COMMENTARY

Training in Spiritual Care: On the Right Course

Betty R. Ferrell, PhD, RN

Disclosures

December 20, 2016

A Training Program for Spiritual Care

Those in the field of palliative care have voiced significant concerns in recent years about workforce shortages, including a dearth of specialists, and the need to train generalists to meet a burgeoning need for providers. Almost all of this literature has been related to specialist palliative care physician shortages, but a recent article[1] makes an important contribution to the literature by sharing an example of training to prepare interprofessional clinicians as generalists in spiritual care.

The investigators conducted training to prepare 115 clinicians across several disciplines to have generalist knowledge in spiritual care. This education approach was very appropriate, given extensive literature documenting how ill-prepared most clinicians are in spiritual care.

The article describes the very impressive workshop pedagogy and content. A variety of teaching methods were used, including simulations of spiritual care assessment and communication using professional actors. Participants in the workshops (20-30 clinicians per course) completed questionnaires before and after the workshop and 3 months later. The results demonstrated improvement in 15 spiritual generalist skills within three areas (spiritual screening and care plan, provision of spiritual care, and professional development). Fourteen of the 15 skills remained significantly higher at the 3-month follow-up, suggesting that these skills were retained.

Viewpoint

Spiritual care is a key domain of quality palliative care, as documented in national guidelines such as those from the National Consensus Project.[2] Spirituality includes religious beliefs but also encompasses a wide array of concerns including existential issues, meaning, purpose, hope, and forgiveness. The evidence that patients and families want spiritual needs addressed and that positive outcomes result when that care is provided is growing.[3,4,5,6] This article cites the challenges in meeting the recommendations made by many organizations to ensure that spiritual care is provided to patients facing serious illness. A major challenge is meeting these spirituality needs within a culturally diverse society.

This study is innovative in that it was conducted in a children's hospital. The pediatric population has unique needs for spiritual care and is an ideal setting for this work because the field of pediatrics is a model of patient- and family-centered care and interdisciplinary collaboration to deliver that care.

This training program serves as a model for others and could be widely expanded to adult settings and across disease groups and settings. Expanding the generalist level of spiritual care is central to improving palliative care and addressing the very real workforce demands, optimal use of our chaplains as spiritual care specialists, and raising the bar for all clinicians.

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