Developing and testing the EPICC Spiritual Care Competency Self‐Assessment Tool for student nurses and midwives

Tove Giske*, Annemiek Schep‐Akkerman, Bodil Bø, Pamela H. Cone, Britt Moene Kuven, Wilfred Mcsherry, Benson Owusu, Venke Ueland, Joanne Lassche‐Scheffer, Rene van Leeuwen, Linda Ross

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Aims and objectives: To develop and psychometrically test a self-assessment tool that measures undergraduate nursing and midwifery students’ perceptions of spiritual care competence in health care practice. Background: Spiritual care is part of nurses/midwives’ responsibility. There is a need to better benchmark students’ competency development in spiritual care through their education. The EPICC Spiritual Care Education Standard served as groundwork for the development of the EPICC Spiritual Care Competency Self-Assessment Tool. 

Design: Cross sectional, mixed methods design. A STROBE checklist was used. Methods: The Tool (available in English, Dutch and Norwegian) was developed by an international group. It was tested between July–October 2020 with a convenience sample of 323 nursing/midwifery students at eight universities in five countries. The Tool was tested for validity using Kaiser–Meyer–Olkin (KMO) test, exploratory and confirmatory factor analysis, one-way ANOVA and independent samples t test. The reliability was tested by Cronbach's alpha coefficient. Qualitative data were analysed using thematic analysis. 

Results: The KMO test for sampling adequacy was 0.90. All, but two, items were related to the same factor. Cronbach's alpha coefficient for the Tool was 0.91. Students found the Tool easy to use, and they gained new insights by completing it. However, students felt that some questions were repetitive and took time to complete. Conclusions: The Tool has construct and discriminant validity, and high internal consistency (is reliable). In addition, students found the Tool useful, especially in early stages of education. 

Relevance to clinical practice: The Tool affords student nurses and midwives the opportunity to self-evaluate their knowledge, skills and attitudes about spirituality and spiritual care. The Tool offers students, educators and preceptors in clinical practice a tangible way of discussing and evaluating spiritual care competency.

Original languageEnglish
Article number16261
Number of pages15
JournalJournal of Clinical Nursing
Issue number00
Early online date14 Mar 2022
Publication statusE-pub ahead of print - 14 Mar 2022


  • spiritual care competency
  • spiritual care
  • instrument development
  • nursing/midwifery competences
  • nursing/midwifery students
  • psychometric testing


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