Chaplain, Can You Carry This Cross for Me? A Reflection on My First Year of CPE-Clinical Pastoral Education

What is the meaning of sacrament? How can a professional Orthodox Christian lay chaplain participate in sacramental ministry without the grace given by ordination? This piece on Christina Hanegraaff's first year as a Clinical Pastoral Education resident explores this question through reflecting on her experiences of entering into people's suffering and carrying their cross alongside them-a modern-day Simon of Cyrene.

Recognizing and Managing Performance Anxiety in First-Year Supervised Pastoral Education (SPE) Students: Description, Causes and Remedies

Describes the nature of performance anxiety that can appear in students doing their first clinical placement in Supervised Pastoral Education¹ in the Canadian Association of Spiritual Care. Explores origins of performance anxiety drawing on research, the Diagnostic and statistical manual of mental disorders-5, theology of Paul Tillich and supervisory experiences of authors. Examines Canadian contextual factors like COVID-19, culture and multi-faith. Offers ways students might manage anxiety with help from supervisors and peers.

Implementing Spiritual Care in the Pediatric Complex Care Clinic

A project integrated a Clinical Pastoral Education Fellow into a clinic designed to treat children with medical complexity (CMC). The integration of a chaplain into the care team fulfilled the goal of increasing accessibility to spiritual care through a quality improvement project and seemed to positively affect patients and the interdisciplinary team itself. These efforts demonstrate the need for research to better understand the relationship between spiritual screenings, interventions, and outcomes for CMC patients.

Is Supervised Pastoral Education (SPE) "Substantially Equivalent" to a Recognized Psychotherapy Program in Ontario?

After completing their Supervised Pastoral Education units provided by the Canadian Association for Spiritual Care, two soon-to-be-certified Spiritual Care Practitioners applied to the College of Registered Psychotherapists of Ontario. Both were rejected because their Supervised Pastoral Education program was not deemed to be "substantially equivalent" to a recognized psychotherapy program. This came as a surprise since similarly qualified Canadian Association for Spiritual Care Practitioners in Ontario are also members of the College of Registered Psychotherapists of Ontario through a process called "grandparenting." Using the 10 characteristics of a College of Registered Psychotherapists of Ontario recognized program, this paper examines Canadian Association for Spiritual Care's SPE program in detail, showing how closely it aligns with the College of Registered Psychotherapists of Ontario's description of an equivalent psychotherapy program. I conclude by suggesting the College of Registered Psychotherapists of Ontario should embrace Supervised Pastoral Education as an equivalent program and grant memberships, not just to those grand parented in, but to future Canadian Association for Spiritual Care Practitioners.

Grieving Kairos Moments

This article is a reflection on the loss of Kairos due to the COVID-19 pandemic. Kairos moments cannot be re-scheduled, they must be mourned.

Out Of The Ashes: The Alberta Consortium For Supervised Pastoral Education Program

In Alberta, Canada, supervised pastoral education has grown and thrived for over 50 years. In 2008, due to healthcare funding changes, it was nearly eliminated. This article describes regenerative processes by which former structures have transformed into a new configuration for supervised pastoral education program delivery, including innovative roles for spiritual care preceptors and theological colleges. Out of the ashes, a phoenix is rising. It is called the Alberta Consortium for Supervised Pastoral Education program.

Toward an Integrative Model of Psychospiritual Therapy: Bringing Spirituality and Psychotherapy Together

As a supervisor-educator for the Canadian Association of Spiritual Care, my primary task is to help developing spiritual care providers and psychospiritual therapists learn how to use psychotherapy within the field of spiritual care. The purpose of this essay is to share a psychospiritual model that I teach my students that helps them see how psychospiritual therapy is a form of spiritual practice that helps their clients experience healing from the sacred.

Blessings and Cursings: The Liberating Gift of Profanity in Clinical Pastoral Education

Profanity, derived from the Latin for "not sacred," has long been seen as antithetical to spirituality. Social norms around organized religion, respectability, race, gender, etc. compound this perception. In this article, I examine how the use of profanity in Clinical Pastoral Education can help students experience personal, social, and physical freedom. Association of Clinical Pastoral Education outcomes, demographic data, and a student experience provide support for this assertion.

Embedding Critical Reflection in Training for Spiritual Care Supervision and Practice: The Experience of a Specific Student Group

This article explores student experiences of a subject called Supervision in Spiritual Care Using Critical Reflection in postgraduate study in Australia for spiritual carers and ministers of religion. Their online dialogue identified how students used critical reflection in practice, and what they saw as the benefits and challenges in their learning. This affirms the value of a critically reflective approach to spiritual care and how this can be used in supervision and in practice.

What's the Point of Clinical Pastoral Education and Pastoral Counselling Education? Political, Developmental, and Professional Considerations

Further clarity is needed regarding the uniqueness of spiritual care and psycho-spiritual therapy. In this article, this uniqueness is described as the relative spiritual health of spiritual health professionals. Drawing upon political philosophy, spiritual development theories, and studies in spiritual health, three traits of spiritual health are revealed that spiritual health professionals need to function effectively in their work environments. The article ends with four recommendations for both clinical pastoral education and pastoral counselling education.

Training Healthcare Chaplains: Yesterday, Today and Tomorrow

This article invites theological school educators, clinical pastoral education educators, representatives of the professional healthcare chaplaincy organizations, and social scientists to begin a shared conversation about chaplaincy education. To date, we find that theological educators, clinical educators, professional chaplains, and the healthcare organizations where they work are not operating from or educating toward a common understanding of what makes healthcare chaplains effective. Before we identify five key questions that might help us be in shared conversation and move towards educating the most effective chaplains, we briefly describe the history of education for healthcare chaplaincy. We then describe what we learned in interviews in 2018 with 21 theological and 19 clinical educators who are educating healthcare chaplains in theological schools and clinical pastoral education residency programs, year-long educational programs in hospitals and other settings that focus on preparing people for staff chaplain jobs. Their different approaches and frames inform the five questions with which we conclude.

Significant Change in the North American Spiritual Care Education and Psychotherapy Movement

ACPE: The Standard for Spiritual Care and Education (previously Association for Clinical Pastoral Education) has received the membership of the American Association of Pastoral Counselors (AAPC) into an integrated organization. This integration may mark the beginning of an organizational trend.

Training Community Clergy in Serious Illness: Balancing Faith and Medicine

Community-based clergy are highly engaged in helping seriously ill patients address spiritual concerns at the end of life (EOL). While they desire EOL training, no data exist in guiding how to conceptualize a clergy-training program. The objective of this study was used to identify best practices in an EOL training program for community clergy. As part of the National Clergy Project on End-of-Life Care, the project conducted key informant interviews and focus groups with active clergy in five US states (California, Illinois, Massachusetts, New York, and Texas). A diverse purposive sample of 35 active clergy representing pre-identified racial, educational, theological, and denominational categories hypothesized to be associated with more intensive utilization of medical care at the EOL. We assessed suggested curriculum structure and content for clergy EOL training through interviews and focus groups for the purpose of qualitative analysis. Thematic analysis identified key themes around curriculum structure, curriculum content, and issues of tension. Curriculum structure included ideas for targeting clergy as well as lay congregational leaders and found that clergy were open to combining resources from both religious and health-based institutions. Curriculum content included clergy desires for educational topics such as increasing their medical literacy and reviewing pastoral counseling approaches. Finally, clergy identified challenging barriers to EOL training needing to be openly discussed, including difficulties in collaborating with medical teams, surrounding issues of trust, the role of miracles, and caution of prognostication. Future EOL training is desired and needed for community-based clergy. In partnering together, religious-medical training programs should consider curricula sensitive toward structure, desired content, and perceived clergy tensions.

Reflections for Clinical Pastoral Education Students in Psychiatric Settings

This article focuses on Donald Capps's books on mental illness. In doing so I highlight three key insights from Capps that I have applied in my own ministry with persons with mental illness in various psychiatric hospitals. These insights, together with my own experience as a chaplain, lead to three practical lessons for clinical pastoral education students in psychiatric settings. I provide some context for my interest in mental illness and my friendship with Capps, as well as some background regarding how Capps's writings on mental illness fit with certain broader themes in his own work as a pastoral theologian. This essay is personal throughout.

Transforming Chaplaincy Requires Transforming Clinical Pastoral Education

Clinical Pastoral Education (CPE) is a process focused on developing students' personal integration. Outcomes for CPE need to expand to reflect current research in religion and spirituality because religion and spirituality impacts coping, meaning making, decision-making, and health care outcomes. Focusing CPE outcomes on religious/spiritual beliefs and practices used by patients will equip chaplains to provide research-informed spiritual care for families and discipline-specific information for the interdisciplinary team.

Chance Encounters: Rap Music as a Relational and Pedagogical Resource in Clinical Pastoral Education

Music has long been regarded as a valuable tool for educators. Over the last three decades, rap music has grown to become a global phenomenon. However, due to historical and cultural factors, rap music is often underutilized in Clinical Pastoral Education. This article discusses the social significance of rap music, highlights how rap music informed my supervision of a clinical pastoral education student, and examines Chance the Rapper's mixtape Coloring Book as a case study on the utilization of rap music as a relational and pedagogical resource in spiritual education.

Frames for the Future: Developing Continuing Education & Professional Development Programs for Spiritual Care Practitioners: A Perspective from Victoria, Australia

This article examines the educational issues in ongoing professional education for spiritual care practitioners. A meta-evaluation of registration and evaluation data over four years (between 2013 and 2016) of one such monthly program conducted by Spiritual Health Victoria (Australia) will be examined. Recommendations are made to support healthcare managers and spiritual care educators in designing and developing continuing education programs for spiritual care practitioners in a variety of other professional health and care contexts.

Preparation for Pastoral Counseling and Spiritual Care: Strengthening Pastoral "Felt Knowledge" and Empathy through the Appreciation and Use of Contemporary Films

Contemporary film offers something unique in the preparation and practice of pastoral counselors and spiritual caregivers by expanding both "felt knowledge" and strengthening empathic responses to care seekers. By experiencing well-chosen films, pastoral counselors and other spiritual caregivers will be better prepared to work with relevant feelings in various caregiving contexts, and clients will gain many rewards, as both their healing and growth will be enhanced. This will be especially true when pastoral and spiritual caregivers are working in areas of need where they have limited personal or professional experience.

Pastoral care, spirituality, and religion in palliative care journals

With the growth and development of palliative care, interest in pastoral care, spirituality, and religion also seems to be growing. The aim of this article is to review the topic of pastoral care, spirituality, and religion appearing in the journals of palliative care, between January 1984 and January 2002.

The Florida Clergy End-of-Life Education Enhancement Project: A description and evaluation

The Florida Clergy End-of-Life Education Enhancement Project was a model program developed to provide an interdenominational and statewide model of clergy education on loss, grief, dying, and death. The authors describe the project including materials and curriculum as well as present data from the project’s evaluation.

Clergy and their partners in ministry responded enthusiastically to the project. As a whole, they reported higher levels of knowledge on end-of-life (EOL) issues at the conclusion of the training. Clergy and their ministerial teams also reported that they were better informed about the technical, procedural, medical, and legal issues that arise at the end of life and expressed the desire for subsequent training. The project indicates that clergy both recognize the need for additional training and are anxious to improve their abilities to minister to the dying and bereaved. The model presented here could easily be applied to local organizations such as hospices or denominational training.

The Impact of Education on Views of Homosexuality in the Senior Clergy of Hidalgo County, Texas

This study explores clergy perspectives on homosexuality and mental health. Interviews were conducted with 245 senior clergy of faith-based organizations in Hidalgo County, Texas. Analyses revealed that the less education the individual had, the more likely he or she viewed homosexuals as being more psychologically disturbed than heterosexuals. Clergy also expressed uncertainty in their views and actions regarding referral practices. A need for clergy education on views of homosexuality is documented. Suggestions are made for future research and education.

'Out of the Whirlwind': Clinical Pastoral Education and Climate Change

This article traces the development of an innovative program of Clinical Pastoral Education (CPE), conducted in 2013 in Victoria, Australia. Interns were placed in environmental contexts; the program's aim was to enhance the eco-ministry identity of interns as they attended to the anxieties and concerns of people affected by ecological change, as well as listening to the cries and groans of Earth. In this sense, pastoral care acknowledges the environment and our human presence within it as of religious and spiritual concern. The theological and supervisory rationales of the program are outlined and include a careful alignment of parallel competencies with the existing objectives and standards required for accreditation. Guidelines for sacred practice in nature, place/case study and the more-than-human verbatims are described, and an illustrative example of such a verbatim is also included.

Spiritual Care Education and Rural Systems in Swan River

The provision of spiritual care, and the training of spiritual care providers, must be embedded within the larger systems (economic, social, generational, and environmental) and communities within which clients reside. This study analyzes the results of a systems approach to CPE training that focused on the rural context of Swan River, Manitoba. It addresses the need for new approaches to contextualizing CPE training and for understanding the uniqueness of rural contexts in particular.

The Haircut

The article describes my experience - and the lessons learned - with a terminally ill patient in 1977 as a clinical pastoral education chaplain intern.

Behavioral Outcomes of Supervisory Education in the Association for Clinical Pastoral Education: A Qualitative Research Study

This study advances the work of developing a theory for educating Clinical Pastoral Education (CPE) Supervisors by describing the behaviors which result from the successful completion of CPE supervisory education. Twenty-eight Association for Clinical Pastoral Education (ACPE) Certification Commissioners were interviewed to identify the behaviors demonstrated by Supervisory Education Students (Candidates) which influenced the decision to certify them at the level of Associate Supervisor. Specific behavioral descriptors are listed for each ACPE supervisory competency.

The Evolution of Research Paradigms in Pastoral/Spiritual Care, Counseling, and Education

This partially autobiographical article is presented as a chapter in the narrative of the evolution of research methodology in the social sciences and the impact that evolution has had on pastoral/spiritual care research as the author has experienced and observed it during the latter part of the 20th century and the early years of the 21st century.

An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education

CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered.

The Effects of CPE on Primary Relationships--Is It Worth Exploring?

Clinical Pastoral Education (CPE) can be a life transforming experience for students, but does it also transform students' primary relationships? An online survey of past CPE students at Royal Perth Hospital, Western Australia, found that--overall--CPE had a positive effect on primary relations in key areas, in particular communication, intimacy and spirituality. Recent relationships were more negatively affected. Some relationships did not survive CPE. Structural and pedagogical implications require further research.

The Intergenerational Transmission of Core Values in Clinical Supervision

Four authors representing four generations of therapists reflect upon the role of core values that are communicated in the supervision hour. They further reflect upon how such values are transmitted from one generation of therapists to the next. Drawing upon their own experience of giving and receiving supervision, the authors hypothesize the existence of an intergenerational process by which values are passed on from one generation to the next.

Spiritual Care Training Provided to Healthcare Professionals: A Systematic Review

This systematic review was conducted to assess the outcomes of spiritual care training. It outlines the training outcomes based on participants' oral/written feedback, course evaluation and performance assessment. Intervention was defined as any form of spiritual care training provided to healthcare professionals studying/working in an academic and/or clinical setting. An online search was conducted in MEDLINE, EMBASE, CINAHL, Web of Science, ERIC, PsycINFO, ASSIA, CSA, ATLA and CENTRAL up to Week 27 of 2013 by two independent investigators to reduce errors in inclusion. Only peer-reviewed journal articles reporting on training outcomes were included. A primary keyword-driven search found 4912 articles; 46 articles were identified as relevant for final analysis. The narrative synthesis of findings outlines the following outcomes: (1) acknowledging spirituality on an individual level, (2) success in integrating spirituality in clinical practice, (3) positive changes in communication with patients. This study examines primarily pre/post-effects within a single cohort. Due to an average study quality, the reported findings in this review are to be seen as indicators at most. Nevertheless, this review makes evident that without attending to one'the repeliefs and needs, addressing spirituality in patients will not be forthcoming. It also demonstrates that spiritual care training may help to challenge the spiritual vacuum in healthcare institutions.

Critically Engaging "Mutually Engaged Supervisory Processes": A Proposed Theory for CPE Supervisory Education

Revisions to the processes for training and certifying supervisors continue to be debated within the Association for Clinical Pastoral Education (ACPE). In 2012 Ragsdale and colleagues published, "Mutually engaged supervisory processes," a qualitative research study utilizing grounded theory based on interviews with 19 recently certified Associate CPE Supervisors, of nine components that facilitate the development of CPE supervisory education students. In this article we critically engage this theory and the research upon which it is based. We also reflect on three issues highlighted by the theory: personal transformation in CPE supervisory education, how CPE supervisory education students develop theoretical foundations for their work, and engaging multicultural issues in supervisory education. We conclude that this theory offers ACPE the possibility of using research to guide future modifications to its practice of Supervisory education.

The influence of secular and theological education on pastors' depression intervention decisions

Will a pastor refer to a mental health center? If they feel qualified to intervene themselves, they may not. Because pastors often provide grief counseling, it is important to understand the decisions they make when intervening with depressed individuals. A random sample of 204 Protestant pastors completed surveys about their treatment practices for depression. Fisher's exact analyses revealed that more pastors with some secular education yet no degree felt that they were the best person to treat depression than pastors who had no secular education or pastors who had at least a secular bachelor's degree. However, the level of theological education did not influence beliefs about the pastor being the best person to treat depression. In addition, neither secular nor theological education level influenced pastors' views on referring people to mental health centers for depression treatment. Based on findings, this paper discusses implications for best practices in training pastors on depression and other mental health topics.

"Look at me, but don't!"--Revisiting the narcissistic dilemma in clinical pastoral supervision

Clinical Pastoral Education is a shame-sensitive endeavor. This article discusses the impact of shame in supervision by considering students' experiences of shame as well as the supervisor's shame and their resulting dilemmas. Exploring the paradox of shame from a psychological and theological perspective, the author suggests that shame can serve students' self-discovery, if it is engaged through pastoral confirmation and transformative interventions. Empathic attunement and humor are highlighted as effective means in such interventions.

The ACPE supervisory education process: an historical perspective

As the number of Clinical Pastoral Education students increases, supervisors in the Association for Clinical Pastoral Education (ACPE) are in short supply due to retirements. We explore factors associated with this supply problem, reporting here four results from our survey of active and retired supervisors. We identify the ages of the current supervisory pool, the ages at which supervisors were certified and the length of time spent in the supervisory education program across the decades. The survey results also identify what supervisors perceive as the most helpful components of their supervisory education. These four results identify trends across the decades that may be associated with the present and future shortages of supervisors.

Teaching research in clinical pastoral education: a survey of model practices

The Association of Professional Chaplains (APC) developed Standards of Practice for Acute and Long-term settings. Standard 12 promotes research-literate chaplains as important for the profession. Since many chaplains receive training in clinical pastoral education (CPE) residency programs, the aim of this study was to identify model practices for the teaching of research in such programs. Using a purposeful sample, this study identified 11 programs that offered "consistent and substantive" education in research. Common features included the existence of a research champion, a culture supportive of research, and the availability of institutional resources. The study identified models and methodologies that CPE programs can adopt.

Educating chaplains for research literacy: results of a national survey of clinical pastoral education residency programs

There is growing evidence that leaders in professional health care chaplaincy recognize the important role of research. The Standards of Practice recently approved by the Association of Professional Chaplains (APC), and especially the standard about research (Standard 12), provide strong evidence that the profession sees research, and research-literate chaplains, as important for its future. The aim of this study was to identify the extent to which Association for Clinical Pastoral Education, Inc (ACPE) accredited clinical pastoral education (CPE) residency programs are preparing their graduates to be the kind of research-literate chaplains described in these Standards. We interviewed CPE supervisors from 26 randomly-selected CPE residency programs. We found 12% of the programs had intentional and substantive research-related curricula, 27% of the programs offered some limited exposure to research, and 62% of the programs provided no education about research. We found also that supervisors often defined "research education" in terms of actually conducting research projects. CPE residency programs potentially play a central role in educating research-literate chaplains. Future research should examine the incentives and barriers that influence the inclusion of research education in CPE residency programs.

Spiritual/cultural competency: methods in diversity education

Diversity education in clinical training such as CPE is best developed in an interactive group context, guided by methods and approaches promoting mutual disclosure that includes the leader. Each member is invited to portray a web of meaning with cultural, spiritual and religious threads that comprise a personally knitted reality, a narrative foundational to identity and interaction. Differences between people in the training context challenge previously held notions, distribute authority in the group and foster open ended learning that enriches the activities of clinical supervision. This article describes group educational methods with case examples that foster spiritual/cultural competency, each member a person in context with the opportunity to be distinct and connected, a threshold for all other dimensions of diversity learning in pastoral practice.

Mutually engaged supervisory processes: a proposed theory for ACPE supervisory education

Nineteen newly certified Association for Clinical Pastoral Education (ACPE) Associate Supervisors were interviewed to determine how they learned to do Clinical Pastoral Education (CPE) supervision. Grounded theory was the qualitative research method used in gathering and analyzing data for this IRB approved study. The emerging theory, Mutually Engaged Supervisory Processes, includes nine processes: Discerning Vocation, Feedback, Support, Supervisory Practices and Identity, Theory, Increased Awareness, Shift in Personhood, Offering Presence, and Owning Authority. Member checks confirmed the trustworthiness of the results.

Organ procurement and health care chaplaincy in Australia

As part of an Australian national project, quantitative data via a survey were retrospectively obtained from 327 Australian health care chaplains (staff and volunteer chaplains) to initially identify chaplaincy participation in various bioethical issues-including organ procurement. Over a third of surveyed staff chaplains (38%) and almost a fifth of volunteer chaplains (19.2%) indicted that they had, in some way, been involved in organ procurement issues with patients and/or their families. Nearly one-fifth of staff chaplains (19%) and 12% of volunteer chaplains had also assisted clinical staff concerning various organ procurement issues. One hundred of the surveyed chaplains volunteered to an interview. Qualitative data were subsequently coded from 42 of the chaplains who had been involved in organ procurement requests. These data were thematically coded using the World Health Organization 'Pastoral Intervention Codings' (WHO-PICs). The qualitative data revealed that through a variety of pastoral interventions a number of chaplains (the majority being staff chaplains) were engaged in the critical and sensitive issues of organ procurement. It is argued that while such involvement can help to ensure a holistic and ethically appropriate practice, it is suggested that chaplains could be better utilized not only in the organ procurement process but also for the training of other chaplains and clinicians.

Seminarian attitudes toward counseling

This paper examines whether seminarians are interested in referring parishioners to pastoral counselors or prefer handling commingled psychological and spiritual problems through counseling parishioners themselves. Research results revealed openness toward referral and also a strong interest in counseling persons themselves. Forms of collaboration other than referral were also examined, and seminarians indicated openness to using consultation, training, and personal therapeutic support. Implications for church-psychology collaboration, generally, are discussed. Areas for further research are recommended.

Richard Clarke Cabot, M.D., a unitarian critique

This article is written to correct a historical impression about Richard C. Cabot, one of the founders of Clinical Pastoral Education (CPE). Contrary to the popular understanding that he was a typical Unitarian, the author posits that even though Cabot may have been a typical liberal, in his theology, he was an atypical Unitarian. This article places Cabot in his family and historical contexts, his involvement in CPE, and comments on his theology, noting how this differed from the prevailing Unitarian theology of his day.

Rural African American clergy: an exploration of their attitudes and knowledge of Alzheimer's disease

Rural African American clergy's ability to recognize Alzheimer's Disease (AD) and their capacity to provide support to elders with this illness has been neglected in the literature. Using a mental health literacy framework, the purpose of this research was to explore rural African American clergy knowledge and beliefs of AD. In-depth interviews were conducted with 9 African American clergy who oversaw churches in central Kentucky. Although few had direct experience with providing pastoral care to elders with AD, all clergy were literate and aware of the need for additional training. This study seeks to further clarify the role of African American clergy and their understanding of AD to inform the future development of appropriate interventions and establish better collaborative community treatment relationships.

Perspectives & perceptions: spiritual care and organizational climate in Christian schools

Caring and spirituality are concepts Christian nursing programs transmit through explicit official, operational, and implicit hidden curricula. A measurable facet of the hidden curriculum is organizational climate. This study explored interrelationships between perspectives of spiritual care held by students and educators in Christian baccalaureate nursing programs, and their perception of organizational climate. Findings revealed that students who felt better cared for tended to have more positive perspectives of spiritual care.

Enhancing objectivity in pastoral education: use of standardized patients in video simulation

Measurement of student learning outcomes in clinical pastoral education has historically been assessed through student self-report instruments and subjective evaluation by CPE supervisors. Valid quantitative measurement is limited. This study utilizes standardized patients and a behavioral interview checklist to measure the impact of an initial summer unit of CPE training. Results demonstrate measurable change in student interview style behavior suggesting that simulation utilizing standardized patients is a valid objective measure of students' behavioral communication styles.