Chaplains and narrative identity : a convergent mixed methods study of Clinical Pastoral Education interns.


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Healthcare unfolds in stories (Charon, 2008), meaning that a physician must listen to the patient’s narrative before making a treatment plan. Likewise, a chaplain must hear the patient’s story before offering an appropriate intervention (Cooper, 2018). More than 90% of chaplaincy interns and residents train in medical facilities (White et al., 2020). Those who earn credit through the Association for Clinical Pastoral Education (ACPE) engage in a narrative-oriented curriculum and practice story-oriented bedside care. The intersection of narrative identity (Ricoeur, 1991) and chaplaincy training deserves attention because narratives permeate caregiving and frame the process of adult learning (Foote, 2015). Despite the prominent role of personal narrative in the andragogy of Clinical Pastoral Education (CPE), no known studies have empirically assessed the narrative identity of chaplaincy students. I chose a convergent mixed methods research design and analyzed data through narrative identity theory (NIT) as an a priori theoretical framework (Hallford & Mellor, 2017; McAdams & McLean, 2013). I collected quantitative data through a pre-test and post-test of the Awareness of Narrative Identity Questionnaire (ANIQ). The ANIQ includes four subscales for factor analysis: narrative awareness, temporal coherence, causal coherence, and thematic coherence (Hallford & Mellor, 2017). I collected qualitative data through individual, semi-structured interviews. Taking recommendations from the NIT literature (Adler et al., 2017), I developed the interview protocol in parallel with the four subscales of the ANIQ. Ten graduate students enrolled in a unit of CPE participated. The possibility that a unit of CPE can increase awareness of narrative identity represents the most important integrated finding in this study. On this point, the quantitative and qualitative results tell a harmonious story. Participants reported quantitative and qualitative growth for the same three subscales: narrative awareness, causal coherence, and thematic coherence. The merged data revealed one central conflict: while none of the quantitative data yielded significant results, qualitative results indicated growth in three out of four subscales. Divergent results do not imply contradiction, and I embraced a complementary approach to the results (Slonim-Nevo & Nevo, 2009). Retaining that tension in the results honors the participants and generates research questions for the future.