To fulfill a graduation requirement for my Master’s of Divinity degree, I enrolled in a mandatory internship in 1998 called Clinical Pastoral Education (CPE) at Erlanger Hospital in Chattanooga, Tennessee. I had no idea what I was getting myself into or how much impact that program would have on me. Unbeknownst to me, that internship began my unanticipated career in health care chaplaincy. The internship focused mainly on developing students’ self-awareness. We were asked deep, probing questions about ourselves to help us better understand and use ourselves to provide effective spiritual and emotional support to patients. Oddly enough, one fundamental question remained unanswered throughout the internship: what exactly do health care chaplains do? To find an answer to that question, I sneaked off to the hospital library to see what others had written on this question. I had become a researcher, and this was my first research question. I was not trying to become one; I simply wanted to have more confidence in what I was doing as a chaplain intern when I visited patients. Unfortunately, the internship offered no encouragement or training to engage students’ research questions. Neither did my theological degree program. The lack of education in scientific research for aspiring chaplains is a problem that holds the field of health care chaplaincy back from realizing its potential as an allied health profession.
For the past 25 years, health care chaplaincy leaders have called for chaplains to become more evidence-based and research literate (Fitchett, 2017; Fitchett, Nieuwsma, Bates, Rhodes, & Meador, 2014; Fitchett, Tartaglia, Dodd-McCue, & Murphy, 2012; O’Connor & Meakes, 1998; St. James O’Connor, 2002; Tartaglia, Fitchett, Dodd-McCue, Murphy, & Derrickson, 2013; Weaver, Flannelly, & Liu, 2008). Beaudry and Miller (2016) define research literacy as “the ability to locate, understand, discuss, and evaluate different types of research; to communicate accurately about them; and to use findings for academic and professional purposes” (p. 4). In 2002, Fitchett (2002) argued that health care chaplaincy should become a research-informed profession in the next decade. In 2009, the Association of Professional Chaplains (APC) set an expectation that all chaplains should be research literate when they established the first set of Standards of Practice for Chaplains in Acute Care and included research literacy (Tartaglia et al., 2013).
A study conducted from 2004-2006 found that most chaplains had no formal training in research and reported feeling anxious and inadequate when it came to involvement (Murphy & Fitchett, 2009). In 2012, Fitchett and colleagues (2012) conducted a study of Association of Clinical Pastoral Education (ACPE) residencies to determine the extent to which they prepared their graduates to be research literate. Only 12% of the programs studied had research-related curricula, 27% provided limited exposure to research, and 62% offered no programming to increase research literacy. In 2013, Tartaglia and colleagues (2013) conducted a study to determine what educational practices CPE residencies employed to increase research literacy. They identified the following: didactic presentations, assigned readings, article discussions, and integration of research findings into verbatim case studies (Tartaglia et al., 2013).
To address the problem of research illiteracy among health care chaplains, George Fitchett and colleagues established the Transforming Chaplaincy with the support of a $4.5 million grant from the John Templeton Foundation (White and Fitchett, 2020). The project developed several different approaches to increasing research literacy, such as publishing a reader on chaplaincy research to be used in chaplaincy education programs, establishing a website with resources for chaplains interested in learning more about research, creating online courses about research for chaplains, and offering small program grants (approximately $2000 per program) to CPE residencies to develop research curricula (White and Fitchett, 2020). However, the greatest impact the Transforming Chaplaincy may have had was through their research fellowships, which provided scholarships and stipends for 17 board-certified chaplains to earn accredited master’s degrees in public health (White and Fitchett, 2020). While the Transforming Chaplaincy substantially contributed to increasing research literacy among chaplains, additional solutions are needed.
Cadge et al. (2020) reported an increase in chaplaincy-focused graduate theological degrees in divinity schools and theological seminaries over the last 20 years. Health care chaplaincy degrees need not be limited to theological institutions, though. Chaplaincy educators should develop new graduate-level degrees that focus on studying theology and religion with the added component of the scientific study of health and spirituality. Such degrees could include a combination of course work, clinical experiences, and clinical supervision, similar to the educational programs in social work and counseling, which typically require 48-60 graduate credit hours and may be completed in two years. Course work could include theories of spiritual care, spiritual assessment, individual and group counseling skills, human development, ethics, world religions and spiritualties, thanatology, organizational development, and, of course, research methods.
Nowhere along the educational pathway do aspiring health care chaplains receive training in scientific research, which is a problem holding back the field from reaching its potential. A quarter-century ago, leaders in health care chaplaincy began calling upon chaplains to become research literate. Transforming Chaplaincy made great strides towards that end, but more innovation is needed. New graduate degrees should be created and curricula tailored to today’s healthcare chaplains’ specific tasks, including research literacy, participation, and leadership.
