To provide high-quality care that is responsive to spiritual concerns within a multicultural context, student physicians and other health care professionals must develop skills in spiritual care and be able to do so with patients from different cultures and different spiritual and religious backgrounds, particularly at the end of life. This article describes the experience of successfully introducing a curriculum on spirituality and multicultural literacy into the required Family Medicine Clerkship at Stanford University School of Medicine. Rather than a program of separate classes on spirituality, culture, and end-of-life care, an effective curriculum includes a matrix of learning activities that address: 1) a cross-cultural approach to spiritual needs, 2) spirituality at the end of life, 3) the impact of cultural values at the end of life, 4) the ways in which cultural and spiritual needs interact at the end of life, and 5) the interface between medical culture and a patient's culture. Integrating spirituality and culture with end-of-life care into the fabric of the medical school curriculum is an essential step toward serving our increasingly multicultural and multireligious society.
