Spiritual Care Matters e-learning unit

Innovation

The Spiritual Care Matters GLIDER (a small e-learning unit) is delivered over a six to eight week period. It combines topic information with practice-based scenarios, to provide learners with knowledge of spiritual care whilst also encouraging them to focus on application of the principles and knowledge to their own area of practice, both in terms of patient care and the interprofessional teams they work in. Undergraduate students and NHS staff can complete it simultaneously with each group benefitting from the experience of the other.

The GLIDER has four key elements.

• The first of these is the Spiritual Care Matters (SCM) document (NHS, 2009), which underpins the learning. As they work through the unit, learners are directed to read relevant chapters of the document.
• This is intertwined with the second element, the reality based practice scenarios. These were developed by the project team and aim to raise learners’ awareness of the broad and varied nature of spiritual care. It also illustrates how the information presented in the SCM document can be applied in practice, to the benefit of patients, families and healthcare workers alike. The scenarios form a bridge that links discipline theory to the application of that theory into practice and vice versa.
• The third component is the interaction between learners and teachers via the online discussion boards based on a purpose made film. Activities and discussion linked to the scenarios and film prompt learners to explore spiritual care issues and perspectives sensitively and in a secure environment.
• To facilitate learning and the linking of theory and practice, an interactive element is included, which consists of learning activities and discussion board activities within a sensitive and secure environment.

Students and staff must have a username and password to access the learning unit whilst the facilitation team can email a student privately should there be any requirement for a discussion which may be sensitive in nature.

The learning activities aim to help students link the scenarios to their local practice situation, facilitating a personalised learning experience and the enhancement of professional practice. All learners must engage in the online discussion board, which enables them to gain understanding from considering others’ perspectives and roles thus widening their understanding of different aspects of spiritual care.

The discussion boards are facilitated by a team of academics and chaplains to ensure that any issues raised by students are appropriately addressed and debate encouraged. The interprofessional background of participants enhances the discussion allowing each of them to appreciate the contribution that is made from all levels of healthcare worker. Activities undertaken also include a self-review of the learning which has occurred thus motivating the participant to consider the multi-faceted features of this educational experience.

Assessment is the final element and comprises an online appraisal of the participants’ knowledge which is delivered both at the beginning and end of the study period. For learners this helps to consolidate learning, while also showing progression. After completing both appraisals and an evaluation of the GLIDER learners are given a certificate of completion.

These elements and the flexibility inherent in the GLIDER™ design and delivery ensure a learner-centred experience for participants which facilitates them to think critically and apply the theory to their own practice and learning.

What prompted innovation?

• Spiritual care can be seen as essential to the delivery of all health care, if this is accepted, it is important that all staff coming into contact with patients and their families are prepared in this domain, whilst the spiritual wellbeing of staff must also be considered. In recognition of this, an NHS Education Scotland (NES) working group produced Spiritual Care Matters (2009) which made recommendations for future practice and education of healthcare staff.
• NES sought tenders for project teams to disseminate this document and a team from The University of Dundee and NHS Tayside, supported by NHS Greater Glasgow and Clyde were successful in gaining the maximum grant of £3,000.
• A small e-learning unit (GLIDER) was developed by and funded by NES to disseminate this work. It is targeted towards clinical, ancillary and support staff across a variety of health board areas. This demonstrates collaborative working between education and practice and an interprofessional approach to learning.
• The inclusion of spiritual care is required in healthcare professional undergraduate education programmes whilst the provision of continuing personal/interprofessional development opportunities should ensure that patients receive best care. Patient opinion would support the view that good spiritual care improves their experience and satisfaction.
• Evaluation of the GLIDER demonstrates that participants’ learning will improve patient care and staff wellbeing. The project team will continue to inform future practice by delivering this GLIDER content in a variety of education programmes, where possible using an interprofessional approach, and continuing personal/interprofessional development opportunities. Those who have completed the learning experience are ambassadors for the promotion of effective spiritual care.
• As a result of the GLIDER’s success it is now a compulsory component in the University of Dundee undergraduate nursing programme and has been evaluated very highly by students. Discussions are on-going regarding its inclusion in both dental and medical curricula within the university.

What makes innovation different?

• It encourages participants to reflect upon their own ideas values and beliefs and challenges them through the use of real life scenarios to consider alternative solutions to challenges they face in their daily work
• It is easily accessible but the online discussion and team based approach to facilitation of the GLIDER ensures students also feel supported
• The scenarios have been constructed to ensure they meet the diverse needs of interprofessional students and they gain from that approach as they explore how other professions to their own approach the same issues
• It also encourages participants to consider how they can look after the well being of themselves and their colleagues whilst widening the traditional view that spiritual care is religious care

Changes in practice

Some common themes of change were noted in the participants such as becoming more focussed in their thinking and being able to express their understanding more clearly. They were also more aware of their colleagues’ needs and considerate of faith when expressed by patients and colleagues in a health care context. This was demonstrated by a Healthcare Assistant whose pre-test response was as follows:

What spiritual care means to me is that people should have the opportunities to continue with their faith and have access to members of their religious organisation.

That person’s post-test response to the same question revealed a much more comprehensive understanding:

“I believe spiritual care assists us in times of emotional stress, physical and mental health, loss, bereavement and dying, from diagnosis through treatment and into recovery. Not only in the carer-patient relationship but in supporting their family, other carers, our colleagues and our own family and friends.”

Impact

Participant evaluations regarding the GLIDER content were extremely positive highlighting the benefits they had enjoyed from undertaking this programme of study.

The vast majority of participants reported significant benefits to themselves on a personal as well as occupational level and were clear that this experience would change their approach as demonstrated by the following quotes from participants:

“I would really recommend GLIDER to my colleagues and to our trainees. The reading and references that I am working through are very good and relevant to us all.” Medical Consultant

“As a Christian I thought I knew enough about spirituality to get me through life, after participating in this course I have learned that I didn’t. As an employee of the NHS we are compelled to complete mandatory training events. I think this course would be of benefit to all people in healthcare and should be mandatory. A better understanding of spirituality could only help people be more caring.” Health Care Assistant

It is clear that the participants in this learning experience gained significantly from it which will, in turn, help to ensure that patients, their families and healthcare staff will also benefit as we care differently for them all.

An independent research project concluded that as a result of the GLIDER there was an improvement in patient care and staff well-being – we are awaiting its publication.

The GLIDER was nominated for a College of Medicine Dentistry and Teaching award 2013.

Dissemination

• Reporting to NHS Tayside Spiritual Care Committee and College of Medicine Dentistry and Nursing Learning and Teaching Enhancement Committee
• It has been presented as a conference paper on any occasions.
• Publication:McTaggart, I.J., Munro, G., Rogerson, E., Martindale., L. (2012) Learning about Spiritual Care: It Matters! The Scottish Journal of Healthcare Chaplaincy Vol 15 (1)