ACPE Research

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2018 News 

Newsletter Volume 17 — New Format
Edited by Chaplain John Ehman



  1.     The ACPE Research Committee Begins Work: An Update, by Judith Ragsdale   (pub. 3/11/18)
  2.     ACPE Research Community of Practice (CoP)   (pub. 3/11/18)
  3.     ACPE National Conference Workshops Focusing on Research   (pub. 3/11/18)
  4.     Research Themes for the 2018 APC/NACC Joint Conference   (pub. 3/11/18)
  5.     Joint Commission Article Supporting Chaplains Emphasizes Research   (pub. 3/11/18)
  6.     Chaplains Facilitating Advance Directive Completion Project Reported in JAMA Internal Medicine   (pub. 3/11/18)



1.   The ACPE Research Committee Begins Work: An Update, by Judith Ragsdale  (pub. 3/11/18)

The ACPE's newly established board-level Research Committee has gotten under way and met by conference call on February 8, 2018 to discuss overall plans and the elements of its charge from the ACPE Board, including:

  1. Identify and establish research priorities for ACPE sponsorship and engagement with a horizon of at least three years.
  2. Facilitate and collaborate with research focused on the education of CPE supervisors, providers of spiritual care, and spiritual health educators.
  3. Identify and collaborate with formal and informal leaders in research areas of direct interest to ACPE, including but not limited to the Joint Research Council and the Transforming Chaplaincy initiatives.
  4. Work with FCPE grant processes and ACPE budget processes to fund research that advances the mission of ACPE; establish and maintain processes to evaluate, approve, and monitor progress of FCPE and ACPE funded research.
We are excited ACPE is embracing research as a key aspect of our mission. We hope to guide ACPE in considering how relevant research could beneficially impact our outcomes and education practices. Over the next months, the Committee plans to identify our individual perceptions of ACPE research priorities and gather information from our cognate groups about what they identify as research priorities in ACPE. Our goal is to clarify ACPE research priorities at our ACPE national meeting in May. Our Research website will continue to note developments.

Members of the Committee are: Judy Ragsdale (chair), Moses Taiwo (chair elect), Henry Heffernan, Niyoka Nelson, Angela Obu-Anukam; Ramona Reynolds, Michael Doane, Heather Weidemann, Mark Lee, Angelika Zollfrank, and Csaba Szilagyi. We welcome hearing your thoughts about research priorities for ACPE.



2.   Update on the ACPE's Research Community of Practice (CoP)  (pub. 3/11/18)

The ACPE's newly established Research Community of Practice (CoP) is in the process of formation with the help of its convener, Michael Doane, ACPE Educator and System Director for University of Minnesota Health Spiritual Health Services. Interest in participation has been strong, and Rev. Doane plans to conduct a survey of existing members to better understand areas and levels of member interest. Additionally, he will work closely with the newly formed ACPE Research Committee to foster collaboration and communication.

Communities of Practice have been designated a "flagship activity" for the ACPE, which defines them as "a group of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly." CoPs "anchor us in our grassroots tradition" and have three primary purposes:
  1. To foster supportive and challenging relationships among colleagues,
  2. To promote best practices in the field of clinical pastoral education (CPE), and
  3. To provide ongoing professional development for CPE educators, students and clinical members.

The Research CoP will be part of the Communities of Practice "Fishbowl" event at the May 9-11, 2018 ACPE national conference in Atlanta, GA --on Thursday, May 10th, 10:30 AM - 1:30 PM.

The Research website will continue to note developments.

You may contact Rev. Doane for more information or to join the CoP through



3.   Research-Related Workshops at the ACPE's 2018 National Conference  --Notes by John Ehman  (pub. 3/11/18)

The ACPE's national conference in Atlanta, GA, May 9-11, 2018, will offer eight workshops, three of which mention research in their official descriptions.

  • Compassion-Centered Spiritual Health: Insights from Cognitively-Based Compassion Training (Thursday, May 10, 2018 @ 1:45 PM - 3:15 PM) — Presented by Timothy Harrison and Maureen Jenci Shelton — This workshop explores Cognitively-Based Compassion Training (CBCT), a systematic approach to cultivating compassion (as distinct from empathy) as a skill important for the practice of healthcare professionals. The plan for the session includes the goal: "Become familiar with the research-based benefits of CBCT and the growing field of compassion science."

  • Philanthropy and the Future of CPE (Thursday, May 10, 2018 @ 1:45 PM - 3:15 PM) — Presented by Russell H. Davis and T. Greg Prince — While focusing on strategies for building financial support for CPE programs and spiritual care initiatives, this workshop covers "[f]indings from a survey of CPE Centers" on the topic.

  • Lessons from the Field: Reflections on Past Innovative CPE Projects (Friday, May 11, 2018 @ 1:30 PM - 4:30 PM) — Presented/Moderated by Jasmine Okafor — This workshop offers a panel of past recipients of Innovative Program Awards: grant funds awarded by the ACPE Foundation to support innovative CPE projects that expand CPE into new settings, and/or test new research, methodology or pastoral theology. Panelists will discuss lessons learned from implementing their projects and offer suggestions for how others might design innovative CPE programs.

NOTE: In addition, the new Research Community of Practice (CoP) will be part of the Communities of Practice "Fishbowl" event on Thursday, May 10th from 10:30 AM to 1:30 PM.



4.   Research Themes for the 2018 APC/NACC Joint Conference  (pub. 3/11/18)

The Association of Professional Chaplains and the National Association of Catholic Chaplains will hold a joint conference, July 12-15, 2018 in Anaheim, CA, with one of the event's keynote themes being Empowering the Profession through Research. On Saturday, July 14th at 12:00 Noon, plenary speaker Steve Nolan, PhD, Chaplain at Princess Alice Hospice (Esher, UK) and Visiting Research Fellow, University of Winchester (UK) will present on "Lifting the Lid on Chaplaincy: A First Look at Findings from Chaplains' Case Study Research" --a review of the current state of chaplains' case study research providing insight into how colleagues understand what a difference chaplains make.

Also, the conference will offer variety of Professional Development Initiatives and Workshops that revolve around or emphasize research. The following are listed in chronological order. (Note that some are pre-conference activities.)

  • Outcomes-based Healthcare Chaplaincy: Introducing the Religious Comfort Index (RCI) (Wednesday, July 11, 2018 @ 8:00 AM - 5:00 PM) — Professional Development Intensive presented by Jack D. Giddens. — OBJECTIVES: To introduce results of a research project that establishes the impact and effectiveness of the Religious Comfort Index (RCI), an outcomes-based metric and system for practicing healthcare chaplaincy; to teach clinical patient skills and a departmental systematic approach to implementing an outcomes-based approach to healthcare chaplaincy as demonstrated by the Religious Comfort Index (RCI) system; and to present the relationship and impact of the Religious Comfort Index (RCI) metric and system on patient satisfaction as measured by HCAHPS scores. — DESCRIPTION: This session intends to introduce clinical skill developments, collaborative departmental developments, and the impact of chaplain interventions on HCAHPS scores from a research project conducted from October 2017 - March 2018 at Providence Hospital in Mobile, Alabama in Collaboration with Ascension Health, Inc., using the Religious Comfort Index (RCI), a metric and system for conducting outcomes-based healthcare chaplaincy co-invented by Dr. Jack D. Giddens, DMIN, BCC, CTP, Catholic Chaplain at Providence Hospital and Instructor of Religion at the University of West Florida; and Dr. Harold G. Koenig, MD, Psychiatrist, Professor, and Director of the Center for Spirituality, Theology and Health at Duke University Medical School.

  • Turing a Chaplain Story Into a Chaplain Case Study: a Practical Masterclass in Writing for Publication (Wednesday, July 11, 2018 @ 8:00 AM - 5:00 PM) — Professional Development Intensive presented by Steve Nolan. — OBJECTIVES: Understand the use of chaplain case studies for research and advancing the profession; understand the value of writing a chaplain case study for continuing professional development; and hone skills in writing their own chaplain case study with a view to publication. — DESCRIPTION: Experienced chaplains (minimum 3 years' experience) bring two pieces of written work (each around 2000 words) to the Intensive: one describing their chaplaincy-patient relationship (including some verbatim recording); one analyzing their work (their "Assessment of Spiritual Need," their "Interventions," and the patient "Outcomes"). Participants will work in peer-groups with the tutor to develop their case study towards publication. Following the Intensive, the tutor offers an additional hour's online consultation with each participant, helping them prepare their case towards submission to a peer-reviewed journal. The tutor does not guarantee any participant will have their work published. — Recommended Reading: Fitchett, G. and Nolan, S., Spiritual Care in Practice: Case Studies in Healthcare Chaplaincy (London/Philadelphia: Jessica Kingsley Publishers, 2015); Fitchett, G., "Making our case(s)," Journal of Health Care Chaplaincy 17, nos. 1-2 (2011): 3-18; and McCurdy, D. B. and Fitchett, G., "Ethical issues in case study publication: 'making our case(s)' ethically," Journal of Health Care Chaplaincy 17, nos. 1-2 (2011): 55-74.

  • Human Trafficking and Spiritual Care: Developing and Sustaining Spiritual Care Initiatives with Victims and Survivors (Wednesday, July 11, 2018 @ 8:00 AM - 5:00 PM) — Professional Development Intensive presented by Penny Stacy. — OBJECTIVES: To intentionally and critically examine the role Spiritual Care has in the field of Human Trafficking; to become familiar with evidence that persons who have been trafficked can have a spiritual perspective about their experience characterized by resilience and a desire to share new found wisdom; and to help chaplains develop and maintain research protocols/literacy, including the ability to critically read research and, where appropriate, apply findings in their professional practice. — DESCRIPTION: A key challenge for Spiritual Care providers is identifying characteristics of a Human Trafficking victim and ministering to them. Spiritual Care is a key component in helping victims begin inner healing. This professional development intensive is presented by a 17 year survivor of Human Trafficking who is also a Board Certified Chaplain. This educational opportunity will use lecture and interactive experiential research to meet educational objectives. This activity is appropriate for all attendees, including those just starting out or those who are looking to expand their skills in providing spiritual care to this population. The presenter will utilize real case examples to help attendees develop strategies to help themselves, colleagues and survivors with spiritual struggles around this topic. — Recommended Reading: Cooper-White, P., The Cry of Tamar: Violence against Women and the Church's Response (Minneapolis, MN: Fortress Press, 1995, 2012); Wilson, J. M. and Dalton, E., Human Trafficking in Ohio: Markets, Responses, and Considerations (Santa Monica, CA: Rand, 2007); and Lloyd, R., Girls Like Us: Fighting for a World Where Girls Are Not for Sale, an Activist Finds Her Calling and Heals Herself (New York: HarperCollins Publishers, 2011).

  • The Value and Practice of Qualitative Research in Spiritual Care (Wednesday, July 11, 2018 @ 8:00 AM - 5:00 PM) — Professional Development Intensive presented by Tim Cranfill. — OBJECTIVES: Demonstrate an understanding of purposes and values of qualitative research in general; demonstrate an understanding of the components and processes involved in qualitative research as applied to spiritual/pastoral care; and conduct a basic qualitative research project of their own. — DESCRIPTION: This workshop will introduce basic and intermediate qualitative research methods to the participants, facilitate an understanding of the general value of qualitative studies, and explore how qualitative studies can specifically relate to and have significant value for spiritual care. Issues such as research validity, protection of human subjects, ethical and legal requirements for the use of an IRB will be discussed along with the processes involved in conducting a qualitative study. A minimum of three specific qualitative methodologies will be introduced. The workshop will include an experiential component where the participants will conduct a "mini-interview" and participate in a coding, analysis and interpretation exercise. Participants will discover the implications of qualitative studies for spiritual care, examples of what qualitative data can tell us, and what care and intervention directions qualitative data can suggest for the provision of spiritual care. As pastoral/spiritual caregivers, we already do this work intuitively with our patients on a day to day basis, why not make the leap to utilizing our current skills as tools for research? As chaplains, we value the judicious use of self in our interactions with patients and one another. In much the same way, qualitative research values the judicious use of the self of the researcher --as the researcher is the tool in qualitative research. The primary aim of this workshop is to enable and encourage participants to return to their home environments and engage in improving the quality of care through the use and application of qualitative research. The secondary aim of this workshop is to encourage and engage participants to contribute to the existing literature on spiritual/pastoral care through the implementation and application of basic, intermediate, and sophisticated qualitative studies. — Recommended Reading: Maxwell, J. A., Qualitative Research Design: An Interactive Approach 3rd. ed. (Thousand Oaks, CA: Sage Publications, 2013).

  • Intentional Caring: An Introduction to Outcome Oriented Chaplaincy (Wednesday, July 11, 2018 @ 8:00 AM - 5:00 PM) — Professional Development Intensive presented by Brent Peery. — OBJECTIVES: Understand the historical and theoretical development of outcome oriented chaplaincy; articulate the components of outcome oriented chaplaincy; and demonstrate the practice of outcome oriented chaplaincy. — DESCRIPTION: A confluence of movements within chaplaincy, healthcare and broader culture have made Outcome Oriented Chaplaincy (OOC) a timely topic. We will discuss how OOC can help chaplains provide better care and demonstrate their value within a milieu of evidence-based medicine and organizational quality improvement. — Recommended Reading: Fitchett, G., Assessing Spiritual Needs: A Guide for Caregivers (Lima, OH: Academic Renewal Press, 2002); and Roberts, S., ed., Professional Spiritual and Pastoral Care: A Practical Clergy and Chaplain's Handbook (Woodstock, VT: SkyLight Paths Publishing, 2011).

  • Quantitative Research for Beginners (Thursday, July 12, 2018 @ 8:00 AM - 12:00 PM) — Professional Development Intensive presented by George Fitchett, Kelsey White, and Kathryn Lyndes. — OBJECTIVES: Participants will be able to read and interpret tables with simple research findings; participants will be able to explain the meaning of significant and non-significant findings; and participants will have greater confidence for reading chaplaincy-related research and applying findings to their chaplaincy practice. — DESCRIPTION: The workshop will introduce participants to 3 of the most common statistical procedures used in quantitative research: 1) comparing means or proportion of two groups; 2) testing the association between two variables (correlation); and 3) testing the association between two variables while adjusting for the effects of other factors (multiple regression). The workshop will also introduce participants to significance testing (p values). Each of these procedures will be illustrated with reports (tables) from chaplaincy research. Participants will have the opportunity to work in small groups to apply their learning to the interpretation of additional tables from chaplaincy research. — Recommended Reading: Koenig, H. G., Spirituality and Health Research: Methods, Measurement, Statistics, and Resources (West Conshohocken, PA: Templeton Press, 2011); Fitchett, G., White, K. and Lyndes, K., eds., Evidence-Based Healthcare Chaplaincy: A Research Reader (Jessica Kingsley Publishers, forthcoming 2018); and Myers, G. E with Roberts, S., An Invitation to Chaplaincy Research: Entering the Process (John Templeton Foundation, 2014), available online.

  • Case Studies: Working with a Format. Dutch Case Studies Project. (Thursday, July 12, 2018 @ 8:00 AM - 12:00 PM) — Professional Development Intensive presented by Martin Walton. — OBJECTIVES: Write a case study in a reflective format; more concretely describe the intentions, theoretical perspectives and outcomes in a case study; and discuss and evaluate case studies in a group using an appreciative approach. — DESCRIPTION: The Dutch Case Studies Project in Chaplaincy Care has developed a reflective format for describing case studies in chaplaincy care and an appreciative approach to the evaluation of cases studies in research communities of chaplains. The PDI participants will be introduced to the format which pays particular attention to issues of context, theory and practice, sense perceptions and the description of outcomes with feedback from clients and client systems. The participant group will subsequently function as a temporary research community in the evaluation of a written case study. — Recommended Reading: Fitchett, G. and S. Nolan, S., Spiritual Care in Practice. Case Studies in Healthcare Chaplaincy (London/Philadelphia: Jessica Kingsley Publishers 2015); Health and Social Care Chaplaincy special issue on chaplains' case studies, publication forthcoming in Spring 2018.

  • Analyzing Chaplain Interventions: Presentation and Analysis of a Performance Improvement Initiative (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by Timothy Ford and Alexander Tartaglia. — OBJECTIVES: Identify opportunities for performance improvement for chaplain documentation; discuss "best practice" relationships for chaplain assessment and intervention; and design training interventions to enhance spiritual care documentation and communication. — DESCRIPTION: How do chaplains chart what they do? As part of an ongoing analysis of chaplain electronic charting at one academic medical center, we analyzed our database of over 100,000 charts to determine the relationship between spiritual assessments and chaplain interventions. Findings led to the development of a review by department staff and initiation of a focused intervention for improvement. Presentation will review the analysis of findings and discuss implications for future research opportunities.

  • The Spirituality and Science of Self-Compassion (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by Anne Kertz Kernion. — OBJECTIVES: Identify the 3 components of Self-Compassion; list the 5 paths to Self-Compassion; and be able to practice and share techniques to foster Self-Compassion. — DESCRIPTION: Much of current research is confirming the teachings of ancient wisdom traditions about compassion and self-compassion. This workshop will briefly discuss the neurobiological roots of our survival system and how these impact our ability to be compassionate with both ourselves and others. We'll also cover the ways Self-Compassion can improve our health and wellness, allowing us to serve our communities with more energy and joy. Helpful tips on how to practice Self-Compassion (both for ourselves and others) will be included in this multimedia presentation. — Recommended Reading: Neff, K., Self-Compassion: The Proven Power of Being Kind to Yourself (New York: William Morrow, 2011).

  • Inter-professional Shared Decision Making: Chaplains as Partners (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by M. Jeanne Wirspa and Karen Pugliese. — OBJECTIVES: Understand the concept of shared decision making (SDM) as central to patient-centered care; examine how chaplains are positioned to address 3 major barriers to shared decision making identified in the medical literature; and explore a new conceptual model for shared decision making: inter-professional SDM that includes the professional healthcare chaplain. — DESCRIPTION: Shared decision making (SDM) is a cornerstone of patient-centered care, pairs the expertise of medical providers with the values, beliefs and goals of the patient. The majority of studies on SDM focus on the physician-patient dyad, with some attention to the role of nurses. Scant research exists on the role played by other members of the healthcare team. This workshop draws on original research into how chaplains contribute to SDM and promotes their role in addressing the following barriers to SDM: 1) The lack of attention to religion/spirituality by other members of the healthcare team; 2) The lack of attention to the patient story and values embedded therein; and 3) medical culture's fast pace, fragmented doctor-patient relationship, and obfuscating use of medical jargon. — Recommended Reading: Charles, C., Gafni, A. and Whelan T., "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science and Medicine 49, no. 5 (September 1999): 651-661; Sohi, J., Champagne, M. and Shidler, S., "Improving health care professionals' collaboration to facilitate patient participation in decisions regarding life-prolonging care: an action research project," Journal of Interprofessional Care 29, no. 5 (2015): 409-414; and White, D. B., "Strategies to support surrogate decision makers of patients with chronic critical illness: the search continues," JAMA 316, no. 1 (July 5, 2016): 35-37.

  • Spiritual and Religious Coping of Medical Decision Makers for Hospitalized Older Adult Patients (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by Saneta Maiko. — OBJECTIVES: Investigate the spiritual and religious coping among medical decision makers for critically ill hospitalized patients; clarify the unique findings from all dimensions of spirituality and religion and how they play a role among medical decision makers; and ponder a new way for spiritual and religious care approach that integrates the medical team, family and the community. — DESCRIPTION: Making medical decisions on behalf of others produces emotional distress. Through our research, we have found that spirituality and religion (S/R) have been found to provide significant assistance to cope with this distress, including five key spiritual and religious resources that every patient and family care provider must know. The coping resources identified in this study may guide professional chaplains to design a patient-based and outcome-oriented intervention to reduce surrogate stress, improve communication, patient and surrogate satisfaction, and increase surrogate integration in patient care. — Recommended Reading: Schenker, Y., White, D. B., Crowley-Matoka, M., Dohan, D., Tiver, G. A. and Arnold, R. M., "'It hurts to know... and it helps': exploring how surrogates in the ICU cope with prognostic information," Journal of Palliative Medicine 16, no. 3 (March 2013): 243-249; Geros, K. N., Ivy, S. S., Montz, K., Bohan, S. E. and Torke, A. M., "Religion and spirituality in surrogate decision making for hospitalized older adults," Journal of Religion and Health 55, no. 3 (June 2016): 765-777; and Torke, A. M., Wocial, L. D., Johns, S. A., Sachs, G. A., Callahan, C. M., Bosslet, G. T., Slaven, J. E., Perkins, S. M., Hickman, S. E., Montz, K., Burke, E. S., "The family navigator: a pilot intervention to support Intensive Care Unit family surrogates," American Journal of Critical Care 25, no. 6 (November 2016): 498-507.

  • Simplifying Research: Observations and Advice from a Chaplain Who Chairs an IRB (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by Dane R. Sommer. — OBJECTIVES: Participants will review the history of human subjects' research and the mandated establishment of Institutional Review Boards; participants will understand the basic inner-workings of an Institutional Review Board; and participants will strategize how to overcome some of the basic barriers to research that many chaplains face. — DESCRIPTION: Research is the lifeblood of all medical advancements. It is also the most important bridge to future staffing and programmatic development for nearly all chaplain initiatives. Many chaplains are deeply engaged in innovative and creative programs that bring healing and wholeness to patients, families and staff. But we are hesitant to engage in the human subject's research because of difficulty with the development of research proposals and IRB approval. As someone who has been an IRB member for over 25 years and an IRB Chair for over 7 years, and as a researcher, the overall goal of this workshop is to demystify the creative process of transforming a creative idea about research to the ultimate goal of IRB approval. Time will be given for participants to "think out loud" about their ideas for research.

  • Compassion-Centered Spiritual Health: Insights from CBCT®, Emory University's Program in Compassion (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by Maureen Jenci Shelton. — OBJECTIVES: Describe the rationale, insights, and practical approach of Emory University's CBCT® (Cognitively-Based Compassion Training), a contemplative program designed specifically to cultivate and sustain compassion in a way that is accessible to people of any-or no-faith tradition; gain an introductory experience of several of CBCT's® distinct reflective exercises, each of which is designed to build skills to support the professional and personal well-being of spiritual care responders; explain how compassion and well-being are skills that can be practiced and developed systematically; and understand the rationale for bringing these skills to spiritual care professionals in order to address personal and professional risks of burnout, depression, and anxiety. — DESCRIPTION: Through the experience of several contemplative exercises, this interactive workshop will introduce participants to CBCT's® approach to expanding and deepening compassion (as distinct from empathy) while avoiding the deleterious impacts of empathetic distress or fatigue. The participant will gain familiarity with research-based benefits of CBCT® and the growing field of compassion science. Participants will also learn about the collaboration of Spiritual Health at Emory Healthcare and Emory's Center for Contemplative Science and Compassion-Based Ethics and their ongoing research into the benefits of formalized compassion training within the field of Chaplaincy.

  • What Is a Chaplain Doing in My Doctor's office? Quality of Life Outcomes in Outpatient Oncology (Friday, July 13, 2018 @ 11:15 AM - 12:45 PM) — Workshop presented by Katie Pakos Rimer and Mary Buss. — OBJECTIVES: Consider the impact of embedded palliative and spiritual care on quality of life outcomes for advanced cancer population; survey the content of spiritual care interventions in a dynamic, outpatient, interdisciplinary palliative care oncology setting; and analyze operational challenges to providing spiritual care in a dynamic, outpatient, clinical trial-based oncology clinic in an academic medical center. — DESCRIPTION: In this presentation we will reveal initial findings from our study of the impact of embedded palliative care in an outpatient oncology setting in an academic medical center. We compared several quality of life outcomes (based on the Edmunton Symptom Assessment Scale and FACT spiritual assessment tool) for patients living with advanced cancer and treated by the same oncologists, one with embedded palliative care (palliative care physician and chaplain), and the other without. We will discuss the nature of the spiritual care interventions, the difference in the quality of life outcomes between the two patient populations, and the challenges of providing spiritual care in a setting where patients, families, and even physicians may not expect it.

  • Community Partnerships and Cultural Humility: Keys for Intercultural Spiritual Care (Saturday, July 14, 2018 @ 10:15 - 11:45 AM) — Workshop presented by Andrea Cano and Hilda Lethe-Drake. — OBJECTIVES: Assess own understanding of intercultural issues, unconscious bias, and impact on spiritual care; map cultural assets, communities, organizations in patient service areas to build relationships, enhance knowledge, deepen capacity, improve patient and family centered care, and set metrics; and determine ways to advance and maintain intercultural perspectives in chaplaincy standards of care. — DESCRIPTION: This session explores the scope of intercultural perspectives from racial ethnic, gender identity, class, culture, literacy, and geographic distinctions of rural, urban, frontier communities. Invites interactive wisdom sharing with workshop attendees about challenges and effective strategies. Offers chaplain survey results of best practices and issues yet to resolve. Suggests tools and models for personal assessment, cultural mapping, engaging distinct populations, and outcomes for community benefit. Provides a bibliography and webography of recent research and information resources.

  • Bereavement Follow-Up Care and Quality Improvement Research: Chaplains Can Do Both (Saturday, July 14, 2018 @ 10:15 - 11:45 AM) — Workshop presented by Chuck Christie and Anita Renahan-White. — OBJECTIVES: Describe steps in designing and implementing a Quality Improvement Initiative; imagine the implementation and practical application of a Chaplain Led Bereavement Follow-Up Project with a Quality Research Component; and begin planning their own care/quality initiative. — DESCRIPTION: Based on a Chaplain-led bereavement program for the next-of-kin (NOK) of patients who have died on the Palliative Care Service. The program has a two-pronged purpose: First, to provide chaplain-led bereavement care to families of the Palliative Care Service. Second, to retain, gather and sort data gleaned from bereavement care to identify quality improvement opportunities in EOL care by the Palliative Care Team and the Medical Center. The Workshop will discuss the steps in designing, implementing, and evaluating a care initiative with a quality research component. Participants will have the opportunity to imagine their own care/quality initiatives.

  • The Role of Shadowing in Chaplain Education: Report of a Study Among Palliative Care Chaplains (Saturday, July 14, 2018 @ 10:15 - 11:45 AM) — Workshop presented by Karen Pugliese, George Fitchett, and Casey Ritchie Clevenger. — OBJECTIVES: Examine the results of a qualitative research study on the impact of shadowing as an effective learning methodology for advancing chaplains' professional practice in Palliative Medicine; discuss the benefits and challenges of chaplain observation for fellows, mentors and their respective Palliative Care Teams; and explore future research opportunities using qualitative analysis and evaluation of shadowing in chaplain education, training and supervision. — DESCRIPTION: The workshop will report findings of a study of shadowing among professional chaplains who participated in a 2-year Palliative Medicine education program. During the program chaplain fellows spent 40 hours shadowing (observing) several chaplain mentors. Key findings from interviews with the 7 fellows and 5 mentors will be presented. Additional themes will be highlighted by a panel of several fellows and mentors who participated in the project. Workshop participants will have an opportunity to discuss the implications of the study findings for chaplain education (basic education, specialty education e.g., palliative care, and continuing education).

  • Transforming Chaplaincy Roundtable: A Review of the Emerging Research in the Field (Saturday, July 14, 2018 @ 10:15 - 11:45 AM) — Workshop presented by Geila Rajaee, Allison Delaney, and John Betz. — OBJECTIVES: Expose participants to emerging research in the chaplaincy field; and provide a bridge between research and clinical practice. — DESCRIPTION: This workshop will provide an opportunity for the Transforming Chaplaincy Fellows (Cohort 1) to share their experiences and knowledge in the emerging field of research and clinical practice as it relates to chaplaincy.

  • Spirituality as an Inherently Psychological Process: Integrating Evidence Based Practices from the Field of Psychology to Create Effective Pastoral Interventions (Saturday, July 14, 2018 @ 10:15 - 11:45 AM) — Workshop presented by Michael Sibley. — OBJECTIVES: The participants will be able to find and evaluate appropriate sources of evidence based literature from the field of psychology and be able to consider the source's capacity to inform a potential pastoral intervention or care technique; the participants will be able to recognize the value of the evidence base from the field of psychology in formulating and delivering pastoral interventions and will learn methods to integrate this evidence base toward their work in their current ministerial context; the participants will be able to take evidence based practices from the field of psychology and utilize them in developing effective pastoral interventions and creating sound evidence based practice in the field of pastoral care moving ultimately toward developing a body of evidence based information that can guide the field of pastoral care and counseling. — DESCRIPTION: A review of the literature related to pastoral interventions in a psychiatric context renders very little in the way of evidence based practice related to effective pastoral interventions for psychiatric patients. The field of psychology, on the other hand possesses a wealth of evidence based interventions and techniques. By integrating the techniques supported by the evidence in the field of psychology with best practices and "doing what works" from a pastoral care perspective, effective pastoral support can occur as the evidence base from the field of psychology can serve as a scaffold for the field of pastoral care as it seeks to develop its own evidence based practice. The purpose of this presentation is to discuss the interplay between psychological interventions and pastoral interventions recognizing that the process by which people grow and develop spiritually also is an inherently psychological process contributing to psychological growth as well. With that in mind, all pastoral interventions have a psychological underpinning as spirituality and the processing of religion is an inherently psychological process. Moving forward, these disciplines have the capacity to inform one another and work together to build interventions and move evidence based practice forward for both the fields of psychology and pastoral care and counseling.

  • Evaluating the Impact of Chaplain Care on End-of-Life Outcomes in the ICU (Saturday, July 14, 2018 @ 3:00 - 4:30 PM) — Workshop presented by George Fitchett, Alexia Torke, Daniel Grossoehme, and Kristen Schenk. — OBJECTIVES: Describe impact of chaplain care on length of stay for patients who die in ICUs; describe care provided by chaplains for patients/family members when patients die in ICUs; and discuss implications of research for making the case for provision of spiritual care in ICUs. — DESCRIPTION: This workshop will describe a three-month retrospective chart review study exploring association between chaplain spiritual care and end-of-life outcomes in ICUs. Documentation of chaplain care at six ICU sites (two academic medical centers with board-certified chaplains, two academic medical centers with student chaplains, and two faith-based community hospitals with board-certified chaplains) will be analyzed for a) associations between chaplain care and end-of-life outcomes (length of stay, code status, palliative care, advance directives, and withdrawal of treatment) for patients with advanced illness admitted to ICUs; and b) variations by institution (academic versus community) and chaplain experience (staff versus student).

  • Spirituality in the Context of Vicarious Trauma (Sunday, July 15, 2018 @ 8:15 - 9:45 AM) — Workshop presented by Beth Muehlhausen. — OBJECTIVES: Articulate a beginning understanding of qualitative research, specifically phenomenology methodology; identify spiritual patterns that aid in coping with vicarious trauma; and discuss implications for spiritual care departments in caring for front line staff who work with trauma patients and their families. — DESCRIPTION: This workshop will share findings from a qualitative research project that sought to understand the role of spirituality in vicarious trauma. Doctors, nurse practitioners and physicians' assistants who work directly with trauma patients were interviewed in person regarding how their spirituality impacted their work and how their work impacted their spiritual beliefs. The 24 research participants included 19 Christians, 1 Conservative Jew, 1 Hindu, 1 Muslim and 2 Humanists. Physicians represented surgery, orthopedics, emergency, critical care/pulmonology and neurosurgery. Spiritual patterns emerged across religions and specialties including: 1) spirituality as a guiding force 2) strong need for a support system 3) use of coping mechanisms and 4) vicarious growth.

  • Integrating Research Literacy into Spiritual Care Education and Practice (Sunday, July 15, 2018 @ 8:15 - 9:45 AM) — Workshop presented by Christina Shu and Pamela Lazor. — OBJECTIVES: Discuss the successful integration of a research literacy educational component into a CPE program and Spiritual Care Department; equip staff chaplains who are interested in research/research literacy to teach and work with CPE students/programs and other chaplains to enhance their research literacy skills; and evaluate the challenges and benefits of building capacity for and implementing a research literacy educational program. — DESCRIPTION: Research literacy is a requirement for board certification and an essential skill for professional chaplains. This workshop focuses on the integration of research literacy into a CPE program and Spiritual Care Department. In 2016, Cedars-Sinai received the Transforming Chaplaincy grant for implementing a research literacy curriculum and developed this curriculum to fit the needs of CPE students, alumni, and staff chaplains. Chaplains who completed the curriculum reported a deeper understanding of research, and greater likelihood to pursue and integrate research into their professional practice. Using research is now incorporated into the routine functioning of our CPE program and Department.

  • Qualitative Research Methods for Beginners (Sunday, July 15, 2018 @ 1:00 - 5:00 PM) — Professional Development Intensive presented by Daniel H. Grossoehme. — OBJECTIVES: Distinguish between three qualitative research methods and appropriate uses of each; describe at least two ethical issues in qualitative research; and critically read and understand published qualitative research studies. — DESCRIPTION: Qualitative research is the most accessible means of entry for chaplains into the world of research. Like clinical conversations, qualitative methods elicit people's stories. Using examples from published qualitative studies, we will explore grounded theory, phenomenology, content analysis and case studies with attention to which method is best suited to different research questions. Study design and ethical issues will also be addressed.

  • Partnering with the Divine: Integrating the Arts in Spiritual Care (Sunday, July 15, 2018 @ 1:00 - 5:00 PM) — Professional Development Intensive presented by Stephanie Gameros. — OBJECTIVES: Participants will gain an increased theological, clinical and theoretical framework to aid them in integrating the arts as spiritual care; participants will be guided through several exercises which could be applied directly to the patient's bedside; and participants will learn best practices and receive practical applications for the utilization of visual Art, Music, Dance and Poetry in our role as Professional Chaplains. — DESCRIPTION: Facilitators will provide a summary of the clinical research highlighting the healing benefits of the arts, in order to aid chaplains in communicating the need for the arts in healthcare, and to empower chaplains to partner with members of the interdisciplinary team and administrative leaders in developing new programs. Participants will themselves experience the healing power of the arts as spiritual care through various activities involving visual art, poetry, music and dance. This will be a fun and interactive four hours for the participants. — Recommended Reading: Cameron, J., The Artist's Way: A Spiritual Path to Higher Creativity (New York: J.P. Tarcher/Putnam, 2002); Mooney, S. F., Bending Toward Heaven: Poems After the Art of Vincent van Gogh (Eugene, OR: Resource Publications, 2016); and Sacks, O., Musicophilia: Tales of Music and the Brain (New York: Alfred A. Knopf, 2007).



5.   Joint Commission Article Supporting Chaplains Emphasizes Research  (pub. 3/11/18)

The Joint Commission has highlighted chaplaincy in a two-part article in its January and February issues of The Source, which is touted to healthcare organizations as "the accurate and authoritative resource you need to improve your compliance with Joint Commission accreditation and certification requirements" [--see the publication's web page]. Research is noted throughout, however this is essentially a popular-style report with many declarative statements about chaplains not tied tightly to empirical studies. It appears to rest largely upon interviews with chaplains Stephen King (Seattle Cancer Care Alliance, Seattle, OR), Amy Greene (Cleveland Clinic, Cleveland, OH), and George Fitchett, (Rush University Medical Center, Chicago, IL). Both parts are available through the ACPE website.

"Part 1. Body, Mind, and Spirit" [The Source 16, no. 1 (January 2018): 6-12] features on the first page a sidebar [p. 6] describing research about the contribution of chaplains' involvement to palliative care.* It goes on the address chaplains' potential importance for improving patient and family satisfaction [pp. 9-10], for respecting patient rights [p. 10], for the uplift and support of clinical staff [p. 11], and as "part of the interdisciplinary, collaborative team" [p. 10], with periodic allusions to research. At various points, the role of chaplains is directly and indirectly connected to Joint Commission Standards: for Rights and Responsibilities (i.e., RI.01.01.01), for Leadership (i.e., LD.04.04.05), and for the Provision of Care (i.e., PC.02.01.05).

In "Body, Mind, Spirit, Part 2" [The Source 16, no. 2 (February 2018): 1-6], research is cited regarding screening for chaplain referrals [pp. 1-2], conducting a spiritual history and assessment [pp. 2-3], and assisting with decisions about end-of-life care [p. 3-4], before concluding with comments about how chaplaincy is taking steps toward more evidence-based care [pp. 4-5]. It appears to encourage screening with either the Rush Spiritual Struggle Screening Protocol or by the two questions: "Do you struggle with the loss of meaning and joy in your life?" and "Do you currently have what you would describe as religious or spiritual struggles?" by stating that "[c]urrent research points to using [these]" [p. 2 --citing Fitchett, G. and Risk, J. L., "Screening for spiritual struggle," Journal of Pastoral Care and Counseling 63, nos. 1-2 (2009): 4.1-12; and King, S. D. W., Fitchett, G., Murphy, P. E., Pargament, K. I., Harrison, D. A. and Loggers, E. T., "Determining best methods to screen for religious/spiritual distress," Supportive Care in Cancer 25, no. 2 (February 2017): 471-479]. Again, the material is connected to Joint Commission Standards, particularly regarding the Provision of Care (i.e., PC.01.02.11, PC.01.02.13, and PC. 02.02.13). A link is given at the end to the Transforming Chaplaincy website.

Chaplain researchers may be most interested in the this as a resource for "authoritative" and highly positive statements by the Joint Commission regarding the value of chaplaincy, useful in establishing relevancy and context when composing the introductory or discussion sections of their own articles. One caution about the connections made to specific Joint Commission standards: some of the standards do indeed explicitly mention spiritual care, but others do not; the article posits some connections only through inference. For example: "Chaplains should play an integral role on the interdisciplinary care team, as required by Joint Commission Provision of Care, Treatment, and Services (PC) Standard PC.02.01.05" [Part 1, p. 10]; but that standard, with a single element of performance being "Care, treatment, and services are provided to the patient in an interdisciplinary, collaborative manner," clearly does not stipulate chaplains' involvement. [A listing of Joint Commission Standards for acute care hospitals that specifically mention spirituality/religion/beliefs, may be found linked to our October 2012 Article-of-the-Month, Items of Related Interest §IV —worth comparing to the lists in the Source.] On the whole, this two-part article is one of the most strident endorsements of chaplains ever made by the influential Joint Commission, and its emphasis on research for making its case is significant.

* The summary is from Fitchett, G., "Recent Progress in Chaplaincy-Related Research," Journal of Pastoral Care and Counseling 71, no. 3 (2017): 163-175; referring to research originally reported in Rabow, M. W., Dibble, S. L., Pantilat, S. Z. and McPhee, S. J., "The comprehensive care team: a controlled trial of outpatient palliative medicine consultation," Archives of Internal Medicine 164, no. 1 (January 12, 2004): 83-91; and Rabow, M. W., Petersen, J., Schanche, K., Dibble, S. L. and McPhee, S. J., "The comprehensive care team: a description of a controlled trial of care at the beginning of the end of life," Journal of Palliative Medicine 6, no. 3 (June 2003): 489-499.



6.   Chaplains Facilitating Advance Directive Completion Project Reported in JAMA Internal Medicine  (pub. 3/11/18)

In a quality improvement project at a community hospital in suburban Chicago, IL, a physician invited a sample of 60 patients to discuss advance care planning with a chaplain in the exam room immediately following the medical encounter. Inclusion criteria were: 70+ years old, with decision-making capacity, and no record of an Advance Directive. All patients accepted, and 48 (80%) completed an Advance Directive during the sessions that lasted a mean of 23.2 minutes (with a SD 7.8 minutes).

The topics explored with the chaplain included: patient's current life circumstances, family members, support systems, experience with critical illness (their own or a loved one), experience with EoL decisions, palliative care and hospice, the role of faith in their lives and the influence of their beliefs on health care decision-making, and the level of medical interventions they might wish for themselves. [p. E1]
This project suggests the feasibility and effectiveness of such medical office discussions with chaplains. In the authors' opinion, "[t]he physician's introduction of the chaplain was vital..." [p. E2].

The project is reported as a Research Letter in JAMA Internal Medicine, online first, January 16, 2018: Lee, A. C., McGinness, C. E., Levine, S., O'Mahony, S. and Fitchett, G., "Using chaplains to facilitate advance care planning in medical practice." The corresponding author is Chaplain Aoife C. Lee, Spiritual Care Department, Rush Oak Park Hospital, 520 S. Maple Ave., Oak Park, IL 60304 ( George Fitchett is also a chaplain co-author.


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