What you’ll learn in this article…
- SCA's October 2026 white paper defines Spiritual Care Nursing competencies.
- Capstone University's course leads to SCA's CSCN credential.
- EPICC offers individual feedback; SCCS measures cohort change for accreditation.
On October 5, 2026, the Spiritual Care Association announced its eleventh foundational white paper, "Spiritual Care Nursing: A White Paper for the Development and Implementation of a Specialized Nursing Practice."1 For most nursing faculties, the gap is not whether to address spirituality but that the topic sits in a lecture or two with no shared competency language aligned with clinical nurse educator competencies. The Westberg Institute/Capstone University pathway and the Certified Spiritual Care Nurse credential now give that language a clinical anchor. For nursing curriculum development, the pressure is less about adding a course and more about deciding which competency language, assessment points, and role boundaries sit inside existing outcomes.
What the SCA Spiritual Care Nursing White Paper Gives Educators
The Spiritual Care Association's October 5, 2026 announcement1, reported on cincinnati.com, gives nurse educators a concrete reference point: the foundational paper "Spiritual Care Nursing: A White Paper for the Development and Implementation of a Specialized Nursing Practice," available at SCA Foundational Papers. SCA defines Spiritual Care Nursing (SCN) as an emerging specialized practice that builds on whole-person, patient-centered care and adds advanced preparation in spiritual assessment, clinical judgment, individualized Spiritual Nursing Plans of Care, evidence-based interventions, outcome documentation, and interdisciplinary collaboration.
A framework educators can actually work from
The paper proposes a Clinical Practice Model for Spiritual Care Nursing as the organizing delivery structure. In the public foundational-papers summary, the model is anchored in whole-person spiritual assessment, nursing clinical judgment, individualized interventions, documentation, evaluation, and collaboration with professional chaplaincy and the interdisciplinary team. Stage-level diagrams and fuller essential attributes are not yet published, so programs should treat those details as pending rather than fixed.
Turning the competencies into teachable work
The proposed competencies translate well into assignments and observations that reflect evidence-based teaching strategies for nursing educators. Have students complete a Whole-Person Spiritual Nursing Assessment™ on a written case or standardized patient. Grade a one-page Spiritual Nursing Plan of Care that links an assessment finding to an evidence-based intervention and an outcome note. Observe role-play for therapeutic presence, deep listening, and spiritual inquiry. Require a boundary or referral reflection that names when to consult a chaplain. Add a final reflective practice entry on resilience and professional self-care, drawing on self-compassion in nursing curriculum. Cover cultural humility, ethics, and boundaries by asking students to state a patient's expressed spiritual preference and one possible moral tension they would take to the team.
From Course to Credential: The Westberg Institute, Capstone University, and the CSCN
How does a working RN move from learning the basics of spiritual assessment to holding the Certified Spiritual Care Nurse credential? The path has two steps, and nurse educators should understand where each fits.
Two education paths, one credential direction
The Westberg Institute, in collaboration with Capstone University, is establishing two advanced education pathways in Spiritual Care Nursing. The first provides registered nurses advanced education and competency development. The second leads to the Certified Spiritual Care Nurse (CSCN) credential through SCA for nurses who meet additional eligibility requirements.
Capstone's online Spiritual Care Nursing course is built around four modules: foundations, assessment and clinical judgment, evidence-based interventions, and integration and leadership.2 Coursework emphasizes spiritual assessment, care planning, documentation, outcome evaluation, and interdisciplinary collaboration. Capstone also offers a 45-credit online Master of Theology in Spiritual Care Nursing, but the advanced course's exact length, start/end dates, weekly workload, and hours are not clearly stated in the available research.1
What faculty should verify before advising students
Do not advertise a fixed cost or hour count for the advanced course. A separate Foundations of Faith Community Nursing course lists 36.5 hours and an $825 fee, but that figure is not confirmed for the advanced Spiritual Care Nursing course.45 Similarly, SCA states CSCN eligibility generally includes RN status, an approved education pathway, and a competency assessment, and describes the credential as a professional certification within the broader category of specialty nursing certificates, not licensure or board certification.3 Research does not yet spell out the full checklist, RN licensure jurisdiction, minimum clinical experience, exam details, renewal fees, or CE requirements. Verify these details on the Capstone University School of Spiritual Care Nursing page and the SCA site before including them in student-facing materials.
Use it as continuing education, not a prelicensure replacement
For faculty, the course works best as post-licensure continuing education for nurse educators. Frame the RN-to-CSCN pathway as a specialty progression: first RN licensure and initial practice, then advanced spiritual care education, then SCA's additional eligibility review and competency assessment. It does not replace prelicensure spiritual care content; it deepens it after licensure.
The Spiritual Care Association's October 2026 white paper is its 11th foundational publication. Earlier papers addressed hospital chaplaincy, hospice and palliative care chaplaincy, and spiritual care roles for physicians, nurses, and social workers. That sequence places the new nursing framework inside an established interdisciplinary conversation rather than a standalone initiative.
Mapping Spiritual Care Competencies to Courses You Already Teach
Spiritual care does not require a standalone course. Prelicensure threads focus on screening, respectful communication, and referral, while MSN threads shift toward curriculum design, program evaluation, mentoring, and quality indicators. Start with two threads, such as health assessment and palliative care, then add more as the program matures.
| Curriculum Thread | Level (Prelicensure / MSN) | Spiritual Care Competency Focus | Sample Learning Activity | Evidence of Learning |
|---|---|---|---|---|
| Health Assessment | Prelicensure | Basic spiritual screening and respectful inquiry | Students conduct a structured spiritual screening during a simulated patient intake | Written screening note identifying one spiritual concern and an appropriate referral cue |
| Therapeutic Communication | Prelicensure | Nonjudgmental spiritual conversation and active listening | Role-play a nurse asking about spiritual resources without directing the patient's beliefs | Peer feedback checklist and a one-paragraph reflective self-assessment |
| Ethics | Prelicensure | Scope of role and respect for diverse spiritual values | Case study of a patient who declines a chaplain referral but asks the nurse to pray with them | Short written response that explains boundaries and a patient-centered next step |
| Palliative and End-of-Life Care | Prelicensure | Recognizing spiritual distress and documenting a Spiritual Nursing Plan of Care | Students construct a plan of care for a dying patient with spiritual pain | Plan of care rubric shows one spiritual concern, one evidence-based intervention, and a chaplain collaboration note |
| Mental Health | MSN | Differentiating spiritual distress from psychiatric symptoms and mentoring learners | Graduate students supervise a prelicensure simulation debrief on spiritual versus depressive content | Debrief guide with observed student responses and a brief mentoring reflection |
| Capstone or Practicum | MSN | Curriculum design, program evaluation, and quality indicators for spiritual care education | Students audit one course for a spiritual care competency gap and propose a measurable outcome | Written audit map and one quality indicator with an evaluation method |
Related Articles
EPICC vs. SCCS: Which Spiritual Care Competency Tool Fits Your Program?
Choosing between EPICC and SCCS usually comes down to this: do you need a tool that gives individual students immediate feedback on their own learning gaps, or a validated scale that can measure change across an entire cohort for accreditation and research? Both are self-report instruments, but they serve different pacing and purposes in a competency-based nursing curriculum.
Origins and structure
The EPICC Spiritual Care Competency Self-Assessment Tool comes from the EPICC Network and was designed specifically for nursing and midwifery education. Its 28 items span four key areas of spiritual-care competence, including intrapersonal spirituality. The SCCS is the older instrument, widely known as the Spiritual Care Competence Scale, and is commonly reported as a 27-item measure with subscales covering assessment, professional development, personal support, referral, attitude, and communication.
Validation and typical use
The EPICC tool's original validation involved 323 nursing and midwifery students at eight universities in five countries during 2020. Later Persian, Spanish, and Portuguese validations expanded that base.123 A competency-based education program using EPICC showed significant improvement across all four domains.4 The SCCS has a longer validation literature, including foundational work by van Leeuwen and colleagues, and is frequently used as an outcome measure in nursing education research.
Which to choose
For course-level assessment and formative student feedback, EPICC is the more direct fit. Its self-assessment design invites students to identify gaps in knowledge, skills, and attitudes, and it works well as a pre/post check inside a single course. For program evaluation or research where you need a stable measure across cohorts and years, the SCCS may feel sturdier because of its longer track record.
If you are measuring one course, start with EPICC. If you are evaluating a program or conducting a study, consider the SCCS. In all cases, remember the self-report bias: students may over- or under-rate their readiness, so pair either tool with structured reflection, case review, or an observed skills demonstration.
Teaching Strategies That Work: Case Studies, Reflection, and Role-Play
Which classroom methods actually move nursing students toward measurable spiritual care competence? Recent systematic reviews point to a consistent pattern: multicomponent programs that pair conceptual teaching with experiential practice show gains, but no single method can be isolated as the decisive ingredient. A 2025 review of 10 studies with 749 students across Iran, Taiwan, and Turkey found overall improvements, yet did not establish one superior format. A 2024 Korean meta-analysis of nine mostly lecture-based programs likewise could not separate the effect of case studies, role-play, or reflection.1 A 2022 review favored self-reflection, group reflection, case discussion, simulation, and multidisciplinary teamwork, again as combined approaches. Simulation, for example, appears valuable for experiential practice, but a 2026 qualitative study reports promise rather than a standardized protocol. Faculty should sequence these nurse educator teaching strategies rather than bet on one.
Four classroom-ready activities
- Nonreligious patient case study: Present a patient who declines prayer but describes feeling lost after a cancer diagnosis. Ask students to identify spiritual distress apart from religious need and draft a nursing response that exercises clinical judgment in nursing. Tip: invite responses to the patient's statements, not to students' own beliefs.
- Reflective journaling on personal worldview: Use structured prompts such as "What gives my life meaning?" and "How might my worldview affect the care I offer?" Tip: grade for presence and depth of reflective thinking, not disclosure; allow students to write privately or select prompts.
- Role-played spiritual history: Assign students scripted roles across faith traditions and secular worldviews, including a Muslim patient, a Buddhist patient, and a secular humanist. Tip: provide scripts so no one has to represent their own tradition.
- Chaplain referral simulation: Run a scenario where a patient's spiritual distress outpaces nursing scope. Students practice naming what they can address and when to consult a chaplain. Tip: debrief role boundaries without asking students to share personal beliefs.
A skill you can't grade is a skill students will skip.
How to Assess Spiritual Care Competency Without a Standalone Course
You can assess spiritual care competence by building a standalone course, or you can grade it inside the course you already teach. For most prelicensure programs, the second option is more realistic, and it works when you make spirituality visible on a rubric rather than treating it as an add-on.
A five-point rubric that fits existing care plans
A workable rubric can grade five moves, all drawn from the nursing process:
- Spiritual screening and assessment: identifies what matters to the patient using a simple prompt such as "What's most important to you?" and "How can I help?"
- therapeutic communication: stays present, avoids steering toward the student's own beliefs, and responds to cues.
- Spiritual Nursing Plan of Care: documents at least one spiritual need, a goal, an intervention, and an evaluation.
- Referral and collaboration: recognizes when to involve a chaplain or another interdisciplinary team member.
- Reflective self-awareness: names how the student's own beliefs affected the interaction.
This mirrors the four EPICC competency areas: intrapersonal spirituality, interpersonal spirituality, assessment and planning, and intervention and evaluation. Assessment and planning should check that the student asks; intervention and evaluation should check that the student does something and documents the result.
Where to document it
Do not invent separate paperwork. Add a short field to the standard care plan or clinical record: spiritual needs identified, nursing response, and referral. Students can write the Spiritual Nursing Plan of Care within the existing plan-of-care section. No single standardized student template exists in all settings, so keep your criteria simple and consistent. Wales' Care and Treatment Plan offers one useful model because Domain 7 explicitly covers social, cultural and spiritual needs.
Add one item to simulation and clinical tools
High-fidelity simulation is especially useful for observing whether a student identifies and addresses a spiritual need in real time. Add a single behavioral anchor to the existing clinical evaluation: "Recognized a spiritual concern and responded with assessment, communication, planning, intervention, referral, documentation, or reflection." Avoid adding separate scoring scales unless your program is already piloting one.
Surveys such as the Spiritual Care Competence Scale (SCCS) and the Spirituality and Spiritual Care Rating Scale (SSCRS) are established competency assessment tools nursing that can track change over time, and EPICC offers a self-assessment. Use those as pre- or post-measures to supplement observed or written work, not to replace graded assignments. A student who self-rates highly on a survey still needs to show the skill in a care plan, simulation, or clinical encounter.
Role Boundaries: What Nurses Do, What Chaplains Do, and How to Teach the Difference
Where does a nurse's spiritual care role end and a chaplain's begin?
The boundary starts with scope, not with religiosity. Under the current ANA Code of Ethics, nurses protect dignity and may never impose their own beliefs. Joint Commission-related guidance expects a spiritual screen on admission. In practice, nurses screen for spiritual distress, gather a spiritual history within the nursing assessment when that is part of their training, provide basic supportive presence, advocate for the patient's values, and refer when needs go beyond nursing scope. A nurse can make that referral without a provider order, following organizational procedure.3 Board-certified chaplains are the spiritual care specialists for in-depth assessment, counseling, religious ritual, sacramental care, and complex spiritual distress.2 The 2026 Spiritual Care Nursing white paper frames these roles as complementary, not competing.
Prayer, consent, and gray zones
Prayer is not off limits, but it should be patient-initiated.2 If a patient asks, offer choice, respect the answer, and never use prayer to evangelize or pressure. Teach the same consent rule for touch or any physical gesture. A patient with no religious identity may still need meaning, connection, or help processing an existential concern, so assess for distress without assuming belief.
Teach it with one shared case
Pair nursing and chaplaincy students on a single case: a patient facing surgery expresses fear and asks the nurse, "Will you pray with me?" Nursing students identify the spiritual screen, the patient-initiated request, and the referral threshold. Chaplaincy students describe how they would assess the deeper distress, offer ritual support, and follow the patient's tradition. Together they map the handoff, documentation, and what happens if no chaplain is available: the nurse facilitates referral to virtual or community resources with the patient's permission. This co-analysis makes the boundary visible and actionable.
Accreditation Alignment: AACN Essentials, CCNE, ACEN, and NLN
The tension nurse educators face is not whether spiritual care belongs in nursing education but where to document it: inside existing accreditation language or as a separate required thread. The strongest current route is to embed it in language accreditors already recognize, then map it deliberately.
Using the 2021 AACN Essentials as the anchor
Domain 2, Person-Centered Care, describes care as "holistic, individualized, just, respectful, compassionate, coordinated, evidence-based, and developmentally appropriate" and places the person "within multiple complicated contexts, including family and/or important others."1 That frame naturally covers a patient's spiritual and religious beliefs when they influence values, preferences, identity, or health decisions. Keep in mind that the 2021 glossary does not include spirituality as a defined term, unlike the 2008 Essentials, so faculty should anchor spiritual care under Domain 2 competencies rather than waiting for a glossary definition.1
CCNE and ACEN: what the self-study actually needs
CCNE's 2024 standards require programs to incorporate the 10 AACN Domains, 8 Concepts, and 45 numbered competencies, numbered 1.1 through 10.3.2 That includes Domain 2 but does not add a separate spiritual-care mandate. A one-page competency map showing where spiritual assessment, spiritual nursing plans of care, and outcome documentation sit inside Domain 2, communication, and clinical judgment strengthens the self-study narrative. For programs navigating ACEN vs CCNE requirements, current ACEN standards do not establish explicit spiritual-care language, so programs should use the competency map as evidence of holistic integration rather than claiming a specific ACEN requirement.
NLN and faculty preparation
Current NLN nurse educator competencies documents do not establish an explicit spiritual-care requirement. If a program uses NLN language about holistic or human flourishing care, cite that where it appears in the program's own documents. Before assigning spiritual care content, identify the faculty who will teach it. At minimum, those educators should complete the SCA foundational paper review or the Westberg Institute/Capstone University spiritual care nursing education pathway. Faculty who assess higher-stakes simulations or CSCN preparation should hold or be pursuing the Certified Spiritual Care Nurse credential.
No accreditor currently requires a spiritual care course or the CSCN. That leaves the decision local: integrate spiritual care into the existing competency framework and document it with evidence that an accreditor can see.
