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Fall 2012 Newsletter
On-Line Newsletter Volume 11, Number 1
Published October 28, 2012
Edited by Chaplain John Ehman, Network Convener
Network members are encouraged to submit articles for upcoming issues.
The Newsletter is published three times a year: Fall, Winter, and Spring-Summer.
(The Winter 2013 issue will be published in late February.)
Table of Contents
1. New Pew Survey of Religious Affiliation: "'Nones' on the Rise"
2. A Spiritual Health Research Initiative at the Emory Center for Pastoral Services, by George H. Grant
3. Research-Related Activity at the VCU ACPE Center, report from Diane Dodd-McCue
4. Update on Research in the Curriculum at St. Luke's Health System, Kansas City, MO, report from Stephen Overall
5. Proposal Regarding Educating CPE Supervisors: Exploring the Emerging Theory of Supervisory Wisdom, from Judith R. Ragsdale
6. Proposal Regarding the Perception of Chaplains as a Unique Resource for the Communication of Needs to the Clinical Team, from John B. Hartman
7. What is the Efficacy of Clinical Pastoral Education in Teaching Resiliency and Coping Skills for Clergy? --update from Beth Jackson-Jordan
8. "Looking for Excellence in Supervision: A Researcher's Reflection on Her First Unit of CPE," by Sharon Ghamari-Tabrizi,
9. Gerald Gundersen's "Challenge to Promote Shared Learning in Pastoral Care"
10. Harold Koenig on the "Role of the Chaplain on the Medical-Surgical Team"
1. New Pew Survey of Religious Affiliation: "'Nones' on the Rise"
On October 9, 2012, the Pew Research Center’s Forum on Religion and Public Life issued "'Nones' on the Rise: One-in-Five Adults Have No Religious Affiliation," a report of findings from a telephone survey of 2,973 adults from across the US that was conducted between June 28 and July 9, 2012, along with other data sources. Pew offers both an executive summary and the full report (PDF) online freely for download. Among the findings:
The number of Americans who do not identify with any religion continues to grow at a rapid pace. One-fifth of the U.S. public – and a third of adults under 30 – are religiously unaffiliated today, the highest percentages ever in Pew Research Center polling. In the last five years alone, the unaffiliated have increased from just over 15% to just under 20% of all U.S. adults. Their ranks now include more than 13 million self-described atheists and agnostics (nearly 6% of the U.S. public), as well as nearly 33 million people who say they have no particular religious affiliation (14%). [report p. 9]
However, ...many of the country’s 46 million unaffiliated adults are religious or spiritual in some way. Two-thirds of them say they believe in God (68%). More than half say they often feel a deep connection with nature and the earth (58%), while more than a third classify themselves as “spiritual” but not “religious” (37%), and one-in-five (21%) say they pray every day. [report pp. 9-10]
[T]he way that Americans talk about their connection to religion seems to be changing. Increasingly, Americans describe their religious affiliation in terms that more closely match their level of involvement in churches and other religious organizations. ...[T]he ranks of the unaffiliated are swelling in surveys partly because Americans who rarely go to services are more willing than in the past to drop their religious attachments altogether. [report p. 11]
One important factor behind the growth of the religiously unaffiliated is generational replacement, the gradual supplanting of older generations by newer ones. ...But generational replacement is not the only factor at play. Generation Xers and Baby Boomers also have become more religiously unaffiliated in recent years. [report p. 16]
This survey should be of interest to chaplain researchers for a number of reasons, including the challenge of developing or employing survey questionnaires with language that connects with the way Americans talk about their religious affiliation. The data also hold some specific points of interest, for example: "[a]mong those saying that religion is very or somewhat important in their life and who attend worship services a few times a year, seldom or never...," 6% of the religiously affiliated reported that a reason they did not go to services more often was "health issues" [report p. 50]. Also, "...those with a religious affiliation are more likely to cite practical issues in getting to services (24% vs. 15% among the unaffiliated asked)" [report p. 51].
The Pew Forum is a well-regarded source for information on religious/spiritual trends, and among the topics listed on their home page (www.pewforum.org) are beliefs and practices, particular issues, and demographics. Our Newsletter also featured a Pew survey on prison chaplains in the Spring-Summer 2012 issue.
2. A Spiritual Health Research Initiative at the Emory Center for Pastoral Services, by George H. Grant, PhD, Director of Research and Innovation, Emory Center for Pastoral Services
The Emory Center for Pastoral Services (ECPS) is essentially the chaplaincy department for the Emory University Healthcare System in Atlanta, Georgia and has been for over 40 years (current executive director is Elwood Spackman). It is a large center with over 32 permanent staff, 20 chaplain residents, and 20-25 year round chaplain interns. ECPS currently serves seven main campuses (Wesley Woods Center and Hospital, St. Joseph’s, Emory Univ. Hospital Clifton, Emory Univ. Orthopedic and Spine Hospital, Emory Univ. Hospital Midtown, Emory John’s Creek, Southern Regional Medical Center) and one community wide center called Emory Clergy Care.
The ECPS is structured as a three-legged stool of enterprises: service, education and research. The Clinical Pastoral Education program (ACPE, Inc) spans across all three of those enterprises. We have a healthy mixture of permanent staff representation that ensures continuity in quality and educational value. The research enterprise has evolved over the years vacillating from individual projects centered on theory/phenomenology, team projects concentrating on the efficacy of chaplaincy and in recent years (up to 2010) a chaplain resident requirement to write a paper on theory or experience.
In 2010, the center, ushered by a new director for research, began to understand research as a campus specific, department-wide initiative. The adopted plan is to engage permanent and temporary staff in nine month long team experiences devoted to research literacy and the educational and productive value of walking through a project process. A new team is constituted in the fall on campuses where residents and permanent staff are established.
In our first year 2010-2011 three teams spent nine months moving through a method from literacy to a developed presentation that included engagement with staff from other disciplines according to interests and expertise. It was decided that any project developed would not require Institutional Review Board acceptance, but instead rely upon insights and interpretations gained from educational events. The research teams walked through research methods, electronic search, literature review, conception of a "problem," data collection and manufacturing of an exploratory/descriptive product. Two products were successfully presented to the healthcare system and were well received. In the just completed second year three projects were successfully presented and the initiative is now into a pattern of growing and solidifying the curriculum and process. The projects were focused on quality of work life experience (staff support) which in turn result in a positive impact on the system’s values of patient-family centered care. The "products" were professional power-point driven presentations to the entire healthcare community.
The long-term expected outcome of this research team experience is that the learning of how research is conducted will lead to funded, IRB reviewed, rigorous studies centered on spiritual health. By allowing shared leadership in the team meeting experience regardless of rank, the research team approach encourages leadership growth of permanent and temporary staff alike. It is anticipated that four teams will have successful experiences from here on. It is believed that research in spiritual health at this level is a team endeavor. ECPS is working toward equipping chaplains and other spiritual care responders with the tools necessary to join inter and multi-disciplinary studies as spiritual health researchers in health science.
The Center for Palliative Care and the Spiritual Health Research Initiative at Emory is one of six teams nationwide funded to grow the field of chaplaincy research by the John Templeton Foundation through the Healthcare Chaplaincy, Inc. The other five awardees are Duke University, Children’s Mercy-Kansas City, University of California-San Francisco, Dana-Farber Cancer Institute and Advocate Health of Chicago.
3. Research-Related Activity at the VCU ACPE Center --report provided by Diane Dodd-McCue, DBA, Program in Patient Counseling, School of Allied Health Professions, VCU
Melvinie Lewis, a graduate student in Virginia Commonwealth University’s Patient Counseling MS program, presented a research article critique to the first year residents as part of their Research Basics for Chaplains class. Melvinie was a student in this class last fall. She is completing her chaplaincy training and an independent study on VCU’s Family Communication Coordinator (FCC) protocol, which is used with potential organ donor cases. The article she critiqued focused on an Australian study that used mixed methods research.
Dr. Alexander Tartaglia and Dr. Diane Dodd-McCue presented a workshop on implementing research curriculum in CPE programs at the 2012 ACPE National Conference and at the 2012 Mid-Atlantic Regional Conference. The presentation featured the results of a recent random survey of research curriculum as well as examples of training techniques currently being used.
The 2012 VCU CPE Alumni Survey is currently being distributed on-line. The alumni survey is the outgrowth of an independent study research project by Jenny Taylor-Troutman, a VCU CPE alumna. The on-line survey platform, REDcap, at use by a consortium of academic medical centers, allows for survey development and administration as well as data management. Training in this software is a component of chaplain resident research training and is used by a number of CPE faculty.
The Department’s commitment to research is reflected, in part, by its research outcome. Refereed articles accepted or published over the past year include:
Tartaglia, A., Dodd-McCue, D. and Derrickson, P. "How to Write a Research Article." Chaplaincy Today --Forthcoming, Fall-Winter 2012.
Moriello, G., Cotter, J., Dodd-McCue, D., et al. "The Effect of Implicit Stereotypes on the Physical Performance of Older Adults." Educational Gerontology --Forthcoming, Fall 2012.
Geisz-Everson, M., Bennett, M., Dodd-McCue, D. and Biddle, C. "Disrupted by Disaster: Shared Experiences of Student Registered Nurse Anesthetists Affected by Hurricane Katrina." Journal of Psychosocial Nursing and Mental Health Services 2012, 50, no. 1 (2012): 32-38.
Geisz-Everson, M., Dodd-McCue, D. and Bennett, M. "Shared Experiences of CRNAs Who Were on Duty in New Orleans During Hurricane Katrina." AANA Journal 2012, 80. no. 3 (2012): 205-212.
Tartaglia, A. "Response to 'The Future is Now: Revisiting Lawrence Holst’s 1985 Predictions for Hospital Chaplaincy'." Chaplaincy Today 28, no. 1 (Spring/Summer, 2012): 21-24 [responses].
Fitchett, G Tartaglia, A Dodd-McCue, D. and Murphy, P. E. "Educating Chaplains for Research Literacy: Results of a National Survey of Clinical Pastoral Education Residency Programs." Journal of Pastoral Care and Counseling 66, no. 1 (2012): 3:1-12 [online journal page designation]. This was the April 2012 Article-of-the-Month.
Sicat, B., Willett, R., Breden, E., Rybarczyk, B. and Flack, A. "Interprofessional Team-Based Learning Module: Depression." MedEdPORTAL (2012): www.mededportal.org/publication/9059.
4. Update on Research in the Curriculum at St. Luke's Health System, Kansas City, MO --report provided by Stephen Overall, Director of Pastoral Education at Saint Luke’s Health System
Marc Giedinghagen, ACPE Supervisor, and Lucy Hood, RN, PhD, Professor of Nursing at Saint Luke's College of Health Sciences, are once again working with our Resident group to inspire them to identify some potential "new discoveries" to enhance CPE students' skills at becoming "reflective practitioners" in search of different and potentially dynamic ways to think about our work as chaplains.
Advanced Ministry Specialty Projects are in the early development stage for each of our four Residents. The students have expressed growing interest and energy in identifying some exciting projects that realistically can be explored at least at a basic level during the short learning season of a one-year residency. They are encouraged to use the Research Network Website and read some of the work that has been there to see if currently published research could be a stepping stone for their further investigation.
The research component of the CPE curriculum includes attention to methodology and the formation of guiding questions that could both focus students' attention and open opportunities for dialogue with fellow healthcare team members. Examples would be: "What might we do collaboratively to enhance the wellbeing of those we serve?" "What difference, in health outcomes, might it make to have a holistic approach to patient care?" and "Can any human-subject focused research be effective that does not include a consideration of our subjects beliefs, values, and feelings?" Such questions relate to who we are as students and teachers of change and transformation -- and participants in creative processes --and can be key to the challenge of being an effective pastoral care provider.
Editor's Note: In the fall of 2010, ACPE members responded to a call for research proposals from then-Executive Director Theresa Snorton, after the ACPE Board passed a motion to explore options for research in the organization, and a list of potential projects was collected through the Research Network. The overall initiative is currently in a hiatus, but the proposals were and are noteworthy, and two are highlighted and updated here. --J.E.
5. Proposal Regarding Educating CPE Supervisors: exploring the emerging theory of Supervisory Wisdom, from Judith R. Ragsdale
Judith R. Ragsdale, MDiv, PhD, Director, Education & Research, Department of Pastoral Care, Cincinnati Children's Hospital Medical Center (Cincinnati, OH), originally submitted the following in response to the ACPE Board's initiative:
My dissertation was a grounded theory study of educating CPE supervisors that resulted in an emerging theory of Supervisory Wisdom. This was published in the Journal of Pastoral Care and Counseling (Ragsdale, Holloway & Ivy, 2009). In the summer of 2010, Marla Coulter-McDonald and I developed a discernment unit to help students explore whether they were prepared--personally and professionally--to enter into CPE Supervisory Education. This explored the dimension of the emerging theory called Selecting Students. We had 3 students who we might very well have accepted into a Supervisory CPE program. One student could begin supervisory education today, the other would need to do at least one more unit of Level II CPE to prepare to be an SES, and the third student was really at Level I. Two got credit for Level II CPE and one got credit for Level I. Our plan is to write about this unit as a descriptive study; our goal is to help other supervisors consider the benefits of offering such a discernment unit before accepting a student into supervisory education. This will need to be retroactively submitted to the IRB. This emerging theory was based on interviews with nominated ACPE supervisors considered especially adept at providing supervisory education. My other project is to do another grounded theory study of recently certified ACPE Associate Supervisors to see whether their experience of what proved helpful in their education is similar to or different from the reports of the supervisors in the original study done in 2007 (the one published in 2009). This second project is in the literature review stage.
Since that first response to the call for proposals, Dr. Ragsdale continued to pursue the second project she noted, and that has now been published in the September 2012 issue of the Journal of Pastoral Care and Counseling. See: Ragsdale, J. R., Steele-Pierce, M. E., Bergeron, C. H. and Scrivener, W. E., "Mutually Engaged Supervisory Processes: A Proposed Theory for ACPE Supervisory Education," [3:1-16 --online journal article designation]. Note: ACPE members of course have free access to this article via the journal's login page. --J.E.
6. Proposal Regarding the Perception of Chaplains as a Unique Resource for the Communication of Needs to the Clinical Team, from John B. Hartman
John B. Hartman II, DMin, Director of Pastoral Care Services at Greenville Hospital System / University Medical Center (Greenville, SC), offered this proposal in response to the ACPE Board's initiative:
The first two measures of quality measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey concern nurse and physician communication:
1) Patients Who Reported that Their Nurses "Always" Communicated Well.
2) Patients Who Reported that Their Doctors "Always" Communicated Well.
There is limited research looking at the role of healthcare chaplains in fostering communication between the clinical team and patients. As the HCAHPS survey underscores, the presence of good communication between the clinical team and the patient regularly leads to better healthcare outcomes and a reduction of waste of healthcare resources. The focus of the research project would be: Do patients and family members perceive the role of the healthcare chaplain as providing them with a unique resource to communicate their needs to the clinical healthcare team?
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7. What is the Efficacy of Clinical Pastoral Education in Teaching Resiliency and Coping Skills for Clergy? --update from Beth Jackson-Jordan, Supervisor, Carolinas Medical Center NorthEast, Concord, NC
ACPE Supervisor Beth Jackson-Jordan (Carolinas Medical Center NorthEast) is continuing her research on clergy health, which she originally shared at our meeting during the Salt Lake City conference:
I am developing a research project to study the impact of CPE on the emotional, physical and spiritual health of clergy. A 2008 Duke Divinity School Clergy Health Initiative survey of over 1,700 United Methodist clergy in North Carolina revealed higher than average rates of serious physical and mental health conditions as well as increased numbers of young clergy leaving the profession within the first five years. My research question is What is the efficacy of Clinical Pastoral Education in teaching resiliency and coping skills for clergy? Please contact me if you are interested in collaborating on this project.
She also has written an article, "Clergy Burnout and Resilience: A Review of the Literature," which has been accepted for publication by the Journal of Pastoral Care and Education.
Rev. Jackson-Jordan may be contacted at Beth.Jackson-Jordan@carolinashealthcare.org or 704-403-3335.
8. Looking for Excellence in Supervision: A Researcher's Reflection on Her First Unit of CPE, by Sharon Ghamari-Tabrizi, PhD
Last summer I had the privilege of taking my first unit of CPE at the National Institutes of Health under the supervision of Rev. Ellen Swinford. Her skills as a chaplain, pedagogue, and supervisor are remarkably fine. In comparing my experience with other chaplain interns at CPE Day mid-way through the unit, I learned that not everyone was lucky enough to train under the guidance of a master pedagogue.
The fact that my CPE experience was so productive as a result of landing an excellent supervisor was a matter of dumb luck triggered my curiosity about the pedagogical model in CPE.
What is distinctive about CPE’s pedagogical method is:
- the instructional material is the individual case in all its particularity and detail
- in group and individual supervision, the CPE student explains the sequence of observation, interpretation, reasoning behind her words and actions.
- the CPE student’s peer group -- at the same level of expertise -- as well as more advanced clinicians -- listen to the case, and then offer comments regarding her thoughts and actions
Group feedback is the means by which the presenter learns:
- to identify his/her own blindspots, errors, assumptions, biases.
- that being accountable to one’s profession for one’s action is normative and productive. (In other words, this process socializes the novice into the professional norms of sharing case material and seeking feedback non-defensively.)
- that there are multiple ways of interpreting the same data.
There is no single best way or right way to interpret a case. In medicine, a gathering of physicians can be persuaded by a medical examiner undertaking an autopsy as to the proximate cause of death. But even here, data can be interpreted by competing interpretative frameworks from different specialties. In the case of psychosocial-spiritual suffering there are countless ways to observe, interpret and respond to someone in pain.
The ACPE has chosen clinical experiential learning as the medium for developing a novice’s practical reasoning as a chaplain. If experiential learning is the basis for Clinical Pastoral Education, with the case study method in verbatim form established as the ideal for chaplaincy education, then one must have normative ideals as guidelines. The whole point of clinical case study -- in contrast to generalizations from textbooks -- is to maintain focus on the individual details and specificities of the persons in view.
The pedagogical approach in the history of chaplaincy was two-fold: the central feature of training was, and remains, the case study. Let’s break this down into its parts.
1. One learns by case study. The student learns by exposing his/her practical reasoning and interpretation to his/her peers and supervisor and invites critique, discussion. One is exposed to alternative interpretations and behaviors.
2. Public presentation of the case is the means by which the chaplain learns to be accountable for his/her reasoning. One writes chart notes (as well as verbatims) in order to be accountable for one’s actions to oneself and to one’s peers, and by extension, to the patients and staff with whom one engages. Since, by definition, one can never know the contours and make-up of one’s own blindspots, one requires the assistance of others to learn what one cannot see and know intuitively and internally.
The chaplain intern/resident’s models are her CPE supervisors as well as the staff chaplains in her training hospital, speakers at professional conferences, and authors of articles and books. However, for student applicants, there is essentially only the interview process and hearsay reports of reputations to indicate whether a supervisor is among the best of the best or a mediocre practitioner. The professional community agrees that there is a range of skill among CPE supervisors in the United States. Therefore, how shall the professional community find its model of excellence?
The ACPE promulgates standards, but these are normative. While the ACPE is accredited by the US Department of Education, the provision of CPE is not offered to chaplain interns and residents through the medium of post-graduate degree-granting institutions. Decades ago, the decision was made by the professional organizations that preceded the ACPE to keep clinical pastoral education separate from university settings. The locus of control would be highly decentralized.
While the professional organization evolved standards for defining the required skills and comportment of a hospital chaplain, the interpretation of these standards remained firmly the prerogative of the individual supervisors in hospital settings. In other words, an institutional structure was put into place that guaranteed considerable autonomy to the individual supervisors. Indeed, as the ACPE Presidential Task Group on Training and Certification remarked in August 2006, "While our organization excels at developing thoughtful standards to guide supervisory practice, it remains a challenge to embed the standards into actual practice, given how practices evolve differently from center to center and supervisor to supervisor." The variation is considerable. The task group noted, "Our educational methods are often developed autonomously, and … they often reflect diverse practices across the organization." [Report of the ACPE Presidential Task Group on Training and Certification, August 2006: 2; accessed from the ACPE website on 8/24/12]
The organizational structure of limited external oversight of individual supervisors could plausibly be tied to the experiential, process-oriented, and empirical basis of clinical chaplaincy’s pedagogy. The primary consequence of this arrangement is not only the simple fact of diversity in supervisory style and skill across the nation, but more significantly, the invisibility to the larger community of the range of skills, ideas, behaviors that are modeled to CPE students by supervisors across the country. Unless a supervisor chooses to write and publish, the only outsiders permitted to see/learn/know about a supervisors’ skills and behavior are members of the ACPE certification and accreditation committees and specific peer groups. The principle of confidentiality blocks the possibility of other chaplains learning anything about the specific skills of a supervisor.
What is confidentiality meant to protect? If there is a complaint of alleged unethical behavior, confidentiality can protect the dignity and reputation of the alleged malefactor. BUT by insisting on confidentiality in evaluating a supervisor, those who are excellent cannot be known to the wider professional community. They remain unknown to their peers.
It has long been the tradition that unlike the case study method in medicine, Clinical Pastoral Education has put a premium on keeping the chaplain intern/resident small group’s discussion of case studies entirely confidential. The result is that the field of interpretation is limited to a handful of people.
If the ACPE pedagogical principle is unvaryingly individualistic, then the normative paradigm for chaplaincy must also be individual examples. But if one has the bad luck of encountering a mediocre supervisor, how shall novice chaplains learn what excellence looks like in the particular? I speak not only a consumer of Clinical Pastoral Education but as a career researcher quite new to the ACPE, and I believe the organization and its future students would benefit from a wider and more transparent methodology for describing and evaluating supervisors and identifying best practices
[Dr. Ghamari-Tabrizi was the 2011 David B. Larson Fellow at the Kluge Center of the Library of Congress. She may be contacted at sharon_ghamari-tabrizi@mail.harvard.edu. --J.E.]
9. Gerald Gundersen's "Challenge to Promote Shared Learning in Pastoral Care"
Chaplain Gerald Gundersen (currently at the Psychiatric Institute of Washington, DC) is an experienced researcher and a member of the Research Task Force of the National Association of Catholic Chaplains. In the summer of 2012, he contacted our Research Network about a paper which he had developed for the NACC: "The Challenge to Promote Shared Learning in Pastoral Care," In this, he proposes that "shared learning can...move pastoral care initiatives forward through applied research by putting useful pastoral care strategies to the test" [paper p. 1]. His vision includes a web-based resource for sharing pastoral interventions that practitioners have found successful, with one possible result being the "development of a broadly based reservoir of data containing precious seeds for growth, insight, and applied research" [paper p. 7]. He comments on our own site's section for the SCIPE project:
Right now, there are very few ways for pastoral care providers to contribute to shared learning through an interactive process. The Association for Clinical Pastoral Education (ACPE) Research Network identifies the "Spiritual Care Initiative for Professional Excellence" as a useful resource. The section on Knowledge Base of Spiritual Care Samples documents and organizes over 350 "best practices" that include the experiences of professional chaplains. This is a valuable approach to broader-based sharing of information. [paper p. 6]
His paper is available for download. As with the NACC, Chaplain Gundersen invites comments from the ACPE, and he may be contacted at jgundersen1@verizon.net.
Note: The NACC's "Strategic Plan 2012-2017" includes the following two objectives: "Assess and communicate current research on the value of professional chaplaincy to members and other stakeholders/constituents" and "Partner with associations and clinical research faculties to engage our members in research" [under Goal II].
10. Harold Koenig on the "Role of the Chaplain on the Medical-Surgical Team"
Our Network often cites the work of Harold G. Koenig, MD. His original research is voluminous, and his reviews and commentaries are well known for putting the complex field of spirituality & health into clear perspective. Our August 2012 Article-of-the-Month was, in fact, one of his commentaries, highlighted for its potential value to new CPE students. Now Dr. Koenig has written a brief but robust piece for the journal of the Association of Perioperative Registered Nurses on the "Role of the Chaplain on the Medical-Surgical Team" [AORN Journal 96, no. 3 (September 2012): 330-332]. It advocates strongly for chaplains and makes a case in part on the basis of research. For example:
By addressing the spiritual and emotional needs of patients, chaplains can affect patients’ physical health and surgical outcomes. There is a rapidly growing research base that indicates that the emotional, religious, and spiritual needs of patients influence their health outcomes. This includes affecting basic physiological processes, such as immune, endocrine, and cardiovascular functions. [p. 331]
He goes on immediately to mention the speed of wound healing, mortality rates, hospital length of stay, and the prevention of futile treatment, arguing that "chaplains play an important role in patients’ physical outcomes, as well as their spiritual and emotional ones" [p. 331].
The piece is not comprehensive, and it may understate the interfaith nature of chaplaincy and give a less than precise description of the process of becoming a chaplain, plus it unfortunately includes that weak citation of Bliss, et al., "Chaplain intervention reduces costs in major DRGs: an experimental study," [--for more on that citation, see the note at the bottom of our June 2011 Article-of-the-Month page]. Nevertheless, as an enthusiastic and research-minded championing of chaplaincy, this short article is worth a look.
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