RESUMEN
In light of questions that have been raised about education for professional healthcare chaplaincy, we examined the skills and knowledge Clinical Pastoral Educators believe students need to perform the essential tasks and responsibilities of a chaplain. At 19 recently re-accredited ACPE centers across the country, we asked educators about the knowledge chaplains need to be effective, the specific content areas they teach, and how didactic education is planned and organized within their programs. Beyond a focus on religious diversity, we found little consensus among educators regarding a core knowledge base that should be taught during CPE. While most respondents in our study recognize the importance of didactic education in preparing students to become chaplains, there is a lack of consistency in didactic curricula across programs. Our findings suggest the need for broader conversation and collaboration among educators, national chaplaincy organizations, and theological schools regarding the goals, priorities, and outcomes of CPE.
Asunto(s)
Servicio de Capellanía en Hospital , Cuidado Pastoral , Clero , Curriculum , Atención a la Salud , HumanosRESUMEN
This article invites theological school educators, clinical pastoral education educators, representatives of the professional healthcare chaplaincy organizations, and social scientists to begin a shared conversation about chaplaincy education. To date, we find that theological educators, clinical educators, professional chaplains, and the healthcare organizations where they work are not operating from or educating toward a common understanding of what makes healthcare chaplains effective. Before we identify five key questions that might help us be in shared conversation and move towards educating the most effective chaplains, we briefly describe the history of education for healthcare chaplaincy. We then describe what we learned in interviews in 2018 with 21 theological and 19 clinical educators who are educating healthcare chaplains in theological schools and clinical pastoral education residency programs, year-long educational programs in hospitals and other settings that focus on preparing people for staff chaplain jobs. Their different approaches and frames inform the five questions with which we conclude.
Asunto(s)
Servicio de Capellanía en Hospital/tendencias , Cuidado Pastoral/educación , Competencia Profesional/normas , Religión y Medicina , Catolicismo , Clero/estadística & datos numéricos , HumanosRESUMEN
PURPOSE: To evaluate single-agent activity of bevacizumab in patients with recurrent glioblastoma. PATIENTS AND METHODS: Patients with recurrent glioblastoma were treated with bevacizumab 10 mg/kg every 2 weeks. After tumor progression, patients were immediately treated with bevacizumab in combination with irinotecan 340 mg/m(2) or 125 mg/m(2) every 2 weeks, depending on use of enzyme-inducing antiepileptic drugs. Complete patient evaluations were repeated every 4 weeks. RESULTS: Forty-eight heavily pretreated patients were accrued to this study. Thromboembolic events (12.5%), hypertension (12.5%), hypophosphatemia (6%), and thrombocytopenia (6%) were the most common drug-associated adverse events. Six patients (12.5%) were removed from study for drug-associated toxicity (five thromboembolic events, one bowel perforation). Thirty-four patients (71%) and 17 patients (35%) achieved radiographic response based on Levin and Macdonald criteria, respectively. Median progression-free survival (PFS) was 16 weeks (95% CI, 12 to 26 weeks). The 6-month PFS was 29% (95% CI, 18% to 48%). The 6-month overall survival was 57% (95% CI, 44% to 75%). Median overall survival was 31 weeks (95% CI, 21 to 54 weeks). Early magnetic resonance imaging response (first 96 hours and 4 weeks) was predictive of long-term PFS, with the Levin criteria being more predictive than Macdonald criteria. Of 19 patients treated with bevacizumab plus irinotecan at progression, there were no objective radiographic responses. Eighteen patients (95%) experienced disease progression by the second cycle, and the median PFS was 30 days. CONCLUSION: We conclude that single-agent bevacizumab has significant biologic and antiglioma activity in patients with recurrent glioblastoma.