Development of a spiritual care education matrix: Factors facilitating/hindering improvement of spiritual care competency in student nurses and midwives.

Spiritual care is a fundamental aspect of caring and compassionate nursing/midwifery practice. However, nurses/midwives consistently report feeling unprepared to provide spiritual care for various reasons. A key reason appears to be the lack of structured spiritual care education in undergraduate nursing/midwifery curricula. Between 2016 and 2019, the three-year, European EPICC project ('Enhancing nurses' and midwives' competence in Providing spiritual care through Innovative education and 'Compassionate Care') sought to address gaps in nursing/midwifery competence in spiritual care. A key project output, and the focus of this paper, is the EPICC Gold Standard Matrix for Spiritual Care Education ('EPICC Matrix'), which depicts the complex array of factors hindering/facilitating the development of nursing/midwifery spiritual care competency. The EPICC project followed two major studies that identified factors contributing to nursing/midwifery spiritual care competency development. This evidence, along with the mixed methods focus of the EPICC project to enable co-projection of its outputs informed the development of the EPICC Matrix. The EPICC Matrix was considered to represent 'the cultural, social and political environment in which spiritual care competency develops' in student nurses/midwives. The EPICC Matrix illustrates spiritual care educational considerations during the process of selecting suitable nursing/midwifery students; through the specific aspects of the teaching and learning environment, the student as a person, and the clinical environment in which spiritual care competency develops; and finally, how the student is assessed as competent in providing spiritual care. Recent research supports the use of the EPICC Matrix in undergraduate nursing/midwifery curricula and strengthens the case for support of the other EPICC project outputs, including: the EPICC Spiritual Care Education Standard, EPICC Adoption Toolkit, and the continuation of the EPICC Network. Further testing of the EPICC Matrix to determine its relevance in different cultural/professional contexts within and outside of Europe would be welcomed.

The development of a consensus-based spiritual care education standard for undergraduate nursing and midwifery students: An educational mixed methods study.

AIMS: The aim of this study was to develop a consensus-based Spiritual Care Education Standard for undergraduate N/M students to use in undergraduate programmes. DESIGN: Mixed methods were used consisting of qualitative and quantitative methods based on the principles of Delphi research. METHODS: The sample consisted of a total of 58 (N = 58) participants from 21 European countries. Data collection was conducted from June 2017 - February 2019 and took place in facilitated iterative action learning cycles and online surveys. Data were analysed by descriptive statistics and qualitative analysis. Consensus was stated by >90% agreement. RESULTS: The process resulted in an EPICC Spiritual Care Education Standard consisting of the following four spiritual care competences: Intrapersonal spirituality, Interpersonal spirituality, Spiritual care: assessment and planning, Spiritual care: intervention and evaluation. For every competence, learning outcomes were described in knowledge, skills and attitudes. CONCLUSION: This Standard guides N/M spiritual care education, student assessment and research. It can be the starting point for discussing spiritual care competences in other healthcare professions. Follow-up research should focus on implementation of the standard and on assessment of students' spiritual competence. IMPACT: The Standard guides curriculum and programme development. The Standard guides students in performing their learning process. The Standard provides a frame of reference for policy making and follow-up research.

Design and development of a spiritual care competency framework for pre-registration nurses and midwives: A modified Delphi study.

This is the second of two papers reporting the development of a spiritual care competency framework for pre-registration nurses and midwives as part of a PhD study using an embedded sequential mixed methods eclectic research design. The first paper outlines how 116 competency items were generated from an in-depth review of international literature, and offers a theoretical model to underpin development of the Framework. AIM: This paper reports how the Framework was developed. METHOD/RESULTS: Five focus groups were held with stakeholders in Malta (chaplains/spiritual leaders, undergraduate nursing/midwifery educators, qualified nurses/midwives, parents/carers, patients/clients) to ensure that aspects of spirituality/spiritual care important to them, but not identified in the literature review, were included in the Framework. The resulting 55 competencies in seven domains formed the Delphi Questionnaire which was validated using a two round modified Delphi method involving experts from Malta. The final seven domain 54 item Framework demonstrated good to strong internal consistency, stability and a good fit with a six factor model. CONCLUSION: The Framework's greatest immediate contribution is in its ability to inform undergraduate nursing/midwifery spiritual care curriculum design and delivery. Further development of the Framework could assist in student selection ensuring that the 'art' of nursing/midwifery has parity with the 'science'.

Nurses' and midwives' acquisition of competency in spiritual care: a focus on education.

BACKGROUND: The debate that spirituality is 'caught' in practice rather than 'taught' implies that spiritual awareness comes about through clinical experience and exposure, requiring no formal education and integration within the curricula. This is challenged as it seems that providing students with a 'taught' component equips students with tools to identify and strengthen resources in 'catching' the concept. AIM: This study forms part of a modified Delphi study, which aims to identify the predictive effect of pre- and post-registration 'taught' study units in spiritual care competency of qualified nurses/midwives. METHODS: A purposive sample of 111 nurses and 101 midwives were eligible to participate in the study. Quantitative data were collected by the Spiritual Care Competency Scale (SCCS) (Van Leeuwen et al., 2008) [response rate: nurses (89%; n=99) and midwives (74%; n=75)]. RESULTS: Overall nurses/midwives who had undertaken the study units on spiritual care scored higher in the competency of spiritual care. Although insignificant, nurses scored higher in the overall competency in spiritual care than the midwives. CONCLUSION: 'Taught' study units on spiritual care at pre- or post-registration nursing/midwifery education may contribute towards the acquisition of competency in spiritual care.