Becoming a Spiritual Care Generalist: Spirituality Training for Palliative Care Fellows (QI640)

Abstract

•Describe a systematic approach to spiritual care training for palliative care physician fellows.•Describe the integration of the systematic approach to spiritual care training into the palliative care fellowship. Despite palliative care's commitment to include spiritual care in patient care, research is lacking regarding competencies or methods for teaching spirituality to palliative care fellows. We developed a chaplain-led rotation to improve our training of palliative care fellows in the spiritual dimensions of care. To pilot a spirituality training program based on clinical pastoral education (CPE) as part of a palliative care fellowship and determine whether educational goals, content, and methods were relevant to learners and to generate hypotheses for future research. Palliative care fellowship at Northwestern Feinberg School of Medicine and Northwestern Memorial Hospital (NMH), the site of an ACGME-accredited palliative care fellowship that trains four fellows per year. The authors designed and implemented a required 9-month spirituality training program. The program used multiple educational strategies including: beginning and ending week-long intensives, monthly 2-hour interdisciplinary discussions, and experiential experiences such as clinical joint visits with chaplains, and interfaith site visits/discussions. Learners completed 3 pre- and postprogram surveys: 1) Spiritual Care Competency Scale (Van Leeuwen, et al 2009), 2) seven Likert-rated statements, 3) narrative responses to report the most useful part of the curriculum and their remaining questions. Four fellows participated and all of them completed all three surveys. Fellows reported increased agreement regarding the appropriateness of inquiring about spiritual and religious beliefs in the clinical encounter, their perceived competence in taking a spiritual history, and their perceived knowledge of available spiritual care resources. Fellows also had an increase in their perceived comfort in working with hospital chaplains, addressing miracles and addressing spiritual-existential distress with patients/surrogates. This pilot spirituality training improved the attitudes and perceived competence in spiritual care of the palliative care fellows. It suggests that a modified CPE program can be an effective approach for training palliative care fellows in spiritual care thereby strengthening comprehensive patient-centered care.