Chaplains and quality improvement: can we make our case by improving our care?

To date, the field of health care chaplaincy has little information about what constitutes "quality spiritual care. "A qualitative study of four focus groups in New York, Illinois, Arizona, and California was conducted to gather preliminary information about how health care chaplains' experience and understand "quality" and "quality improvement" in spiritual care. The study revealed that many chaplains feel a tension inherent in the task of measuring spiritual care services; how does one evaluate interactions that may seem ineffable? The study also enumerated chaplains' creative efforts, often shaped by institutional contexts and cultures, to address these difficulties in measuring spiritual services.

Ethics, professionalism, and humanities at Michigan State University College of Human Medicine.

This article describes the variety of approaches used at Michigan State University's College of Human Medicine for teaching ethics, professionalism, and humanities to undergraduate medical students: courses in ethics and health policy; mentoring programs; selectives in history, literature, and spirituality; structured patient care experiences; and discussions with students in their clinical years on the ethical and professional challenges confronting them in their clinical experiences. Some of these approaches, such as the structured patient-care experience, may be unique to Michigan State. The authors place special emphasis on discussing the challenges that confront this curriculum, including struggles to keep up with the pace of change in the health care system, preserving and highlighting the linkages between the "ethics" and the "professionalism" strands of the curriculum, making optimal use of Web technologies, successfully communicating to students the ultimately practical importance of the medical humanities other than ethics, and solving the problems of geography created by a widely dispersed community campus system.