Abstract
1.Describe a systematic approach to Spiritual Care (SC) Training for Palliative Care (PC) Physician Fellows.2.Describe the Integration of the Systematic Approach to Spiritual Care (SC) Training into the Palliative Care (PC) Fellowship. Despite evidence and guidelines identifying it as a core dimension of Palliative Care (PC), Spiritual Care (SC) may be the least developed dimension of PC for physicians. The authors developed a SC curriculum for PC fellows to improve their training in spiritual dimensions of care. The goal of the rotation was to 1) gain understanding of PC fellows’ SC experiences and clinical skills over time and 2) identify curricular elements with the most impact on PC fellows. PC Fellowship at Northwestern Feinberg School of Medicine and Northwestern Memorial Hospital (NMH) located in Chicago. This was required, longitudinal nine-month SC curriculum based on literature review, prior experience from both the Palliative and Spiritual Care Teams, and a needs assessment of PC Fellows. The curriculum began and ended with three six-hour days of focused work and met bi-weekly for an hour a total of fourteen times during the academic year. The curriculum included five topics (introduction to SC, conducting a spiritual history, spirituality in self-care and patient care, spiritual-existential distress, and miracle literacy). Fellows participated in interactive didactic sessions, small group discussions, clinical with chaplains, interfaith site visits, synchronized virtual sessions, and experiential and reflective activities. Fellows completed pre and post surveys using a competency scale (Leeuwen et al., 2009), Likert-rated statements, and narrative responses via an exit interview. Fellows reported an increase in perceived competence taking a spiritual history, comfort in working with hospital chaplains, comfort engaging in SC issues with patients and their families, including addressing miracles, and addressing spiritual-existential distress with patients/surrogates. This pilot rotation demonstrated the effectiveness of a required longitudinal SC curriculum as part of a PC fellowship. We believe that this approach can help provide fellows with the tools, skills, and support they need to approach generalist-level spiritual care with their patients and their families.
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