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July 24, 2018

Culturally-Appropriate Palliative Care CPE


Culturally-Appropriate CPE

Dr. Christina Puchalski, George Washington University Institute for Spirituality and Health

Funded by the F.I.S.H. Foundation

ACPE and GWU are working jointly to assist Chile in establishing a Chilean-based clinical pastoral education program for the purpose of educating palliative spiritual care givers in a culturally appropriate manner. At the conclusion of this process, Chile will have its first clinical pastoral education program, and will have an established institutional relationship with ACPE and GWU to train future palliative care givers in spiritual care. This program is a pilot to help GWish and ACPE learn how to assist international organizations to launch such initiatives in a sustainable manner.

Spirituality has been recognized as an essential element of palliative care since Cecily Saunders defined the concept of total pain in 1980s— psychosocial and spiritual as well as physical. Yet a central challenge has been the lack of professional spiritual care in most of the world. To address this GWish with the ACPE developed a collaboration with colleagues in Chile to demonstrate how a culturally-appropriate spiritual care program can be developed that trains clinicians to address spiritual issues with patients and helps the local health care system develop a CPE-like program that fits the culture of Chile. Dr. Puchalski has already presented at the medical school at the Pontificia Universidad Católica de Chile, where the deans endorsed a training program for clinicians. The overview of this pilot project is to study what is currently available in spiritual care in Chile and to work with leaders in Chile to help them develop a culturally appropriate model of professional spiritual care and to develop their own curriculum for health care professionals that would integrate the chaplains in training.

The primary beneficiaries of this project are the people of Chile as the recipients of integrated, interdisciplinary spiritual care during some of the most vulnerable moments in their lives. The interdisciplinary teams also benefit, as do other staff and professionals within their clinical contexts. This is also a pilot project for similar contexts throughout Latin America. Ultimately, the team hopes to partner with CHRISTUS Health as they seek to advance spiritual care throughout their hospitals in Latin America.

Dr. Christina Puchalski, as seen in the PBS show "Spiritual Healthcare"

This project consists of:

  1. Investigating what is currently taught and practiced in clinical settings in Chile. This is done via surveys with collaborators at the Pontificia Universidad Católica de Chile school of medicine. This includes investigating religious- and culturally-based healers and practices.
  2. Teleconference with a group from the medical school, hospital, and palliative care teams to review survey findings, learn more specifics about how spiritual care is addressed from the clinicians, and meet who is currently doing spiritual care. (For example, a Catholic sister is the spiritual care provider on the palliative care team). The team is then tasked with identifying a leadership group which would be responsible for developing the medical school curriculum and one that would be responsible for piloting a professional spiritual care training program. The team thens select 2-3 appropriate representatives for a CPE training experience and the GWish Summer institute.
  3. Chile will send these representatives for 10-14 days to experience the ACPE program at Virginia Commonwealth University, which has both a medical school and school of public health. Students participating in the ACPE program can also concurrently pursue a Masters in Public Health, providing an exciting example of the potential of such an integrated program for our Chilean partners.
  4. These representative and GWish and ACPE will then help write the basics of the training curriculum to be implemented in Chile.