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Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns

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Abstract

Improved collaboration between physicians and chaplains has the potential to improve patient experiences. To better understand the benefits and challenges of learning together, the authors conducted several focus groups with participants in an interprofessional curriculum that partnered internal medicine residents with chaplain interns in the clinical setting. The authors derived 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.

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Abbreviations

JHBMC:

Johns Hopkins Bayview Medical Center

CPE:

Clinical pastoral education

PH:

Patrick Hemming

PT:

Paula Teague

References

  • Association for Clinical Pastoral Education (ACPE). (2010). ACPE standards and manuals. Decatur, GA: ACPE.

  • Anandarajah, G., & Mitchell, M. (2007). A spirituality and medicine elective for senior medical students: 4 years’ experience, evaluation, and expansion to the family medicine residency. Family Medicine, 39(5), 313–315.

    PubMed  Google Scholar 

  • Archer, J. C. (2010). State of the science in health professional education: Effective feedback. Medical Education, 44(1), 101–108. doi:10.1111/j.1365-2923.2009.03546.x.

    Article  PubMed  Google Scholar 

  • Balboni, T. A., Balboni, M., Enzinger, A. C., Gallivan, K., Paulk, M. E., Wright, A., & Prigerson, H. G. (2013). Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Internal Medicine, 173(12), 1109–1117. doi:10.1001/jamainternmed.2013.903.

    Article  PubMed  PubMed Central  Google Scholar 

  • Balboni, M. J., Sullivan, A., Enzinger, A. C., Epstein-Peterson, Z. D., Tseng, Y. D., Mitchell, C., et al. (2014). Nurse and physician barriers to spiritual care provision at the end of life. Journal of Pain and Symptom Management 48(3), 400–410. doi:10.1016/j.jpainsymman.2013.09.020.

  • Balch, C. M., & Shanafelt, T. (2010). Combating stress and burnout in surgical practice: A review. Advances in Surgery, 44, 29–47.

    Article  PubMed  Google Scholar 

  • Bandura, A. (1989). Human agency in social cognitive theory. American Psychologist, 44(9), 1175.

    Article  CAS  PubMed  Google Scholar 

  • Campbell, J. C., Coben, J. H., McLoughlin, E., Dearwater, S., Nah, G., Glass, N., & Durborow, N. (2001). An evaluation of a system-change training model to improve emergency department response to battered women. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 8(2), 131–138.

    Article  CAS  Google Scholar 

  • Campbell, N., Stuck, C., & Frinks, L. (2012). Spirituality training in residency: Changing the culture of a program. Academic Psychiatry, 36(1), 56–59.

    Article  PubMed  Google Scholar 

  • Chibnall, J. T., Bennett, M. L., Videen, S. D., Duckro, P. N., & Miller, D. K. (2004). Identifying barriers to psychosocial spiritual care at the end of life: A physician group study. American Journal of Hospice and Palliative Medicine, 21(6), 419–426.

    Article  PubMed  Google Scholar 

  • Clark, P. A., Drain, M., & Malone, M. P. (2003). Addressing patients’ emotional and spiritual needs. Joint Commission Journal on Quality and Safety, 29(12), 659–670.

    PubMed  Google Scholar 

  • Crabtree, B. F., & Miller, W. L. (1992). Doing qualitative research. Newbury Park, CA: Sage Publications.

    Google Scholar 

  • Ekedahl, M., & Wengström, Y. (2008). Coping processes in a multidisciplinary healthcare team: A comparison of nurses in cancer care and hospital chaplains. European Journal of Cancer Care, 17(1), 42–48. doi:10.1111/j.1365-2354.2007.00801.x.

    Article  CAS  PubMed  Google Scholar 

  • Fitchett, G., Rasinski, K., Cadge, W., & Curlin, F. A. (2009). Physicians’ experience and satisfaction with chaplains: A national survey. Archives of Internal Medicine, 169(19), 1808–1810. doi:10.1001/archinternmed.2009.308.

    Article  PubMed  Google Scholar 

  • Forrest, C., & Derrick, C. (2010). Interdisciplinary education in end-of-life care: Creating new opportunities for social work, nursing, and clinical pastoral education students. Journal of Social Work in End-of-Life & Palliative Care, 6(1–2), 91–116. doi:10.1080/15524256.2010.489224.

    Article  Google Scholar 

  • Fortin, A. H., & Barnett, K. G. (2004). STUDENTJAMA. Medical school curricula in spirituality and medicine. JAMA, the Journal of the American Medical Association, 291(23), 2883. doi:10.1001/jama.291.23.2883.

    Article  CAS  PubMed  Google Scholar 

  • Fulford, K., Peile, E., & Carroll, H. (2012). Essential values-based practice: Clinical stories linking science with people. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Galanter, M., Dermatis, H., Talbot, N., McMahon, C., & Alexander, M. J. (2011). Introducing spirituality into psychiatric care. Journal of Religion and Health, 50(1), 81–91.

    Article  PubMed  Google Scholar 

  • Gregory, S. R. (2003). Growth at the edges of medical education: Spirituality in American medical education. The Pharos of Alpha Omega Alpha-Honor Medical Society. Alpha Omega Alpha, 66(2), 14–19.

    PubMed  Google Scholar 

  • Henriksen, A., & Ringsted, C. (2011). Learning from patients: Students’ perceptions of patient-instructors. Medical Education, 45(9), 913–919. doi:10.1111/j.1365-2923.2011.04041.x.

    Article  PubMed  Google Scholar 

  • Institute of Medicine (IOM). (2011). Patients charting the course: Citizen engagement and the learning health system: Workshop summary. Washington, DC: The National Academies Press.

  • King, D. E., & Crisp, J. (2005). Spirituality and health care education in family medicine residency programs. Family Medicine, 37(6), 399–403.

    PubMed  Google Scholar 

  • Koenig, H. G. (2014). The spiritual care team: Enabling the practice of whole person medicine. Religions, 5(4), 1161–1174.

    Article  Google Scholar 

  • Koenig, H. G., Hooten, E. G., Lindsay-Calkins, E., & Meador, K. G. (2010). Spirituality in medical school curricula: Findings from a national survey. International Journal of Psychiatry in Medicine, 40(4), 391–398.

    Article  PubMed  Google Scholar 

  • Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Le Blanc, P. M., Hox, J. J., Schaufeli, W. B., Taris, T. W., & Peeters, M. C. (2007). The evaluation of a team-based burnout intervention program for oncology care providers. Journal of Applied Psychology, 92(1), 213.

    Article  PubMed  Google Scholar 

  • MacLean, C. D., Susi, B., Phifer, N., Schultz, L., Bynum, D., Franco, M., & Cykert, S. (2003). Patient preference for physician discussion and practice of spirituality. Journal of General Internal Medicine, 18(1), 38–43.

    Article  PubMed  PubMed Central  Google Scholar 

  • McClung, E., Grossoehme, D. H., & Jacobson, A. F. (2006). Collaborating with chaplains to meet spiritual needs. Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses, 15(3), 147–156.

    Google Scholar 

  • McCray, L. W., Cronholm, P. F., Bogner, H. R., Gallo, J. J., & Neill, R. A. (2008). Resident physician burnout: Is there hope? Family Medicine, 40(9), 626–632.

    PubMed  PubMed Central  Google Scholar 

  • Morey, J. C., Simon, R., Jay, G. D., Wears, R. L., Salisbury, M., Dukes, K. A., & Berns, S. D. (2002). Error reduction and performance improvement in the emergency department through formal teamwork training: Evaluation results of the MedTeams project. Health Services Research, 37(6), 1553–1581.

    Article  PubMed  PubMed Central  Google Scholar 

  • Otis-Green, S., Ferrell, B., Spolum, M., Uman, G., Mullan, P., Baird, R. P., & Grant, M. (2009). An overview of the ACE project-advocating for clinical excellence: Transdisciplinary palliative care education. Journal of Cancer Education, 24(2), 120–126.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pearce, M. J., Coan, A. D., Herndon, J. E, 2nd, Koenig, H. G., & Abernethy, A. P. (2012). Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 20(10), 2269–2276. doi:10.1007/s00520-011-1335-1.

    Article  Google Scholar 

  • Phelps, A. C., Lauderdale, K. E., Alcorn, S., Dillinger, J., Balboni, M. T., Van Wert, M., & Balboni, T. A. (2012). Addressing spirituality within the care of patients at the end of life: Perspectives of patients with advanced cancer, oncologists, and oncology nurses. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 30(20), 2538–2544. doi:10.1200/JCO.2011.40.3766.

    Article  Google Scholar 

  • Piderman, K. M., Marek, D. V., Jenkins, S. M., Johnson, M. E., Buryska, J. F., Shanafelt, T. D., & Mueller, P. S. (2010). Predicting patients’ expectations of hospital chaplains: A multisite survey. [Not medical educationTy]. Mayo Clinic Proceedings, 85(11), 1002–1010.

    Article  PubMed  PubMed Central  Google Scholar 

  • Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., & Sulmasy, D. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine, 12(10), 885–904. doi:10.1089/jpm.2009.0142.

    Article  PubMed  Google Scholar 

  • Ratanawongsa, N., Rand, C. S., Magill, C. F., Hayashi, J., Brandt, L., Christmas, C., & Ziegelstein, R. C. (2009). Teaching residents to know their patients as individuals. The Aliki initiative at Johns Hopkins Bayview Medical Center. The Pharos of Alpha Omega Alpha-Honor Medical Society. Alpha Omega Alpha, 72(3), 4–11.

    PubMed  Google Scholar 

  • Reed, D. A., & Wright, S. M. (2010). Role models in medicine. In H. J. Humphrey (Ed.), Mentoring in academic medicine (pp. 67–87). New York: ACP Press.

    Google Scholar 

  • Reeves, S., Zwarenstein, M., Goldman, J., Barr, H., Freeth, D., Koppel, I., & Hammick, M. (2010). The effectiveness of interprofessional education: Key findings from a new systematic review. Journal of Interprofessional Care, 24(3), 230–241. doi:10.3109/13561820903163405.

    Article  PubMed  Google Scholar 

  • Smith, R. C., Fortin, A. H., Dwamena, F., & Frankel, R. M. (2013). An evidence-based patient-centered method makes the biopsychosocial model scientific. Patient Education and Counseling, 91(3), 265–270.

    Article  PubMed  Google Scholar 

  • Stewart, M. (2003). Patient-centered medicine: Transforming the clinical method. Oxford: Radcliffe Publishing.

    Google Scholar 

  • Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., & Deutschlander, S. (2009). Role understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care, 23(1), 41–51. doi:10.1080/13561820802338579.

    Article  PubMed  Google Scholar 

  • Talley, J. A., & Magie, R. (2014). The integration of the “spirituality in medicine” curriculum into the osteopathic communication curriculum at Kansas city university of medicine and biosciences. Academic Medicine: Journal of the Association of American Medical Colleges, 89(1), 43–47. doi:10.1097/ACM.0000000000000078.

    Article  Google Scholar 

  • Towle, A., & Godolphin, W. (2013). Patients as educators: Interprofessional learning for patient-centred care. Medical Teacher, 35(3), 219–225. doi:10.3109/0142159X.2012.737966.

    Article  PubMed  Google Scholar 

  • Vallurupalli, M., Lauderdale, K., Balboni, M. J., Phelps, A. C., Block, S. D., Ng, A. K., & Balboni, T. A. (2012). The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. The Journal of Supportive Oncology, 10(2), 81–87. doi:10.1016/j.suponc.2011.09.003.

    Article  PubMed  PubMed Central  Google Scholar 

  • Van de Ridder, J. M. M., Stokking, K. M., McGaghie, W. C., & ten Cate, O. T. J. (2008). What is feedback in clinical education? Medical Education, 42(2), 189–197.

    Article  PubMed  Google Scholar 

  • Walter, U., Plaumann, M., & Krugmann, C. (2013). Burnout intervention. In S. Bährer-Kohler (Ed.), (pp. 223–246) Springer, US. doi:10.1007/978-1-4614-4391-9_14.

  • Williams, C. M., Wilson, C. C., & Olsen, C. H. (2005). Dying, death, and medical education: Student voices. Journal of Palliative Medicine, 8(2), 372–381.

    Article  PubMed  Google Scholar 

  • Williams, J. A., Meltzer, D., Arora, V., Chung, G., & Curlin, F. A. (2011). Attention to inpatients’ religious and spiritual concerns: Predictors and association with patient satisfaction. Journal of General Internal Medicine, 26(11), 1265–1271. doi:10.1007/s11606-011-1781-y.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This project was funded by a grant from the Foundation for Spirituality and Medicine, Baldwin, MD. Dr. Hemming was supported while completing this project by a Health Resources Services Administration Institutional National Research Service Award (T32HP10025B0).

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Correspondence to Patrick Hemming.

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Hemming, P., Teague, P.J., Crowe, T. et al. Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns. J Relig Health 55, 560–571 (2016). https://doi.org/10.1007/s10943-015-0158-7

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  • DOI: https://doi.org/10.1007/s10943-015-0158-7

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