By Austine Duru
For the first time in the history of the NACC, research has become a required competency for certification of chaplains. This development mirrors the growing trend nationally and internationally.
In May 2014, NACC Board of Directors approved the revised standards for certification and recertification of chaplains. Several were added, including three standards that specifically speak to research and research literacy relevant to professional chaplaincy:
Standard 305.7: Articulate how primary research and research literature inform the profession of chaplaincy and one’s spiritual care practice.
To meet this new standard, applicants should be able to read, understand and explain substantive research work published in peer-reviewed journals. Applicants should be familiar with the research work currently available in healthcare chaplaincy and be able to integrate the findings into their pastoral practice.
This new research standard serves a dual purpose. First, it is an effort by the NACC certification commission to stay faithful to the church by aligning the NACC standards with elements of formation from the Co-Workers in the Vineyard of the Lord (USCCB, 2005). This document offers some guidelines around best thinking and practice in the formation of those called to lay ecclesial ministry in the church, and affirms all who are called to serve in this unique role.
Secondly, the new standards attempt to bring the certification process of the NACC current with emerging trends in professional chaplaincy. By adding these standards, the association is also affirming what has already been said in Co-Workers: “Adult learners need a variety of learning methods that maximize participation and draw on participants’ experience. These may include small groups, lectures, discussions, independent research, guided learning projects, theological reflection on field experience, and use of technology (e.g., teleconferencing, distance learning)” (USCCB, 2005).
The NACC Board of Directors also approved the newly revised standards for specialty certification in palliative care and hospice. Two of these new specialty standards are worth noting:
Standard 604.2: Keep current and participate in evidence-based, research-informed best practices in chaplaincy and spiritual care.
Standard 604.3: Integrate chaplaincy care into the organization through appropriate measures, such as policies and procedures, use of evidence-informed spiritual screening, history taking, assessment and documentation processes and education of the interdisciplinary team about the role of the professional chaplain.
To meet this standard, the applicants should be able to show that they are familiar with published research work on the subject, able to critique and evaluate published research work, integrate the findings into their practices, and show sufficient skills to participate in developing and carrying out primary research in chaplaincy.
The new NACC standards coincide with the creation of a Joint Research Council by APC in collaboration with other professional chaplaincy organizations. “Its three primary goals are to: 1) enhance communication among colleagues with mutual interests and in different organizations about research-related educational opportunities, educational resources, research opportunities; 2) collaborate in advocating for research efforts and research literacy and compare strategies being used to move this agenda forward; and 3) provide a central place to identify and disseminate information about opportunities for chaplaincy-related research” (Ehman, 2014).
Already, in a move to establish uniform standards of care, APC approved the Standards of Practice for Professional Chaplains in Acute Settings that specifically address research competency. Standard 12 specifies, “The chaplain practices evidence-based care including ongoing evaluation of new practices and, when appropriate, contributes to or conducts research.” (APC, 2009).
The shift to evidence-based interventions in pastoral care represents next steps in the evolution of pastoral care, dating at least
from the Portland Agreement of 2004. The importance of research in this next phase of healthcare chaplaincy has received greater recognition and has been consistently documented (Fitchett, G, 2011; Bay & Ivy, 2006; Flannelly, Liu, Oppenheimer, Weaver, & Larson, 2003; Gleason, 2004; Koenig, 2008; VandeCreek, 2002; Weaver, Flannelly, & Liu, 2008). A few years ago, Fitchett made a remarkable proposition when he wrote, “Health care chaplaincy should become a research-informed profession in the next ten years” (Fitchett, 2002). Twelve years in, evidence-based pastoral care has become a reality.
This call to support spiritual care and pastoral interventions with research has gained acceptance as chaplaincy organizations realize that research can preserve the future of chaplaincy and at the same time make pastoral care an effective ministry. Research literacy webinars and lectures are being offered across the board for chaplains and chaplain educators. This is indeed remarkable.
The benefits of evidence-based pastoral care are real, but so are the challenges involved. While research helps us connect the dots in efficient pastoral care and develop new models of care delivery, it need not represent a major renunciation of chaplains’ tried and tested practices. Rather, it adds to the knowledge base of chaplains and continues to build on the established traditions, albeit with new evidence. As the research becomes more refined, the standards will certainly be raised for chaplains to perform at much higher integrated level and become more efficient.
As chaplains do more research, they should take care to ensure that their work uses proven methodology and is of high quality. Also, some questions have been raised around informed consent in the use of patient narratives. A central ethical dilemma, notes David McCurdy, would be “striking a balance between protecting patients and providing sufficient detail to make case studies useful” (McCurdy, et. al., 2011).
The future of professional chaplaincy is exciting. I hope that NACC, through its pioneering efforts, will continue to contribute to this future by helping to share substantive research works that are transforming the field of chaplaincy. Professional chaplains must understand the changing landscape of healthcare delivery, without getting too caught up in the debate whether evidence-based research is an oxymoron or a paradox.
Austine Duru, BCC, is director of mission and pastoral care at St. Elizabeth Regional Medical Center & Nebraska Heart Hospital in Lincoln, NE.
REFERENCES:
Association for Professional Chaplains. Standards of Practice for Professional Chaplains in Acute Care Setting. (2009).
Ehman, John, ed. ACPE Research Network. 12. 3 (2014).
Fitchett, George. “Health care chaplaincy as a research-informed profession: How we get there.” Journal of Health Care Chaplaincy 12.1-2 (2002): 67-72.
Fitchett, George. “Making our case (s).” Journal of Health Care Chaplaincy 17.1-2 (2011): 3-18.
Lichter, David A. “CHA Chaplaincy surveys offer key insights.” Health Progress (St. Louis, MO) 95.5 (2013): 57-59.
McCurdy, David B., and George Fitchett. “Ethical issues in case study publication: ‘Making our case (s)’ ethically.” Journal of health care chaplaincy 17.1-2 (2011): 55-74.
