Chaplains on the Medical Team: Structuring Interprofessional Learning for Medical and Spiritual Care Trainees in Direct Clinical Care
Presenters:
Dr. Patrick Hemming, M.D., MPH, Duke University School of Medicine, Department of Medicine, Division of General Internal Medicine, Durham, N.C.
Chaplain Ty Crowe, M.Div., Department of Spiritual Care and Chaplaincy, Johns Hopkins Health System, Baltimore, MD
Reverend Paula Teague, D.Min., MBA, Department of Spiritual Care and Chaplaincy, Johns Hopkins Health System, Baltimore, MD
Many patients see spirituality as important in their lives, and state a need to feel connected in their medical care to their faith or spiritual beliefs. As members of patients’ inpatient support structure, hospital chaplains specialize in addressing these patient needs and can contribute significantly to patients’ satisfaction with care. In current hospital practice, physicians and chaplains generally have limited understanding of each other’s expertise, and collaborate infrequently in patient care. Although others have published interprofessional curricula pairing chaplains with nurses and social workers, and some curricula report involvement of chaplains in medical student teaching, very little literature exists on interprofessional education that pairs chaplain and physician learners.
With regard to collaborating in patient care, physicians and chaplains each have gaps in their training. Among physicians, many report feeling inadequate to address patients’ spiritual needs. Studies have found that physicians express less positive attitudes toward addressing spirituality than other members of the healthcare team, although other studies generally show a receptiveness to chaplains. Chaplains may not be accustomed to or be comfortable approaching physicians in connection with a patient’s care.
The potential benefits of pairing physicians and chaplains include greater patient and provider satisfaction, increased degrees of teamwork, improved spiritual care attitudes, and care that is more patient-centered and value-based. A focus on spiritual care has been associated with positive patient outcomes, such as quality of life and receipt of appropriate end-of-life care. Teaching spirituality in patient care might benefit from an interprofessional approach, especially one that involves physicians and chaplains. Interprofessional education in health care has demonstrated both educational and patient-level benefits in other settings. Existing curricula aimed at teaching physicians about the spiritual care of patients tend to target medical students, only occasionally involve chaplains, and are not set in the context of direct patient care. To address these needs, we initiated an interprofessional educational partnership in 2011, pairing chaplain interns and medical residents in the direct care of hospitalized patients.
The workshop will provide the attendees with the curriculum that has been implemented and studied for three years at Johns Hopkins Bayview Medical Center. The curriculum includes three phases of educational programming; orientation to spiritual care and assessment for both chaplain trainees and medical residents, joint rounding and visitation with patients and reflective practice and evaluation.
Attendees will be able to learn about and experience aspects of the curriculum such as having a spiritual discussion as a medical provider, practicing a spiritual assessment and discussion of the experience as a reflective exercise.
Results about the impact of the curriculum on participants will be shared as well as on-going issues in this shared experiential curriculum format. To better understand the benefits and challenges of learning together, the presenters conducted several focus groups with participants in an interprofessional curriculum that partnered internal medicine residents with chaplain interns in the clinical setting. There are four major qualitative themes from the transcripts: 1. Physician learners became aware of effective communication skills for addressing spirituality. 2. Chaplain interns enhanced the delivery of team-based patient-centered care. 3. Chaplains were seen as a source of emotional support to the medical team. 4. The partnership has three keys to success: adequate introductions for team members, clear expectations for participants, and opportunities for feedback. The themes presented indicate several benefits of pairing physicians and chaplains in the setting of direct patient care and suggest that this is an effective approach to incorporating spirituality in medical training.
Dr. Patrick Hemming, M.D., MPH, Duke University School of Medicine, Department of Medicine, Division of General Internal Medicine, Durham, N.C.
Chaplain Ty Crowe, M.Div., Department of Spiritual Care and Chaplaincy, Johns Hopkins Health System, Baltimore, MD
Reverend Paula Teague, D.Min., MBA, Department of Spiritual Care and Chaplaincy, Johns Hopkins Health System, Baltimore, MD
Many patients see spirituality as important in their lives, and state a need to feel connected in their medical care to their faith or spiritual beliefs. As members of patients’ inpatient support structure, hospital chaplains specialize in addressing these patient needs and can contribute significantly to patients’ satisfaction with care. In current hospital practice, physicians and chaplains generally have limited understanding of each other’s expertise, and collaborate infrequently in patient care. Although others have published interprofessional curricula pairing chaplains with nurses and social workers, and some curricula report involvement of chaplains in medical student teaching, very little literature exists on interprofessional education that pairs chaplain and physician learners.
With regard to collaborating in patient care, physicians and chaplains each have gaps in their training. Among physicians, many report feeling inadequate to address patients’ spiritual needs. Studies have found that physicians express less positive attitudes toward addressing spirituality than other members of the healthcare team, although other studies generally show a receptiveness to chaplains. Chaplains may not be accustomed to or be comfortable approaching physicians in connection with a patient’s care.
The potential benefits of pairing physicians and chaplains include greater patient and provider satisfaction, increased degrees of teamwork, improved spiritual care attitudes, and care that is more patient-centered and value-based. A focus on spiritual care has been associated with positive patient outcomes, such as quality of life and receipt of appropriate end-of-life care. Teaching spirituality in patient care might benefit from an interprofessional approach, especially one that involves physicians and chaplains. Interprofessional education in health care has demonstrated both educational and patient-level benefits in other settings. Existing curricula aimed at teaching physicians about the spiritual care of patients tend to target medical students, only occasionally involve chaplains, and are not set in the context of direct patient care. To address these needs, we initiated an interprofessional educational partnership in 2011, pairing chaplain interns and medical residents in the direct care of hospitalized patients.
The workshop will provide the attendees with the curriculum that has been implemented and studied for three years at Johns Hopkins Bayview Medical Center. The curriculum includes three phases of educational programming; orientation to spiritual care and assessment for both chaplain trainees and medical residents, joint rounding and visitation with patients and reflective practice and evaluation.
Attendees will be able to learn about and experience aspects of the curriculum such as having a spiritual discussion as a medical provider, practicing a spiritual assessment and discussion of the experience as a reflective exercise.
Results about the impact of the curriculum on participants will be shared as well as on-going issues in this shared experiential curriculum format. To better understand the benefits and challenges of learning together, the presenters conducted several focus groups with participants in an interprofessional curriculum that partnered internal medicine residents with chaplain interns in the clinical setting. There are four major qualitative themes from the transcripts: 1. Physician learners became aware of effective communication skills for addressing spirituality. 2. Chaplain interns enhanced the delivery of team-based patient-centered care. 3. Chaplains were seen as a source of emotional support to the medical team. 4. The partnership has three keys to success: adequate introductions for team members, clear expectations for participants, and opportunities for feedback. The themes presented indicate several benefits of pairing physicians and chaplains in the setting of direct patient care and suggest that this is an effective approach to incorporating spirituality in medical training.