June 2013 Article of the Month
This month's article selection is by Chaplain John Ehman,
University of Pennsylvania Medical Center-Penn Presbyterian, Philadelphia PA.
Tartaglia, A., Fitchett, G., Dodd-McCue, D., Murphy, P. and Derrickson, P. E. "Teaching research in Clinical Pastoral Education: a survey of model practices." Journal of Pastoral Care and Counseling 67, no. 1 (2013): 5:1-14 [online journal page designation].
SUMMARY and COMMENT: Our featured study this month builds upon one from 2012 -- "Educating chaplains for research literacy: results of a national survey of Clinical Pastoral Education residency programs" [see Items of Related Interest §I, below] -- by four of our five authors, who are all research leaders in the ACPE. That earlier article found that only 12% of CPE residency programs incorporated intentional and substantive teaching about research. The present article
...identifies and describes current "model practices" in teaching research in CPE. Using a selected sample of programs known to incorporate research in their curriculum, we examined each program’s curricular aims, content, methods, and activities. We also identified resources that facilitated successful implementation of these goals as well as potential barriers/challenges to incorporating a research component in the clinical training of health care chaplains. [p. 2]
It therefore "provides insights for CPE programs considering the incorporation of a research
component to their residency curricula" [p. 10].
The centers included are:
Each is presented with a paragraph-long description covering "(1) context/hospital type; (2) program aims for research inclusion; (3) structure/content of research components; (4) faculty resources to teach/support the research curriculum" [p. 7, and see pp. 7-10]. In addition, detailed findings are given in three tables that identify the centers' "region, the hours of structured research education, the year the center began consistently teaching research, and the typical number of students who would have annually completed the research module(s)" [pp. 4-5]; "the primary objectives, learning outcomes, and methods/activities used to teach research" [p. 5]; and "the institutional and educational resources used to deliver research elements of the CPE program" [pp. 6-7].
- Advocate Lutheran General Hospital
- Cincinnati's Children's Hospital Medical Center
- Emory University Healthcare
- Indiana University Health System
- Milton S. Hershey Medical Center-Penn State
- Providence/Portland Medical Center
- Rush University Medical Center
- St. Joseph’s Healthcare - Ontario
- Saint Luke's Health System of Kansas City
- Hospital of the University of Pennsylvania
- Virginia Commonwealth University/VCU Health
The authors' discussion [pp. 10-11] addresses similarities and differences in the programs, as well as challenges experienced. Among the findings (noted here only in part):
...[A]ll of the selected programs addressed research literacy. Even though a small number sought to teach higher levels of competence such as research collaboration, most programs focused on the aim of research literacy and the promotion of evidence based practice. ...Introducing research into the curriculum was seen as an incremental change requiring a longitudinal perspective. The process of implementing research curriculum required patience and willingness to revisit and revise...[and,]... required the motivation and commitment of a research champion within the program along with the support of other CPE supervisors and faculty. ...Programs were typically associated with academic medical centers or systems that already endorsed an organizational culture of research and where evidence-based practice was normative in the delivery of patient care. ...Relevant resources from both within and outside of the program were identified and incorporated into the research training activities. ...The content of research training was anchored in multiple methods. These included didactic presentations, assigned readings, and article discussions. Most programs attempted to apply research knowledge to the review of verbatim material. Library database usage was emphasized. Overall, pedagogical techniques already employed in CPE were adopted in the delivery of research into the curriculum.
...[C]enters defined research literacy variously. ...Centers with multiple supervisors reported some variation in supervisor support of research initiatives. ...The research curricula...differed relative to time commitments for research teaching and related activities. ...[There were] differences in depth and focus of research topic coverage. ...[And,] only a handful of programs incorporated student collaboration with staff chaplains’ research as an intentional component of their curricula.
...[R]esearch curricula added to the time commitment of both residents and faculty. In some cases the addition of a research curriculum necessitated revision of clinical coverage in order to facilitate protected time for research activities. ...Some centers needed to address a long standing cultural assumption within ACPE that teaching research literacy in clinical pastoral educations equates with either conducting research or training students to become researchers.
The study (as well as its predecessor) formed the basis of a workshop at the 2013 national ACPE conference. For materials from that workshop, plus syllabi from some centers, see Items of Related Interest §II, below.
This is a very important article for the ACPE for at least two reasons. First, it sets a practical foothold for the incorporation of research throughout the organization. The centers identified not only have established strategies for "'intentional and substantive' teaching of research" [p. 4], but they have done so over time by means of trials and errors that other centers may not have to repeat. The purposeful sample of programs here amounts to list of sources for potential consultation by any supervisors looking to enhance their curricula. Second, the article shows how present strategies advance a long line of efforts aimed at "developing research literacy among the CPE residents as well as encouraging them to integrate findings from research into their clinical practice" [p. 3]. The brief History and Review of Literature on pp. 2-3 illustrates that while the ACPE is considering anew the importance of research, this is very much in keeping with a stream of thought and action that has been stirring since the days of Anton Boisen.
[Disclosure of possible conflict of interest: this writer is noted in the article. --JE]
Suggestions for the Use of the Article for Student Discussion:
We have highlighted this article for its significance to the ACPE. It may be of limited appeal to students who do not (yet) have an appreciation of the issues facing the organization. It would perhaps be best suited to supervisory education students, who could be challenged to discuss how they see research playing into a program that they would shape. However, it might be a useful prompt for discussion by any CPE students at the conclusion of a program that included a research element --to give context to the curriculum they have experienced. Even if the article was not assigned in toto, the fine History and Review of Literature section [pp. 2-3] could be excerpted and used to augment a discussion at the end or the beginning of a program about the place of research in Clinical Pastoral Education.
Related Items of Interest:
I. This article should be paired with the study that preceded it, which was our April 2012 Article-of-the-Month:
Fitchett, G., Tartaglia, A., Dodd-McCue, D. and Murphy, P. "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]. [(Abstract:) 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.]
II. See the authors' workshop presentation, based on this month's article (and its predecessor study), at the 2013 national ACPE conference in Indianapolis, IN, available as a PowerPoint or PDF. Also, syllabi from four of the programs in the study are available via our website on a page for "Model Practices for Teaching Research in Clinical Pastoral Education".
III. While our authors have emphasized the teaching of research literacy, they also reference an important article on teaching research skills in CPE:
Hover. M. "Teaching research skills in Clinical Pastoral Education." Theological Education 33, no. 2 (Spring 1997): 79-92. [Original publication of the Association for Theological Schools.]
IV. It is this writer's view that reading research should never be a passive experience but rather an active participation in a stream of thought on a subject. Every article has an intellectual heritage and potential future impact; every study is part of a dialogue among many others seeking to explore a question. One way to realize this is to take advantage of modern information technology in order to go beyond any particular article's report of methodology and findings and see the document as a foothold from which one might step into a wider conversation. Students may be interested in a simple guide to this end, used at in the CPE program of the University of Pennsylvania Health System: "Working from a 'Foothold' Article in the Health Care Literature: A Guide for Chaplains." The effect is to delve deeply into a literate understanding of the research.
V. Students should note that this month's article comes from the Journal of Pastoral Care and Counseling, which is an excellent source for research of interest to ACPE members and for articles useful to all chaplains. The present issue is a good example: of its six major articles, four are reports of research (i.e., those by Cramer, et al.; by Garner; and by Piderman, et al.; in addition to the article by Tartaglia, et al.), one is a review of research literature (i.e., by Jackson-Jordan), and one is written with strong references to research (i.e., by Marsay). The journal has its roots in the ACPE. See also the history of the journal.
Cramer, E. M., Tenzek, K. E. and Allen, M. "Translating spiritual care in the chaplain profession." Journal of Pastoral Care and Counseling 67, no. 1 (2013): 6:1-16 [online journal page designation]. [(Abstract:) Chaplains provide a much-needed service to patients and families requiring spiritual care in the healthcare setting. Despite evidence documenting improvements quality of life for patients using spiritual services, chaplains experience challenges in translating the benefits they provide into concepts understood by patients, team members, and administrators. A qualitative study using interviews with 19 chaplains found that translation problems occur in three main areas: (a) justifying the role to patients and families, (b) determinations of what constitutes a “productive” employee, and (c) effective collaboration with other members of the health care team. This study outlines several strategies used by chaplains to ease the process of translation, as well as some directions for future research.]
"Interpersonal criticism and the clergy." Journal of Pastoral Care and Counseling 67, no. 1 (2013): 2:1-14 [online journal page designation]. [(Abstract:) Though well-crafted criticism can provide valuable information for the recipient, the abundance of literature finds that criticism is overwhelmingly viewed negatively. The consequences of adverse interpersonal criticism were assessed by a focus group of randomly selected clergy members from a large ministerial alliance. Collectively the focus group revealed that interpersonal criticism can have deleterious vocational, psychological, and health consequence for those in the ministry. Clergy reported that criticism from parishioners, the public, denominational officials, and others adversely affect interpersonal relationships and can lead to stress, burnout, and early departure from the ministry. The participants indicated that current training and resources were inadequate to deal with the issue and further denominational support and seminary education was necessary.]
Jackson-Jordan, E. A. "Clergy burnout and resilience -- a review of the literature." Journal of Pastoral Care and Counseling 67, no. 1 (2013): 3:1-5 [online journal page designation]. [(Abstract:) In this article, I review the literature on burnout and resilience among clergy. The existing research shows that the factors related to clergy burnout include the quality of interpersonal skills, relationships outside the congregation, establishment of peer/mentor relationships, the existence of high role expectations, personal spirituality and the ability to set healthy emotional boundaries. Recent studies using positive psychology as a framework identify a number of personal and situational qualities that promote resilience in clergy. Based on these findings, I suggest interventions that should be made by faith groups to better support clergy and make recommendations for further research.]
"Take heed, take care!" Journal of Pastoral Care and Counseling 67, no. 1 (2013): 4:1-8 [online journal page designation]. [(Abstract:) This paper offers a synthesis of public and personal narratives about the effects of stress in working with “wounded others”, weaving together common themes to highlight difficulties associated with doing such work. The intention is to stimulate conversation among individuals, institutions, and organisations for considering ways in which Pastoral Care and Counseling providers can ameliorate negative stress-induced effects of their work.]
Piderman, K. M., Jenkins, S. M., Hsu, J. S. and Kindred, A. S. "Hospitalized young adults' expectations of pastoral interventions." Journal of Pastoral Care and Counseling 67, no. 1 (2013): 7:1-7 [online journal page designation]. [(Abstract:) The objective of this analysis of 4500 inpatients was to identify the experience and expectations of 18-35 year olds regarding chaplain visitation and to compare results with data from older adults. 71% of young adults reported wanting to be visited by a chaplain; 45.5% were visited; 68% indicated that this was important. Young adults value chaplains’ role as a sign of God’s care and presence (77.4%), in providing support for family (73.6%), being present during times of anxiety (66.0%), and praying/reading scripture with them (62.3%). Results were similar to older respondents, but young adults were more likely to value ethical counsel from chaplains (58.5% vs. 38.2%). This study provides clinically relevant information and suggestions for further research.]