Preparing undergraduate student nurses/midwives for spiritual care

AimTo report the findings from two studies and to show: how the first has resulted in changes in teaching/learning about spiritual care in the pre-registration nursing/midwifery programmes in one Welsh university; how the second is being used to shape the future of spiritual care pre-registration nursing/midwifery education across Europe.

ContextSpiritual care, is a key feature in healthcare policy and guidance internationally (WHO 2002, Welsh Government 2015). Spiritual care is expected of nurses/midwives (ICN 2012, NMC 2010, QAAHE 2002) yet nurses consistently report feeling unprepared and want further education (RCN 2010). Spiritual care is important to patients (Ross 2006, Ross & Austin 2013) but is often overlooked (National Care of the Dying Audit for Hospitals, England 2015). We therefore sought to address the disconnect between regulatory body expectation and the experienced reality of practising nurses and patients by conducting two research studies.

Study 1: pilot studyQuestionnaires measuring perceived spiritual care competency, personal spirituality, perception of spirituality/spiritual care and demographics were completed by 531 (86% response rate) undergraduate nursing/midwifery students from 6 universities in 4 countries.

Findings and what changed Tests of association and regression analysis were performed. Students who perceived themselves to be most competent in spiritual care were more likely to view spirituality broadly (p=0.002) and to have high spiritual wellbeing (p<0.001) and spiritual attitude/ involvement scores (p<0.001). Previous healthcare experience was also helpful (Ross et al 2014). We, therefore, moved the spirituality teaching from year 1 to years 2/3 so that students had clinical experience to draw upon. Spiritual care scenarios and exercises which encouraged reflection on personal beliefs/values were included in the programme. Student/staff evaluations indicate improvement in the teaching/learning experience.

Study 2A cross-sectional multinational longitudinal correlational study involving over 3000 students from 22 universities in 8 countries was conducted (2011-15) to investigate if/how students’ perceived spiritual care competence changed over their undergraduate education and to identify factors contributing to any change.

Findings Students’ perceived spiritual care competency increased slightly over the duration of their course (p=<0.001) and two factors were consistently correlated with this: broad perception of spirituality/spiritual care (r range 0.318 – 0.540) and high personal spirituality (r range 0.149 – 0.390). Students considered clinical encounters with patients and discussions with other students to be instrumental in development of competence.

Key messages Spiritual care competency can be learned and personal beliefs/values are important, but further investigation is needed to better understand the complex range of factors which facilitate this learning and to explore best practice in teaching and learning.

Moving forwardAn Erasmus+ KA2 funded project (2017-2019) will enable nurse educators and key stakeholders from across Europe to consider the research findings from the 2 studies and, together with other available evidence and international best practice, to develop/test an innovative, dynamic and flexible Spiritual Care Matrix for nurse/midwifery education which can be adopted by Higher Education Institutions across Europe. We invite undergraduate nurse educators and stakeholders with an interest in spiritual care to participate in this exciting Project.