Spirituality Education for Healthcare Providers

Betty R. Ferrell, PhD, RN


October 09, 2015

Teaching Health Care Providers to Provide Spiritual Care: A Pilot Study

Zollfrank AA, Trevino KM, Cadge W, et al
J Palliat Med. 2015;18:408-414

Spiritual Care

Spiritual care is accepted as a key domain in palliative care, yet extensive evidence demonstrates that healthcare professionals lack knowledge and experience in delivering quality spiritual care.[1,2] This study tested a very impressive training program, the Clinical Pastoral Education for Healthcare Providers (CPE-HP), to address this deficiency in care. The study used simple but critical outcomes of the training including the ability and frequency of religious or spiritual care provision, comfort with religious language, and confidence in providing care. Each of these areas was improved by the training.


The literature related to spiritual care is limited, but far less literature has tested interventions to address this deficiency.[2,3,4] The CPE-HP project is impressive for many reasons. It is an intensive education effort carried out over a 5-month period. The education program is 100 hours, which is very comprehensive given that most professionals have only a few hours, if any, of training in spiritual care. The clinical component of 300 hours is also impressive. This total of 400 hours would represent 10 full-time work weeks, which seems like a very generous amount of training. Over 6 years (2003-2009), the program had 55 participants.

The demographics of the participants are interesting, with 82% women, 58% nurses, and 22% physicians. The religious affiliation of the participants was 40% Protestant, 20% Roman Catholic, and 16% Jewish. The participants had an average of almost 12 years of clinical experience.

The study had many important implications. Previous studies have documented that patients' and family caregivers' spirituality has a significant influence on healthcare decisions, with enormous impact on decisions such as code status, artificial hydration and nutrition, and discontinuing life support.[5,6] For all patients, consistent assessment of spiritual needs is an essential step toward culturally respectful care that honors patient goals and values.

This article provides limited detail about what is actually included in both the classroom teaching and in the clinical practicum experience. It will be helpful for these authors to disseminate their program so that others can use it as a model. Furthermore, it is probable that clinical settings will need less intensive training experiences because 400 hours will be unrealistic for many settings.

Overall, this is an important contribution to the literature with excellent outcome data. The field of palliative care has often been criticized as a "black box" with a great deal of mystery about what care is actually provided. These authors and others studying spirituality can best contribute to the field by helping to clarify what is in this black box of spiritual care training.



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