Health Care Professionals' Reflections on Their Learning as Spiritual Generalists and Integration Into Practice.

INTRODUCTION: Meeting spiritual needs of patients is an important aspect of quality health care, but continuing professional development and training to provide spiritual care remains inadequate. The purpose was to identify participants' learning from simulation-based spiritual generalist workshops and application to practice. METHODS: Interdisciplinary participants completed self-report demographic questionnaires before the workshops and questionnaires after workshops that listed open-ended take-home learning. Responses were analyzed using qualitative content analysis. A subgroup was surveyed 3 to 9 months after training to examine whether and how participants had incorporated workshop learning into clinical work. RESULTS: Workshop participants 181/211 (85.8%) reported learning in four categories: core values and skills of spiritual generalists, understanding spirituality/religion and its role in health care, interfacing with chaplaincy, and interprofessional teamwork. Of the subsample, 73.5% (25/34) completed surveys 3 to 9 months after training. Of those, 25/25 (100%) reported drawing on what they learned in workshops, and 24/25 (96%) reported making clinical practice changes. DISCUSSION: One-day spiritual generalist simulation-based workshops can improve continuing professional development learning experiences to provide generalist level of spiritual care. Workshops offered valuable learning and resulted in applicable clinical skills across professional roles. At 3 to 9 months after training, participants reported improved spiritual screening, recognition of spiritual distress, and referral to chaplaincy.

Efficacy of Training Interprofessional Spiritual Care Generalists.

BACKGROUND: Provision of spiritual/religious (S/R) care has been associated with improvements in patient care, patient-provider relationships, and resource utilization. Clinicians identify a lack of training in S/R care as the primary impediment. The purpose of the study was to evaluate the effectiveness of one-day, simulation-based workshops to prepare interprofessional clinicians to function as capable, confident, and ethical spiritual care generalists. METHODS: Interprofessional practitioners (physicians, nurses, social workers, psychologists, child life specialists) in a quaternary care academic pediatric hospital participated in daylong Spiritual Generalist workshops utilizing professional actors to learn requisite spiritual generalist skills. Participants completed pre- and postworkshop questionnaires on the day of the workshop, and three-month follow-up self-report questionnaires that included 1-5-point Likert scale items focused on 15 spiritual generalist skills. RESULTS: One hundred fifteen interprofessional staff members completed pre- and postquestionnaires and three-month follow-up surveys. Analysis revealed significant mean improvement in all 15 spiritual generalist skills targeted for developing mastery within each of three broad domains: Spiritual Screen and Care Plan, Provision of Spiritual Care, and Professional Development. Although the initial degree of improvement tended to be greater immediately postworkshop, 14 of the 15 spiritual generalist skills remained significantly higher at three months compared to preworkshop. CONCLUSIONS: This daylong workshop of concentrated instruction, including didactics, visual slideshow, simulation of clinical scenarios, and debriefing/discussion components, was efficient and effective in training clinicians from varied disciplines to learn basic generalist-level spiritual care skills and to collaborate more effectively with chaplains, the spiritual specialists.

Matters of spirituality at the end of life in the pediatric intensive care unit.

OBJECTIVE: Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications. METHODS: A qualitative study based on parental responses to open-ended questions on anonymous, self-administered questionnaires was conducted at 3 PICUs in Boston, Massachusetts. Fifty-six parents whose children had died in PICUs after the withdrawal of life-sustaining therapies participated. RESULTS: Overall, spiritual/religious themes were included in the responses of 73% (41 of 56) of parents to questions about what had been most helpful to them and what advice they would offer to others at the end of life. Four explicitly spiritual/religious themes emerged: prayer, faith, access to and care from clergy, and belief in the transcendent quality of the parent-child relationship that endures beyond death. Parents also identified several implicitly spiritual/religious themes, including insight and wisdom; reliance on values; and virtues such as hope, trust, and love. CONCLUSIONS: Many parents drew on and relied on their spirituality to guide them in end-of-life decision-making, to make meaning of the loss, and to sustain them emotionally. Despite the dominance of technology and medical discourse in the ICU, many parents experienced their child's end of life as a spiritual journey. Staff members, hospital chaplains, and community clergy are encouraged to be explicit in their hospitality to parents' spirituality and religious faith, to foster a culture of acceptance and integration of spiritual perspectives, and to work collaboratively to deliver spiritual care.