June 2018 Articles of the Month
by John Ehman, Editor, ACPE Research Article-of-the-Month
and Manager for Pastoral Care, Penn Presbyterian Medical Center, Philadelphia PA
Derrickson, P. and Ebersole, M. "Lasting effects of CPE: a five year review." Journal of Pastoral Care 40, no. 1 (March 1986): 5-15.
Jankowski, K. R., Vanderwerker, L. C., Murphy, K. M., Montonye, M. and Meigs Ross, A. "Change in pastoral skills, emotional intelligence, self-reflection, and social desirability across a unit of CPE." Journal of Health Care Chaplaincy 15, no. 2 (2008): 132-148.
SUMMARY and COMMENT: In a departure from our usual practice of highlighting the latest published research, this month two older articles are featured that may help ACPE members think about the challenge of investigating the effect/effectiveness of CPE. One explores the possible lasting effects, and the other looks at student changes during single program units. This topic should be useful for educators at the individual ACPE center level, but it is also currently receiving close attention by the ACPE Research Committee. Creative studies can continue to speak with relevance for many years after publication, stirring thought about both subject matter and methodology.
In the mid-1980s, when research was quite novel in the ACPE, Paul Derrickson and Myron Ebersole undertook a study at the Hershey Medical Center (Hershey, PA) to see how the CPE experience may have had a lasting effect on graduates of their program. The project was driven in part by the organizational requirement of a self-study for a Periodic Accreditation Review, but the research went on to explore how former students' memories could be a "measurement of the impact of CPE on current pastoral functioning" [p. 5]. This indicator was chosen as a means to collect a broad spectrum of data easily from alumni/ae, though the authors recognized the risks of "subjective bias of the respondents and the inability to validate the accuracy of their reporting" [p. 6]. The 60 graduates of the Hershey center over its first five years of accreditation were sent a questionnaire asking first how well they thought the CPE program complied with the standards and objectives for Clinical Pastoral Education (--the focus of the Periodic Accreditation Review) and then about their memories: "[h]ow often they have memories of CPE," "...[w]hat the content was of those memories," and "...[i]n what pastoral situations they were most likely to recall CPE experiences" [p. 5]. Remarkably, 55 students responded, for a return rate of 91.6%. [Demographic data are presented on p. 6, in one of nine helpfully supplied tables that supplement the narrative of the results.]
The authors' hypotheses and results (and further questions the results posed) are as follows:
- Hypothesis 1: "The more former students recalled experiences from CPE, the more likely CPE experiences were impacting the current functioning of the former student. This is a quantitative measurement, not qualitative assessment" [p. 6].
- --This hypothesis was supported by students' reports, to a surprising extent from the "very high scores" [p. 14] on this question. "This finding indicates that CPE does indeed have a very substantial impact on former students currently functioning in their ministry. If there is as substantial an impact as the data indicate, it would be important to document further the degree to which it is positive or negative" [p. 14].
- Hypothesis 2: "Supervisors maintain that the uniqueness of CPE lies in dealing with "living human documents" under supervision within the context of a peer group. If that hypothesis is true, the content of the students' memories ought to reflect the same emphasis. Otherwise we are not teaching what we think we are" [p. 6].
- --This hypothesis was supported. "The relative importance of the different types of experiences seems consistent and validates our claim that CPE is learning through encounter with the living human document. Students remembered contact with patients most, supervision next and peer group experiences third" [pp. 13-14].
- Hypothesis 3: "Learning theory says people are more likely to transfer learning from one setting to another if the new setting is similar to the original setting. Translating that into our study we thought students were more likely to recall memories when their current pastoral experience was similar to their CPE experiences; that is, hospital visits, crisis situations and counseling would more likely recall memories of CPE than would the link between group dynamics and committee meetings in the church. So we asked when memories were likely to occur; i.e. [W]hat was their context?" [p. 6].
- --This hypothesis was supported in that students' memories indicated that they were "more likely to use their CPE training in situations which are similar to the training experiences," though "[t]here seems to be some broader use of CPE experiences in such things as sermon preparation and personal reflection" [p. 14]. "This raises the questions of how well the students have grasped the idea of process in their overall perspective on ministry and how well does the process help them in circumventing this problem of translation" [p. 14].
- Hypothesis 4: "We have tried to link process with content in our program. Thus, we asked students which seminars they remembered the most and compared it with their responses to the content of their memories. We expected a direct and strong correlation" [p. 6].
- --This hypothesis was supported from the responses. "Emotionally charged situations seem to have a stronger impact on memory and recall. They also seem to impact students because they are new experiences and they are most open to intellectual learning around these topics. Timing in didactic presentations seems crucial to long term retention and recall. It also raises another issue: In another clinical setting would memory and recall show a different effect because of differences in types and intensity of emotionally charged situations?" [p. 14].
- Hypothesis 5: "Finally, we asked students to comment on their memories of supervision and peer group. We hypothesized that Basic students, because they are more likely to be working on pastoral identity issues would have a more personal focus in supervision and group, while Advanced students would have a more professional focus" [p. 6].
- --This hypothesis was not fully supported, with the findings yielding surprises about "a qualitative difference in the experiences of Basic Full-time and Basic Extended students" [p. 14]. "Extended students recall more regarding the issue of teamwork (both within the group and with other professionals), focus more directly on visitation of the sick and treat supervision with a more professional focus. Since the Extended program [at Hershey] is sixteen hours per week and only eight of those hours may overlap with other students, the students feel their isolation more. The structure forces them to build their own support system in ways which might be more professionally productive. Extended students also bring in problems from their parish. This whole set of circumstances seems to foster a professionally focused problem-solving modality rather than a personal professional process orientation" [p. 14]. Regarding Advanced students, they showed "a preference for a more personal focus in supervision" [p. 12] and "ranked supervision much higher than the Basic students" [p. 9].
The authors' observations of the details of this study, in addition to their hypothesis-level summaries, suggest some interesting points for further study. For instance, in contrast to the emphasis that CPE traditionally places on the importance of self-awareness, students in this sample did not seem to identify self-awareness as a particularly strong theme in their memories of supervision [--see p. 13]. Tied to supervision was also the finding that intensive unit students tended to remember their supervisor as therapist, while those from extended units remembered their supervisor more as a professional training mentor. Regarding didactic seminars, it's notable that Extended unit students seemed much more interested in medical information than the other student groups. Also, there was "a striking correlation" [p. 12] between memories of some specific events during CPE and memories of didactic topics: i.e., between specific patients remembered and medical topics, and even more between deaths recalled and didactics around grief and suffering. As concerns memories of emotionally-laden events in CPE, the authors speculate that "[o]ther parts of the process such as writing verbatims and reflections may strengthen the memory capacity" [p. 9]. And in terms of the peer group experience, the data showed that some students were "currently using the group process in the pastoral setting" [p. 13], which would seem to call for more investigation into such student application.
The immediate and practical implications of this research played out in a rethinking of elements of the Hershey CPE program by its educators, leading them to make adjustments to their didactic curriculum, to give more attention to their Basic program, and to design a "core curriculum for each level of training" [p. 15]. The venture also encouraged the authors to undertake further study. They conclude: "It is apparent that this research project has shown us the strength of our program, indicated some areas for possible change and suggested some new questions to pursue" [p. 15]. It should be noted that the authors are careful not to make generalizable claims about their findings, beyond what they personally take to be enlightening about their own program, and even there they recognize limits to their methodology, including perhaps a skewing of data as a function of students having a "high investment in the people doing the survey" [p. 8].
This reader found the article to be quite usefully thought-provoking, now over 32 years later. The idea of focusing on student memories is especially intriguing, in spite of the limitations and risks of that approach, because CPE is an educational modality that works a great deal with the activity of remembrance. It also implicitly acknowledges the important role of memory in any survey of alumni/ae. This article held out an early example of creative research for program evaluation, and it also showed the value of maintaining good contact information on students for feedback not just right after a program but years on. This work was and is a significant contribution to the literature, worthy of remembering.
Editor's Note: One sentence of the article was printed in error. "All but three students gave no answers..." [p. 8] should have been "All but three students gave answers...." or alternatively "Only three students gave no answers...."
Invited Comment to ACPE Research by Paul Derrickson, MDiv, ACPE Certified Educator, Retired (email@example.com):
The project was spurred by having to undergo a reaccreditation review. Mike Ebersole and I felt that as long as we had to do the reaccreditation, we might use it in a creative way. At the time Clinical Pastoral Education was beginning to come under scrutiny, and little was documented about the impact of CPE on students. Also, doing research as chaplains was very rare. We were wondering: When you took away all the support for growth provided by CPE structure and intent, would student revert to "old" ways? A second concern was growing criticism raising the issue of CPE's contribution to the development of pastors and their identity: i.e., Was CPE an appropriate venue in the training of parish pastors?
The article was published with another article as critique [--see Related Items of Interest, §IV, below]. The critique stung partly because it was a surprise. I don't think the journal had ever done that before, and I also had some naïveté as a researcher. I thought if something was new (like research for chaplains) you'd want to nurture it. It was then that I learned how a critique could take the work out of its context and put it against the ideal "scientific methodology and design," rather than identifying the sub-type of study and how well it may live up to the criteria and methodology for that sub-type. Our study was one of the first of its kind. To critique it for not being more sophisticated seemed irrelevant. Yes, there were weaknesses: we as investigators had a vested interest in the outcome, and the methodology was not well-grounded and the concepts employed were not clearly enough defined, but I believe it was not bad for a first try. Today it would have been considered a "customer satisfaction survey." I never received feedback from colleagues about what they thought of the project or article.
Our Second article this month is by Katherine R. B. Jankowski, Lauren C. Vanderwerker, Kathryn M. Murphy, Martin Montonye, and A. Meigs Ross, from 2008, examining changes in CPE students across single units of CPE at the HealthCare Chaplaincy program (New York, NY) from the summer of 2006 through the summer of 2008. Questionnaires were given to all students within the first two weeks of each unit and again at the end of the course, with 144 participants completing both (out of a total sample of 310, for a response rate of 46%). Intensive unit students comprised 55% of the sample, with the remaining being in extended units. Regarding CPE experience, 106 were in their first unit, 21 in their second, and 17 in their third.
The...study compares the personal growth of the intensive and extended unit CPE students using a number of psychological measures, controlling for demographic differences between intensive and extended unit students. Specifically, this study looks at CPE student growth in pastoral skills, emotional intelligence, and self-reflection, while controlling for social desirability and other important demographic variables. It was hypothesized that all CPE students would improve in pastoral skills, emotional intelligence, and self-awareness over the course of their CPE unit. Social desirability was measured as a control variable, so that growth could be evaluated outside of natural inclinations to respond positively to desirable growth questions. [p. 135]
Measures included a Pastoral Skills Scale [--see Related Items of Interest, §II, below], the Schutte Self-Report Emotional Intelligence Test, the Self-reflection and Insight Scale, and the Marlowe-Crowne Short Form (re: social desirability), each described on pp. 136-137. In order to be included in the data set, "participants had to have fewer than twenty percent of the items missing on any one measure, and they must have had data on both the pre-test and post-test questionnaires" [p. 137]. Much of the article [pp. 138-144] details the statistical analysis of the data, beginning with indications of good test reliability [--see p. 138].
Among the results:
As a whole, students in this study showed significant increases in their pastoral care skills and emotional intelligence over the course of their CPE training. However, some groups of students experienced more improvement than others. For pastoral skills, students with fewer years of professional ministry, no prior CPE experience, and lower scores on a social desirability scale experienced more positive change in their skills. The sole significant predictor of improved emotional intelligence and improved self-reflection was participating in an intensive course. In a surprising finding, there was a significant decrease in average self-reflection and insight scores in students in the extended course. In contrast, while not significant, there was a slight improvement in self-reflection in students in their third or fourth CPE unit. These are unique findings and invite further research exploration. [p. 145]
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Students' pastoral skills improved the most in the first unit, with additional increases in subsequent units. Average Emotional Intelligence and Self-reflection and Insight scores improved for intensive unit students but not significantly for students in extended units, and self-reflection and insight significantly decreased in extended unit students. [p. 146]
In discussing the differences between the groups, Jankowski and colleagues refer to Derrickson & Ebersole's 1986 study and the differences between recollections of supervisors as either therapists or mentors. They state that though the present study "did not ask the students how they viewed their supervisors, ...if intensive students in this study also viewed their supervisors as a therapist, this might explain the increase in emotional intelligence and self-reflection in the intensive unit students" [p. 146].
Limitations are well addressed [--see p. 146], such as less than half of students completing the post-test, which left the sample size sufficiently reduced to raise concerns about selection bias influencing the results. "In addition, the reduced sample size provided inadequate power to test for possible interaction effects in the regressions analyses" [p. 145]. Nevertheless, "Despite the limitations, the current study makes a substantial contribution to the CPE research literature by providing an example of a systematic attempt: (1) to evaluate the level of pastoral skills students bring to a unit of CPE; and (2) to measure improvement in those skills as a result of participating in CPE" [p. 145]. The authors particularly recommend the Pastoral Skills Scale [--see Related Items of Interest, §II, below] as a "useful measure to document pastoral skills and confidence, and has potential to help students become aware of their pastoral strengths and weaknesses over the course of a CPE unit" [pp. 145-146].
This article contains a succinct review of a handful of major studies of CPE up through the early 2000s [--see pp. 133-134], and the bibliography is a nice collection of sources. As with the Derrickson & Ebersole article, this one continues to generate productive questions for research, especially in terms of its sophisticated statistical analysis which is attuned to caution around drawing conclusions too quickly, given the complexity of the variables. One ancillary statement also drew this reader's attention: namely, "Students coming into CPE anticipate they will learn skills relevant to being an empathic and efficacious provider of pastoral care" [p. 144]. That itself would seem to warrant an empirical test. More than anything else, however, this perceptive article holds out the prospect of meaningful research within the time frames of individual educational units, bringing the path of improving the CPE process right alongside students' own journeys of growth.
Invited Comment to ACPE Research by Martin Montonye, MS, DMin, ACPE Certified Educator, Bellevue Hospital Center, New York, NY (firstname.lastname@example.org):
Ten years later, this study continues to serve as a good example of collaboration between educators and researchers. Our efforts to measure the effect a unit of clinical pastoral education in skill development, emotional intelligence, and self-reflection remain as relevant as those areas are so to this day. This study could provide a blueprint for future research on change in the measured abilities of our students to validate our educational objectives, outcomes and curriculum.
Editor's Note: Dr. Montonye has offered to make available the original questionnaire used in the study, to any ACPE member. You may contact him at his email address, above.
Suggestions for Use of the Two Articles for Student Discussion:
The prime audiences for these two articles would be ACPE Certified Educator Candidates and researchers, though they might be read with strong interest by many CPE groups near the conclusion of units. The Derrickson & Ebersole article is perhaps the most flexible for its consideration of the place of memories in CPE. A group could be asked simply at the outset, "What memories of CPE most stand out to you?" Responses might not touch on all the areas of the article, but conversation could start off by connecting such personal input with the study's findings. A second question could deepen discussion by asking why people think the memories they've just shared stood out to them. Do the results of the study seem resonant or at least reasonable? The five hypotheses could provide structure for the discussion. Thoughts about the section on the Peer Group [p. 13] might prove particularly interesting. For Certified Educator Candidates, the question of the role of memory in CPE could be explored both in terms of educational utility and program assessment. Most fundamentally, are memories good indicators of the effect of CPE on graduates pastoral functioning? The data tables offer much food for thought. The data around memories of a supervisor/educator as a therapist or mentor would seem to have broad implications for supervisory theory and practice. Moreover, what does the group think of the relatively low numbers associated with memories about self-awareness as a theme in supervision?
The piece by Jankowski, et al. is probably more narrowly suited for Certified Educator Candidates who have knowledge of statistics, as the text delves into the statistical analysis at some depth. The concept of social desirability and its place in the methodology should be a key focus. Each of the four central measures is certainly worth attention, though obtaining the Pastoral Skills Scale might unfortunately be tricky. The group could also be asked to identify all the ways that the authors exhibit their caution against not drawing conclusions broadly or hastily. Further, do the findings about differences between groups suggest that CPE is in reality an umbrella term for an educational modality experienced differently depending on the various types of CPE units? If so, how might this affect one's thinking not only about supervision but about program outcomes? Now as for discussion groups within regular CPE units, this article might be engaging at the very end of a program, when the ideas of pastoral skills, self-reflection, and emotional intelligence could be set against students' own experience of growth. If the Pastoral Skills Scale is not available, then perhaps the Schutte Self-Report Emotional Intelligence Test would be of keen interest. The lion's share of the article may be too statistical for most CPE groups, but profitable discussion could come from a close look at the opening pages and the Discussion section. What indicators would the CPE students use to measure their own change during the unit?
Related Items of Interest:
I. For ACPE members, the Journal of Pastoral Care and Counseling is available through the ACPE website, under the Resources section. Full access through Sage Journals is to all issues, going back to 1968. As this month's featured research should prove, there is much to be gleaned from older articles.
II. Jankowski and colleagues say of the Pastoral Skills Scale (PSS) that it "has been used at a number of CPE centers, but we were unable to trace its origins or development" [p. 136]. Given that the measure is particularly recommended as a "useful measure to document pastoral skills and confidence, and has potential to help students become aware of their pastoral strengths and weaknesses over the course of a CPE unit" [pp. 145-146], the items of the scale are made available here, taken from the multi-instrument questionnaire originally used in the Jankowski, et al. study. If any ACPE member is aware of authorship of the PSS, please contact the Research Article-of-the-Month Editor, so that proper attribution can be noted.
III. A select listing of other research on CPE:
Denham, T. E. "An analysis of CPE student time usage: the impact of training." Journal of Pastoral Care 39, no. 1 (March 1985): 49-57. [(Abstract:) Reports results of a research project on a population of 81 Clinical Pastoral Education students Correlates demographic, training, and emotional variables with time usage Discusses and interprets data and draws implications for CPE Supervisors and for CPE training programs.]
Derrickson, P. E. "Instruments used to measure change in students preparing for ministry: a summary of research on clinical pastoral education students." Journal of Pastoral Care 44, no. 4 (1990): 343-356. [(Abstract:) Surveys studies in which psychometric tools were used in an attempt to measure change in students as a result of their participation in Clinical Pastoral Education Gives special attention to the use of The Minnesota Multiphasic Personality Inventory, the Personality Orientation Inventory, Edwards Personal Preferance Schedule, the Adjective Check List, the Osgood Semantic Differential, Cattells' Sixteen Personality Factor Test, Leary's System for Interpersonal Diagnosis, the Carkhuff Scale, and The Empathy Test Notes positive as well as limiting factors of research in which psychometric instruments have been used]
Fitchett, G. and Gray, G. T. "Evaluating the outcome of clinical pastoral education: a test of the Clinical Ministry Assessment Profile." Journal of Supervision and Training in Ministry 15 (1994): 3-22. [(Comment by Shannon Borchert from a 2008 bibliography published on the ACPE Research site:) This is one of the first articles to quantitatively measure the outcomes of level I and level II CPE. The authors studied 39 students who had taken a year long residency from 1984-1991. They gave the students a pre and post test called the Clinical Ministry Assessment Profile (CMAP). This instrument took several years to develop and was a joint effort between the ACPE and the Association of Theological Schools (ATS). This article demonstrates the outcomes of CPE can be measured. Seventy-eight of the eighty items showed positive changes in students’ attitudes and behavior as a result of their educational experience. This article also studied the reliability of the CMAP instrument itself. Overall, the CMAP instrument is judged to be an effective tool. This article suggests that other types of CPE programs could be measured as well.
Flannelly, K. J., Roberts, S. B. and Weaver, A. J. "Correlates of compassion fatigue and burnout in chaplains and other clergy who responded to the September 11th attacks in New York City." Journal of Pastoral Care and Counseling 59, no. 3 (2005): 213-224. [Among the findings of this study of 343 clergy, including 97 chaplains who participated in disaster-relief following the September 11th attacks in New York City: "Clinical Pastoral Education tended to decrease compassion fatigue and burnout and increase compassion satisfaction in both responders and non-responders" (--from the abstract).]
Greary, T. F "Personal growth in CPE." Journal of Pastoral Care 31, no. 1 (1977): 12-17. [(Abstract:) Personal growth (Self-Actualization) as an effect of Clinical Pastoral Education was investigated. 101 subjects participated. The Personal Orientation Inventory and the Christie Self-Concept Inventory were given before and after the quarter, and, again, after one month. A demographic questionnaire and a limited number of personal interviews were used. Statistical results are favorable to the hypothesis that CPE is an effective procedure for fostering personal growth. This growth seems to diminish upon completion of the quarter, with the exception of the desire to be self-actualized which doesn't lessen over time.]
Jackson-Jordan, E., Stafford, C., Stratton, S. V., Vilagos, T. T., Janssen Keenan, A. and Hathaway, G. "Evaluation of a chaplain residency program and its partnership with an in-patient palliative care team." Journal of Health Care Chaplaincy 24, no. 1 (January-March 2018): 20-29. [(Abstract:) In 2009 a Consensus Conference of experts in the field of spiritual care and palliative care recommended the inclusion of Board-certified professional chaplains with at least 1,600 hours of clinical pastoral education as members of palliative care teams. This study evaluates a clinical pastoral education residency program's effectiveness in preparing persons to provide spiritual care for those with serious illness and in increasing the palliative care team members' understanding of the chaplain as part of the palliative care team. Results showed chaplain residents felt the program prepared them to provide care for those with serious illness. It also showed that chaplain residents and palliative care team members view spirituality as an integral part of palliative care and see the chaplain as the team member to lead that effort. Suggested program improvements include longer palliative care orientation period, more shadowing with palliative care team members, and improved communication between palliative care and the chaplain residents.]
O'Connor, T. S. J., Fox, K., Meakes, E., Empey, G. and O’Neill, K. "Quantitative and qualitative outcome research on a regional basic supervised SPE program." Journal of Pastoral Care 51, no. 2 (1997): 195-206. [(Abstract:) Discusses issues in the evaluation of supervised pastoral education (SPE) programs. Explains four ways of applying triangulation in developing an accurate evaluation of SPE and presents a case study of an SPE program evaluated through triangulation. Offers suggestions about the use of triangulation in SPE program evaluation.]
O'Connor, T., Healy-Ogden, M., Meakes, E., Empey, G., O’Neill, K., Edey, L. and Klimek. S. " The Hamilton SPE Evaluation Tool (HSET): Is it any good?" Journal of Pastoral Care 55, no. 1 (2001): 17-34. [(Abstract:) Presents the Hamilton Supervised Pastoral Evaluation Tool (HSET). HSET is a self-report that evaluates student learning in a basic SPE unit utilizing six areas: supervisory relationship, personal growth, professional growth, theological reflection, learning context, and overall growth. Reviews statistics involving seven regional units consisting of 18 SPE units with 101 students. Utilizes methodological, investigator, and data triangulation by drawing on qualitative study and CAPPE accreditation review. Discusses strengths and weaknesses of HSET and makes recommendations for further use.]
Pfeiffer, J. "Measuring the CPE experience among chaplains in the Presbyterian Church of America and the Orthodox Presbyterian Church." Unpublished CPE Residency project, Hospital of the University of Pennsylvania, 2007. [The report of the project has been made available to ACPE Research by the author.]
Strehlow, K. and Hewitson, J. "The effects of CPE on primary relationships -- Is it worth exploring?" Journal of Pastoral Care and Counseling 69, no. 2 (June 2015): 78-84. [(Abstract:) 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.]
Tartaglia, A. and Dodd-McCue, D. "Enhancing objectivity in pastoral education: use of standardized patients in video simulation." Journal of Pastoral Care & Counseling 64, no. 2 (2010): 2.1-10 [electronic journal article designation]. [(Abstract:) 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.]
Thomas, J. T., Stein, L. I. and Klein, M. H. "A comparative evaluation of changes in basic clinical pastoral education students in different types of clinical settings as measured by the adjective check list and the experience scale." Journal of Pastoral Care 36, no. 3 (September 1982): 181-193. [(Abstract:) Utilizes the Adjective Check List, the Minnesota Multiphasic Personality Inventory, a critical incident report, and a demographic questionnaire to test students in twenty basic CPE units in a before-and-after research design Various statistical analyses indicate that Basic Unit CPE students in several types of CPE settings tend to perceive themselves in a more positive and less defensive way following the CPE experience Describes and tests several other hypotheses relative to the specific settings in which CPE takes place Suggests additional research possibilities]
Trothen, T. J. "Students' perspectives: a Canadian study of supervised pastoral education." Journal of Pastoral Care 54, no. 3 (2000): 325-337. [(Abstract:) Summarizes and analyses the findings of a research study that was commissioned and supported by CAPPE and The Churches' Council on Theological Education in Canada. Surveys students who were completing a basic unit in Supervised Pastoral Education (SPE) to identify the self-perceived effects of the unit on pastoral functioning. Utilizes qualitative and quantitative methods, focus group sessions, consultations, and a literature search to develop a questionnaire which was distributed to eligible students via the Internet. Draws several conclusions that suggest re-examination, further study or program changes, and validates the central focus of SPE basic units on self-awareness and experiential learning.]
VandeCreek, L., Hover, M. and Gleason, J. J. "Quantitative outcomes of Clinical Pastoral Education: a review of the literature." Journal of Supervision and Training in Ministry 21 (2001):132-147. [(Comment by George Fitchett from an unpublished bibliography:) This is a helpful summary of the existing research. Provides structured abstracts for 18 published, quantitative studies of CPE. In their summary of the research the authors describe evidence for learning in 3 areas: actualizing the human potential of students, strengthening their belief that they can succeed in ministry, and positively influencing their future performance in ministry. The authors note that overall the studies contain many weaknesses. Their review includes some old (1958) and small (n=4) studies.]
VandeCreek, L. and Valentino, J. "Affective and cognitive changes in first-unit clinical pastoral education students." Journal of Pastoral Care 4 (1991): 375-386. [Reports the research findings of a study designed to answer two questions: What do Clinical Pastoral Education students learn? What changes result from the CPE experience? Presents statistical results of a test-retest design in which three paper-and-pencil instruments are employed. Discusses the results of the research and urges additional research.]
VandeCreek, L. and Valentino, J. "Symptoms of depression among Clinical Pastoral Education students and their impact upon learning." Journal of Supervision and Training in Ministry 13 (1991): 13-19. [This is a companion to the authors' work on "Affective and cognitive changes in first-unit clinical pastoral education students," cited above.]
Zollfrank, A. A., Trevino, K. M., Cadge, W., Balboni, M. J., Thiel, M. M., Fitchett, G., Gallivan, K., VanderWeele, T. and Balboni, T. A. "Teaching health care providers to provide spiritual care: a pilot study." Journal of Palliative Medicine 18, no. 5 (May 2015): 408-414. [(Abstract:) BACKGROUND: Health care providers' lack of education on spiritual care is a significant barrier to the integration of spiritual care into health care services. OBJECTIVE: The study objective was to describe the training program, Clinical Pastoral Education for Healthcare Providers (CPE-HP) and evaluate its impact on providers' spiritual care skills. METHODS: Fifty CPE-HP participants completed self-report surveys at baseline and posttraining measuring frequency of and confidence in providing religious/spiritual (R/S) care. Four domains were assessed: (1) ability and (2) frequency of R/S care provision; (3) comfort using religious language; and (4) confidence in providing R/S care. RESULTS: At baseline, participants rated their ability to provide R/S care and comfort with religious language as "fair." In the previous two weeks, they reported approximately two R/S patient conversations, initiated R/S conversations less than twice, and prayed with patients less than once. Posttraining participants' reported ability to provide spiritual care increased by 33% (p<0.001). Their comfort using religious language improved by 29% (p<0.001), and frequency of R/S care increased 75% (p<0.001). Participants reported having 61% more (p<0.001) R/S conversations and more frequent prayer with patients (95% increase; p<0.001). Confidence in providing spiritual care improved by 36% overall, by 20% (p<0.001) with religiously concordant patients, and by 43% (p<0.001) with religiously discordant patients. CONCLUSIONS: This study suggests that CPE-HP is an effective approach for training health care providers in spiritual care. Dissemination of this training may improve integration of spiritual care into health care, thereby strengthening comprehensive patient-centered care.] [This article was the ACPE Research May 2015 Article-of-the-Month.]
IV. Accompanying Derrickson & Ebersole's "Lasting effects of CPE: a five year review" was a "Critical comment" by William S. Schmidt, PhD, from the Pastoral Care Department at Royal Alexandra Hospitals, Edmonton, Alberta, Canada [Journal of Pastoral Care 40, no. 1 (March 1986): 15-20]. He argues against the study's written structure, literature review, hypotheses, and methodology. Editor's note: While the scientific enterprise advances through the help of criticism, Dr. Schmidt's piece seems inordinately negative and unappreciative of the trailblazing efforts of Derrickson & Ebersole. Schmidt decries the article for "serious deficiencies" in terms of "its presentation as a model for pastoral research," but Derrickson & Ebersole never make such a claim about their work, and in fact they are quite careful to note the limitations of their study and cautious in reporting their results. On the contrary, in this reader's opinion, their thinking about the possibilities of research at an early stage of the ACPE's attention to empirical investigation was a creative and genuine contribution to the literature. Dr. Schmidt puts forward a number of admonitions in light of ideal forms of scientific research that might have been relevant to the ACPE as an organization at the time, but it was unfortunate that the pairing of his criticism with the featured article may have deflated the perceived value of Derrickson & Ebersole's work. Schmidt states in his conclusion: "The writers of the reviewed article and the center they represent need to be commended for their openness to feedback and for the development of what could turn out to be an excellent quality control device" (p. 20); however, the Journal provided no room for an authors' reply that could have opened up a wider conversation about what the original study was as well as what it perhaps wasn't. That being said, various concerns by Dr. Schmidt could be pertinent to chaplains approaching their own research in the present day.