The second EKM Journal Club took place this Tuesday April 23rd examining spirituality in nursing education. Attending faculty engaged in a thoughtful discussion about how spiritual care education is incorporated into the current curriculum at the UBC School of Nursing.
This months paper:
McSherry W., Gretton M, Draper P, & Watson R. (2008) The ethical basis of teaching spirituality and spiritual care: A survey of student nurses perceptions. Nurse Education Today 28(8) 1002-8
…is available from here within UBC or here using EZProxy outside the University.
In the article the authors examine pre-registration nursing students’ perceptions on spiritual care education. They find that students were divided on the meaning or definition of spirituality. The authors delineate spirituality into two perspectives: a secular existentialist perspective, and a perspective from religiosity. The authors suggest that the “majority [of students surveyed] felt it was wrong for spirituality to imply that some people are better than others” (McSherry, 2008). I
The discussion went as follows, and please join in the discussion with your thoughts (simply click “Leave a Reply” at the end of the post.
The faculty agreed that although this delineation is useful to frame the idea of spirituality, it also narrows it in possibly an-oversimplistic manner. For example, even the existentialist perspective described here does not differentiate views that accept a separation of “spirit” from body and those that don’t (i.e. the mind–body problem/Cartesian dualism ).
The Canadian Nursing Association defines spirituality from a more existentialist perspective as “whatever or whoever gives ultimate meaning and purpose in one’s life, that invites particular ways of being in the world in relation to others, oneself and the universe”. The group agreed that attempting to define spirituality is a value laden process, but realized it is useful to have a common consensus in a definition of spirituality throughout the School of Nursing if we hope to teach to it. In realizing the immense challenge of agreeing on a common definition, we asked, how do we best teach something that has no consensus of agreed definition? The group felt that an open acknowledgement of the different perspectives, and an exploratory non-judgmental approach considering how nurses can meet patient’s spiritual needs would likely be the most effective.
Currently spiritual care education is woven throughout the undergraduate curriculum in the first semester in various thread classes in Relational Practice and those that consider ethics. The group considered that perhaps we do not need to improve the quality of spiritual care education so much, but rather the degree and ensure the content is explicitly addressed.
The trend towards an increased focus on spiritual care education was compared to that of the interprofessional education, although it was noted there is rather a dearth of nursing research in this area.
The group considered, Are UBC students prepared to assist clients in their spiritual needs to a dignified death, and can we improve our spiritual care education? It is necessary to give students the skills they need to effectively assist clients through challenging life transitions.
Noting the sensitivities and challenges around this topic, perhaps “end of life curriculum” manages to address student’s educational needs without tackling the enigmatic and at times thorny issues of spirituality and religion. Teachings about cultural safety, empathetic listening all support teaching of spiritual care. The journal group came to the conclusion that this would be an area worthy of further consideration by the Undergraduate Program and Policy Committee and maybe a student survey along similar lines to that explored in the paper would be useful here.
The recent debate in the media on the private Christian Trinity Western University and it’s attempt to get a Law School approved, and opposition by the Canadian Council of Law Dean’s (CCLD) to a Christian law program also sparked some interest in this subject by the group. This BC University already has a nursing program (and so UTW students and faculty sign a Community Covenant Agreement that has caused the concern of the CCLD).
With this in mind, using a web poll we asked the rather challenging question: Should institutions that promote a single spiritual basis, one that identifies specific practices as right or wrong, be approved to provide generalist RN education for the Canadian public healthcare system? You can participate in this poll at the end of the post.
It was noted the CNA’s position statement on spirituality, health and nursing practice states that “when providing care, nurses do not discriminate on the basis of an individual’s spiritual beliefs” but it goes no further to explain how School’s should approach providing such spiritual care education. However, the question of whether the TWU approach was discriminatory arose, and seemed an area of concern.
At the present moment, CRNBC specific spiritual care accreditation requirements are somewhat vague, but the group were surprised that this issue had not come up upon the prior accreditation of the TWU nursing program by the CRNBC in a similar fashion to the current concerns expressed by the CCLD .
Appraisal of the Paper
Overall, the article earned an average to good rating from the audience. The authors were commended on the originality and attempt to explore these complex issues. The methodology was a little unclear, particularly the validity of the tool used to appraise student beliefs. Overall this work was felt to be a very useful contribution to the knowledge in this area.
Additional Resources
Slides used at the club meeting: EKM Journal Club 2 Slides
Integrating Spirituality into Undergraduate Nursing Curricula; 2008 Paper from IJNES
Forthcoming Workshop
Our upcoming workshop on May 7th will focus on interactive technologies to support classroom polling and will include a demonstration and tutorial on PollEverywhere. Bring your laptops or smartphones! The workshop will take place at 12:00pm in room T206. Please RSVP to Allana at allana.hearn@alumni.ubc.ca
