93)90017-X
  5. Castledine, J. Female genital mutilation: An issue of cultural relativism or human rights. Retrieved from https://www.mtholyoke.edu/acad/intrel/jc.htm
  6. Galanti, G. (2008). Caring for patients from different cultures. Philadadelphia, PA: University of Pennsylvania Press. http://dx.doi.org/10.9783/9780812203479
  7. Greksa, L.P. & Korbin, J.E. (2004). “Amish.” In Encyclopedia of Medical Anthropology, Volume 2: Cultures. C.R. Ember and M. Ember (eds.). New York, NY: Kluwer Academic/Plenum Press, pg. 557-564.
  8. Linnard-Palmer, L. (2006). When parents say no: Religious and cultural influences on pediatric healthcare treatment. Indianapolis, IN: V.G. Reed & Sons.
  9. Living Faith Forum. (2013). The Pentecostal doctrine of healing. Retrieved from http://livingfaithforum.org/healing.html
  10. United Pentecostal Church International. (2011, May 18). Divine healing. Retrieved from http://www.upci.org/resources/instructional-devotional-leadership/87-divine-healing
  11. Padela, A. & Pozo, P. (2007, January). Muslim Patients and cross-gender interactions in medicine: an Islamic bioethical perspective. Journal of Medical Ethics, 37(1), 40. http://dx.doi.org/10.1136/jme.2010.037614
  12. Rice, P.L., Ly, B., & Lumley, J. (1994). Soul loss (poob plig) following a caesarean operation. Medical Journal of Australia, 160. Retrieved from http://uniyatra.com/hmongnet/hmong-au/huplig.htm.
  13. Robinson, G. (2000). Essential Judaism: A complete guide to beliefs, customs, and rituals. New York, NY: Atria Paperback.
  14. Rosner, F. (2005). An observant Jewish physician working in a secular ethical society: Ethical dilemmas. Israel Medical Association Journal, 7, 53-57.
  15. Smith, M. & Lederman Flamm, A. (2011). Accommodating religious beliefs in the ICU: A narrative account of a disputed death. Narrative Inquiry in Bioethics, 1(1), 55-64. http://dx.doi.org/10.1353/nib.2011.0003
  16. Stanford School of Medicine. (2013). Culturally appropriate geriatric care: fund of knowledge. Retrieved from http://geriatrics.stanford.edu/ethnomed/hmong/fund/index.html.
  17. Talati, E. (2012, September 11). Pushing the boundaries: revisiting transfusion of blood products in the children of Jehovah’s Witnesses [Web log post]. Retrieved from http://blogs.law.harvard.edu/billofhealth/2012/09/11/pushing-the-boundaries-revisiting-transfusion-of-blood-products-in-the-children-of-jehovahs-witnesses/
  18. Tanenbaum Center for Interreligious Understanding (2009). The Medical Manual for Religio-Cultural Competence: Caring for religiously diverse populations. New York, NY: Tanenbaum.
  19. Thakrar, D., Das, R. & Sheikh, A. (2008). Caring for Hindu patients. Abingdon, UK: Radcliffe Publishing Ltd.
  20. United States Conference of Catholic Bishops. (2009). “Ethical and Religious Directives for Catholic Health Care Services, Fifth Addition.” Retrieved from http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf.
  21. Valdes, M., Johnson, G., & Cutler, J. (2002). Organ donation after neurologically unsurvivable injury: a case study with ethical implications for physicians. BUMC Proceedings, 15, 129-132.
  22. World Health Organization. (2013, February). Female genital mutilation. Retrieved from http://www.who.int/mediacentre/factsheets/fs241/en/
  23. 42 CFR 482.45 – Condition of participation: Organ, tissue and eye procurement. (1998). Retrieved from Cornell University Law School, Legal Information Institute website: http://www.law.cornell.edu/cfr/text/42/482.45


Stoller L, Blanchard E, Fowler M. Trigger topics: where religion & health care intersect. MedEdPORTAL. 2015;11:10007. https://doi.org/10.15766/mep_2374-8265.10007