October 2021 Article of the Month
Clevenger, C., Cadge, W., Stroud, I. E., Palmer, P. K., Haythorn, T. and Fitchett, G. "Education for professional chaplaincy in the US: mapping current practice in Clinical Pastoral Education (CPE)." Journal of Health Care Chaplaincy 27, no. 4 (October-December 2021): 222-237.
SUMMARY and COMMENT: A vitally useful focus of research for chaplains is what we do as a collective group. This informs the development of our profession, helps us get our bearing on our practice in relation to others, and might be thought of as systematically crowd-sourcing the wisdom of samples of peers. This month's study involves ACPE educators, but it raises for all chaplains the issue of how much of our attention should we be giving to "propositional knowledge" in our field vis-a-vis relational skills and self-awareness in the clinical encounter. The question, "How should chaplains be educated?" is relevant to every chaplain's responsibility for continuing education and professional self-assessment. Data presented here are from only 19 educators, but the sample is purposive, selected from across the US and various CPE settings, and offers much food for thought.
The article's introductory section [pp. 222-224] sets up the debate among educators about the place of didactic material in preparing chaplains for effective careers. It is an open-ended concern, because, "Unlike other health professions, healthcare chaplaincy does not have a professional body that specifies a curriculum that must be offered or completed in order to sit for a licensing exam or other certification process" [p. 223]. And, while major professional chaplaincy organizations require four units of Clinical Pastoral Education for certification, "there are few specifications for what content must be covered in these units" [p. 223].
Traditionally, CPE has emphasized developing self-awareness and interpersonal skill through an action-reflection approach to education.... ...This tradition has meant less emphasis on specific bodies of knowledge that residents may need to be successful chaplains; that is, less emphasis on what is known in CPE as didactic education. N. Keith Little...has observed that while the action/reflection method is excellent for understanding chaplaincy interactions, it does not facilitate the development of a "propositional knowledge" base related to facts, ideas, and theories. Without this base of foundational knowledge residents may leave CPE programs insufficiently prepared for the challenges they face in clinical settings such as how to meet the needs of diverse religious and non-religion populations..., navigate changing health care systems..., or address common ethical issues. [p. 223, and see Related Items of Interest, §II, below]
So, the present research queried ACPE educators about their thoughts on bringing didactic material into the curriculum and specifically explored five knowledge-base areas identified from the chaplaincy education literature: diversity, ethics, organizational behavior, trauma, and research. Data were collected from 1-2 hour interviews conducted in 2018* using a semi-structured guide. All 19 sites had updated curricula, as a function of their having "recently completed the reaccreditation and associated self-study process through the ACPE Accreditation Commission" [p. 224].
In short, the researchers found "substantial variation in the emphasis they place on didactics" [p. 225] and, while "[m]ost shared the belief that CPE needs to balance a focus on intra- and interpersonal skills with propositional knowledge, [they] held different perspectives on what and how this content should be taught" [p. 234]: "...CPE educators are far from agreeing on what that knowledge should be and whether they want to be the ones to teach it" [p. 235].
The authors consider the responses according to whether the participants indicated a strong commitment to didactics, a weak commitment to didactics, or a shift in their thinking on the subject.
Among the findings about specific areas of a potential core knowledge base:
The most intriguing findings of the study for most readers may be in two tables that list "Most important didactic topics" [p. 229] and "Curricula for specific topics" [p. 230]. These are rich sources for ideas, in addition to being representative samples of what is being taught at the 19 involved centers, and they suggest a starting point for general discussion of a possible didactic core curriculum for chaplaincy education. Unfortunately, the table regarding "Curricula for specific topics" is slightly but confusingly misprinted, such that the first topic of diversity appears as if it were the overall subject of the table; but apart from that formatting error, the table is clearly presented.
The authors are forthright about the limitations of this study: small sample size, a focus on only five content areas, and reliance upon educators' self-reports (which in at least one case appeared somewhat out of sync with a center's accreditation materials). Nevertheless, this study seems to this reader a significant contribution to a crucial discussion about the nature of basic chaplaincy education (and, by extension, continuing education), affecting the direction of chaplaincy organizations and the character of chaplaincy as a discipline. The Discussion and Conclusion also acknowledges the practical issue of how much can be covered in the time frame of standard CPE programs. Some educators "warned of the risks of overloading CPE curricula" [p. 234], and one "lamented, 'there is more to teach than you can teach in a year of residency'" [p. 235]. Some alternate models of chaplaincy education are noted, like locating more of the basic curriculum in theological schools and encouraging second-year residencies. Over it all, though, hangs the key finding of the "diversity of CPE educator views and practices related to didactic education for chaplains" [p. 235].
*NOTE: The date of data collection is from a direct communication by the corresponding author.
Suggestions for Use of the Article for Student Discussion:
This month's article favors an audience of educators, but chaplains at every stage of education and career should find it engaging and useful. For new CPE students, it could open a discussion of what they are interested in for their program. For more advanced students, it could lead to a meaningful consideration of ratios of "propositional knowledge" to the development of self-awareness and interpersonal skills. Do they fully understand what is meant by that distinction? Might the group be challenged to use the two tables in the article to construct their own ideal curriculum for didactics? In their opinion, is anything missing from those tabular lists? What do they think of the five identified topics of diversity, ethics, organizational behavior, trauma, and research? If the facilitating educator could set a quota on the number of didactic slots in a curriculum, the group could debate which topics they would prioritize for time and which they would accept being cut. For students in their third or fourth units of CPE, they could be asked whether they'd prefer a basic requirement of more than four units for professional certification as a chaplain in order to cover more educational ground. Is an additional residency (or three additional units) necessary in order to prepare a person fully for professional practice? In what ways do they feel as presently unprepared? Also, the ACPE educator or program director could even use the occasion to articulate the theory and rationale for the existing curriculum (or elaborate upon what has already been stated in the program's handbook or during orientation). What are the students' thoughts on the advantages and disadvantages of a standardized knowledge base curriculum for all CPE programs versus the variety educational foci currently found center to center? Discussion could be quite different between students in part-time/single units and those in residencies, so the mixing of students from the two types of programs might lead to people talking on different wavelengths. Finally, such a discussion of curricula could be used to raise students' consciousness about the responsibility inherent in the very concept of adult learning.
Related Items of Interest:
I. Another branch of the current investigation into didactic material for chaplaincy has been undertaken with faculty of theological schools who teach chaplaincy courses. The work is cited in the present article as still in press, but it has since been published and is available freely online (open access) from the journal.
II. The bibliography for this month's article is relatively short but provides good leads for further reading. However, one article seems foundational to the authors' approach about the place of "propositional knowledge" and should be considered as basic background reading:
III. The Chaplaincy Innovation Lab syllabi page provides a variety of links to resources for didactic content as well as curriculum materials overall.
IV. See our ACPE Research page on Incorporating Research into CPE for some materials useful for didactic purposes.
V. One potentially interesting way to think about didactic material for chaplains might be to consider the materials that chaplains have used to train spiritual care generalists (e.g., physicians, nurses). That's a very different audience, and yet if chaplains believe there to be a core curriculum for those other providers, then the topics may well be ones that chaplains should be in a position to speak to in the course of interprofessional work. See, for instance, the table of Didactic Components of [a] Spiritual Care Generalist Workshop, on p. 816 of the following:
VI. The ACPE Curriculum Committee is currently hosting a series of online Curriculum Resource Room sessions to stir discussion about curriculum development, and in some cases, didactic elements in particular. ACPE members should see the Learning & Resources section of the ACPE SharePoint site for the latest information and access to recordings of past Resource Rooms.
If you have suggestions about the form and/or content of the site, e-mail Chaplain John Ehman, Article-of-the-Month Editor, at firstname.lastname@example.org