Douglas R. Wilson S.T.M.
Director of Spiritual & Religious Care
Kingston General Hospital
Adjunct Faculty Queen’s Theological College
76 Stuart Street
Kingston, Ontario, K7L 2V7A Virtual Learning Seminar as an element in a CPE Unit is a more effective learning tool than the Verbatim Seminar. This article will describe how the Virtual Learning Seminar worked with Basic CPE students. It will outline the benefits of the Virtual Visit when compared to the Verbatim.
Students of the art of pastoral care need to develop their listening, assessment and intervention skills. These skills are best acquired when the student can reflect on the care they have given. The verbatim and the verbatim seminar are the classic way students in Clinical Pastoral Education (CPE) learn these skills. The idea of working with the human document as a learning tool is valid. This paper will demonstrate that the human document seen though the virtual visiting seminar is a viable alternative to the verbatim seminar.
The verbatim traces its beginnings to the 1920s when Anton Boisen introduced the case study as the written human document for theological reflection. Boisen developed a detailed template of the information that needed to be gathered about a person. The strength of this tool was its ability to help students learn how to reflect theologically about the human condition. It did not address the pastoral skills of listening and intervention.
A few years later, Russell Dicks, the chaplain at the Massachusetts General Hospital, began recording notes of his pastoral visits. These notes developed into a recording of “he said, she said” interchange. This tool opened up the pastoral dialogue to scrutiny for the first time. People could critique what happened in the pastoral relationship. This tool addressed the listening and intervention skills of the pastor but did not adequately address the skill development of theological reflection. For many years the dialogue recording and the case study method coexisted with the case study more prominent in mental hospitals and the dialogue style more common in general hospitals. People like Wayne Oats, Carol Wise and Seward Hiltner brought the two approaches together to form the verbatim. 1
The verbatim became a required element in Clinical Pastoral Education in 1945. 2 Today the verbatim remains a sophisticated tool in CPE. The student, in the verbatim, records their plans, their observations and the dialogue. The student does an analysis of the theological, psychological and personal dimensions of the visit. The student concludes with plans for the next visit. The supervisor provides comments and critiques on each written verbatim. The students present their written visits at regularly scheduled verbatim seminars. 3 Most students experience the verbatim to be an invaluable learning tool. 4
Over the years there have been supporters and detractors of the verbatim. Some supervisors feel that the verbatim is a “chore” while others feel it is a discipline in “creative writing”. 5 Some feel that the time taken to write verbatims is disproportionate to the benefits. Those who support the use of the verbatim contend that it enhances pastoral competence and professionalism: helps students learn to pay attention to detail both verbal and non-verbal: as well as provide the supervisor with a window on the quality of pastoral care being offered by the students in the hospital.
There have been a few attempts to replace the verbatim. In 1981 Agnes Barry, concerned that the drudgery of the verbatim was affecting the motivational level of the second year chaplancy residents, introduced 10 Pastoral Care Assignments as an alternative. 6 While Barry reported her experiment to be a good experience, there was nothing further published to support the value of this alternative method.
While seeking a tool to capture a pastoral encounter in the parish setting Gene Fowler rejected the verbatim as inadequate. In 1998, he argued that the verbatim came into use through an early scientific analogy that is no longer acceptable and that a change in the verbatim is “long overdue for revision.” 7 The format of the verbatim dictates a particular view of pastoral care to the exclusion of all others. Fowler argues for a broader tool that would encompass the many dimensions of pastoral care in the parish setting.
In the summer of 1998, Dirk Evans offered a CPE Unit without verbatims. He used role-play exclusively. He reported that the students learned listening and other skills faster with the role-play model than they would have if they had used the traditional verbatim option. 8
The use of the verbatim at the Kingston General Hospital/Queens Theological College Clinical Pastoral Education program has been considered a valid tool of learning. The work of Evans rekindled a desire to reevaluate the verbatim as one of the major components of the program. Queens University has developed a Clinical Learning Centre designed to enhance the clinical skills of all health care professionals. The Clinical Learning Centre recruits volunteers to help medical students, nursing students and physiotherapy students learn the skills of their profession. The Centre advertises for volunteers in the community who are willing to become teachers for the students. Until this time theological students had never been part of the program. A proposal was made to the Clinical Learning Centre to use their facilities as part of the summer 1999 CPE program. Permission to offer an experimental unit of CPE was obtained from the CASC/ACSS Accreditation Committee and the virtual visiting seminar became a reality.
All elements of the experimental unit of CPE at the Kingston General Hospital were the same as previous CPE Units except that the verbatim seminars were replaced by a new element called the Virtual Visiting Seminar. There were no written verbatims and no verbatim seminars.
In the first four weeks of the program, 9 virtual visiting seminars were scheduled to last two hours (10am – 12pm). Each student interviewed a volunteer while a peer observed behind a one-way mirror. The supervisor sat in a control room to observe each of the sessions. After each interview, which lasted 20 – 30 minutes, the student doing the interview, the volunteer and the peer observer participated in a feedback session. It was the peer observer’s responsibility to facilitate the feedback session. A guideline for the feedback session was given to all students at the beginning of the program. The volunteer was given a different guide to help them with their feedback. The volunteer left after he/she had provided feedback. The peer observer provided further feedback to the student interviewer. While the peer observer used a format for the feedback the student was encouraged to allow the discussion to flow naturally. During each of the nine sessions, each student had a chance to be the interviewer and the peer observer. The entire session, interview and feedback was video-taped. These tapes were available, throughout the unit, to the students to review at their own learning pace.
Six seminars were held during the next three weeks of the program. Each student, in rotation, interviewed a volunteer while the whole peer group and the supervisor observed from behind a one-way mirror. This whole process including the visit and the feedback, was video taped. These visits lasted 30 – 50 minutes. After the visit the whole group, including the volunteer, provided feedback to the student interviewer. After the volunteer left, the group provided more feedback to the student. The last six sessions were very similar to a verbatim seminar except the human document was live rather than written. These seminars were scheduled for two hours.
The Clinical Learning Centre recruited the volunteers for the virtual visiting seminars from their bank of volunteers. This was the first time they had been asked to be involved with pastoral care. The volunteers came to the interview with their own needs, wants and troubles. There was a wide range of people – older, younger, disabled, retired, male, female, some with no religious persuasion, a couple of retired clergy – 39 in all. The students did not know anything about the volunteer except their name before the visit. The student had no idea what might be of concern to the volunteer. Unlike a hospital visit, the volunteer was not facing an immediate medical crisis. Like a random parish visit, the volunteer came to the session with needs, concerns or problems that might be occurring in their life that day. This ranged from a grandmother whose grandson was in court charged with murder, a recently retired man who was searching for meaning in life to a lady who had recently confronted a man trying to break into her apartment at night. It was up to the student to discern the deeper spiritual currents in the lives of these people and find ways to address them. While the volunteers conceptualized their role as that of teacher most of the visits turned into deep spiritual encounters. The reactions of the volunteers upon leaving was generally positive with one saying “this is better than two hours with a psychiatrist”. One volunteer left emotionally distraught because of the material raised during the visit. The volunteer was offered follow-up support by the supervisor. A phone call later in the day confirmed that she was coping. The fact that most of the volunteers responded positively to their visits was an added benefit for them. They came expecting nothing more than to help the students learn.
From a number of different perspectives, the virtual learning seminar was a positive learning experience. From the perspective of the supervisor there was no time marking verbatims. This allowed the supervisor time to concentrate on other elements in the program. For example, the supervisor shadowed students while they did their patient visits and provided direct feedback immediately following the visits.
The learning curve of listening, assessment and intervention skills was significantly enhanced. The virtual visiting seminar was dynamic and the feedback was immediate. The time between the student’s visit and the feedback session was immediate. This allowed the students to relate the feedback to the actual event. The video tape allowed the student to replay the visit if their memory of events was different from their peer observer. The learning of pastoral care skills started in the first week of the program with the first virtual visit occurring at the end of the orientation week.
The video taped visits provide good individual supervision material. Students had the option of bringing one of their taped sessions to individual supervision. This provided them with further feedback on their pastoral care and allowed them to introduce issues that were a challenge.
The virtual visits provided the supervisor with an accurate assessment of the student’s skill level. The supervisor observed the student during the virtual visit from the control room. This session provided the supervisor with direct information on the level of pastoral functioning of the student.
The trust generated by the virtual visits enhanced the Interpersonal Relations Group time. Other parts of the program seemed to benefit from the increased interaction between the students. The students were more willing to take responsibility for their own learning. They quickly moved to a level of trust that allowed them to challenge each other on a personal level. This trust built quickly and deepened throughout the program. From the experience of this supervisor, the final level of trust during this unit was significantly deeper than most first unit student groups.
From the perspective of the student they did not spend hours at night writing verbatims. The fatigue level of the students was reduced. The students began to learn pastoral care skills very early in the program. Linked to the pastoral skill development was pastoral identity. As a result of the virtual visit one students commented, “Within a week I felt like I was more aware of what I was about on the floor.”
One student in the program said: “The volunteers at the Clinical Learning Centre were an invaluable training group for me. The safety of the setting, the immediacy of the feedback, the contextual and realistic nature of the visits contributed tremendously to my process of becoming familiar with the pastoral role, practicing communication skills, listening skills, relational skills, observational and feedback skills. These visits were a unique dimension of practice, experience, and influence on people’s lives. They offered a unique middle ground between academic/intellectual learning about the pastoral role and practice in patient visits, an opportunity to experiment with relational and conversational styles with real people, not too much different from hospital patients but in a conscious teacher role for me.”
Virtual visiting allowed students the opportunity to see what they look like during a visit. As one student commented: “In the dance classes of my fine arts training, we always worked in front of mirrors or were video taped so we could see how our body moved. This is the first time I have ever seen myself doing a visit and it was very helpful to note my movements.” Another student said, “Seeing myself on video gave me an entirely different impression of myself than what I had perceived in my mind. Helped me become more intentional in my body language.” A third student commented: ” Being able to ‘see’ myself in an interview was very helpful.” The video taping allowed the students the opportunity to learn how to read the body language of the volunteer and themselves.
Students were exposed to different styles of interaction by rotating among their peers. Peer-modeling acquainted students with other ways of providing pastoral care without imposing any judgment as to which way was right or wrong. They discussed with each other the different styles and discovered those that were most compatible with their personality.
Since students and volunteers knew that this was a learning experience, the student could risk changing their normal way of interacting and get feedback on their efforts. For example, one student decided that she needed to be more assertive in her interactions and tested this during the next virtual visiting seminar. She got feedback from both the volunteer and her peer observer. Later she was able to observe herself by replaying the video. This was a safe place to learn new ways of relating.
The virtual visiting seminars increased the speed of bonding amongst the peer group. It increased the intensity level of group interaction. Trust levels naturally increased because students were observing each other visiting and providing feedback three times a week for the first month. The increased interaction time and the quality of that interaction provided an opportunity for a growing level of trust. One student said, (The) “virtual visiting seminars forced us to observe each other intently and then comment on personal aspects of relating. I think they did enhance the rate at which trust was built.”
The virtual visiting seminar meets an adult learning model. The student could choose what was helpful in terms of their learning. The complete session including the feedback was video taped. If a student wished to review any part of that visit or feedback it was available. Since each of the volunteers was interviewed by another set of peers, students could review the second tape to see what responses a different pastoral style elicited. One student commented: it is “great to be able to compare a visit with one volunteer done by two interns.”
From the perspective of the Education Sub-Committee there were major differences. Each year, at the end of a unit of CPE, the Education Sub-Committee of the Spiritual and Religious Care Advisory Committee meets with the students privately to assess the program. This committee had been operating for seven years and had met with many student groups. The committee has always included a theological professor and a working chaplain amongst its membership. This committee writes a report and the recommendations are taken seriously when the next program is designed. In the past recommendations have influenced the content and layout of the next program. In reviewing this summer’s program, the committee reported that they had not heard such enthusiasm from any previous group. Very positive feedback was given on the virtual visiting seminars. The response to the change in the program this year was more dramatic than anything they had experienced previously.
From the perspective of the patients they benefited from the early skill development and enhanced confidence level of the students. They received a better quality of pastoral care.
Dirk Evan’s use of role playing to replace the verbatim in a CPE program is the only published account of a similar initiative. The use of role-play has some of the advantages of the virtual visit but it may lack some of the realism and spontaneity. In virtual visiting volunteers do not role-play but are themselves. No previous interaction exists between the student and the volunteer so the visits are spontaneous, natural and organic. The visit is just like a pastoral visit. Sometimes in role-playing, the scenario as designed does not get played out because of misunderstandings, hidden agendas or unresolved feelings between students. The virtual visit is a good learning tool because it is a pastoral encounter. The whole process is observed and video taped so that feedback is accurate and relevant to what actually happened.
The verbatim and the virtual visiting seminar deal with the human document. Both reveal the essential nature of the pastoral relationship. Both tools promote pastoral competence and professionalism, promote the learning of listening, assessment and intervention skills and facilitate the student reflecting on how their own personal needs can be a barrier to good pastoral care. In addition they both encourage peer group interaction and peer learning, give the supervisor a glimpse of the quality of pastoral care that the student is providing and provide material for theological reflection.
The verbatim is said to enhance the memory of the student. It is a very portable tool that, once learned, the student can use at any time or place in their future ministry. The verbatim helps a student appreciate that learning can take place no matter how fragmented or distorted their memory might be of an interaction. 9
One student wrote the following: “I would compare the difference between the virtual visits and the verbatims with being at the scene of and actively participating in an historical event and reading about it a few days later in the paper. The two just can’t be compared. Though writing verbatims may develop a student’s acuity to detail, I wonder if such a concern could actually detract from the natural ebb and flow of the interview which seemed easier to follow in the virtual visits.”
As a learning tool, the virtual visiting seminar takes less time to learn. From the first day, the student is able to use the tool and begin to learn listening, assessment and intervention skills. The virtual visiting seminar is an accurate reflection of a pastoral encounter. There is no distortion due to memory or wish that a more appropriate intervention was tried and very little delay time between the pastoral interaction and the feedback. The feedback is immediate which enhances the learning curve significantly and requires less work in preparation for the virtual visiting. The hours spent writing a verbatim is non-existent. This reduces the fatigue factor in the students and allows time for an integration of insights. Anxiety related to not having any verbatim material to meet the assignment deadline is decreased. The virtual visiting seminar promotes the growth of trust in the group. In short, the virtual visiting seminar meets and exceeds all of the educational advantages of the verbatim seminar.
This kind of program can be offered without the help of a Clinical Learning Center. A Chaplain Supervisor can advertise for volunteers, do the screening of the volunteers and provide an environment for the visits. A one-way mirror and video taping are clearly an asset. Video taping can be done with inexpensive equipment. The video recorder can be set on a tripod and left unattended for the entire interview and feedback session. The one-way mirror makes the visit seem more private and helps the student and the volunteer forget about the observers.
Recruiting the volunteers is a very important aspect of this process. Each volunteer needs to know clearly the expectations of the program. They need to know that this is a pastoral visit and that personal material will be addressed. They need to know that their role is to help the students learn and that there is a support system in place to help them if they need more time to decompress after the visit. The volunteer needs to be very clear about their role before they agree to come to a session. In addition, each student should explain to the volunteer exactly what is going to happen at the beginning of the visit and then thank the volunteer after the feedback session. As the volunteer is leaving, the supervisor could ask them for feedback on their involvement and thank the volunteer for helping in the learning process. The supervisor could ask if the volunteer would be willing to be called again for a pastoral care visit.
This model has now been repeated over several years with similarly positive results. Changes are always taking place as the tool is refined. This is an on-going learning process. From this year’s experience, the virtual visiting seminar is a tool worthy of further investigation as a viable alternative to the verbatim seminar in a CPE Unit.
1. Seward Hiltner, Fifty Years of CPE, Journal of Pastoral Care June 1995, Vol.XX1X, No2, p 91.
2. Russell Burck, Pastoral Expressionism: Verbatims in the Pastoral Paradigm, Journal of Supervision and Training in Ministry, 1980, Vol. 3 (198), p. 45.
3. Good Samaritan Society CPE Program, web page http://www.unidail.com/~garysartain/cpe/unitcure.htm 1999.
University of Kentucky, http://www.mc.uky.edu/?CPE/cpe.htm 1999.
Bruce Goettsche, A Case for Fathering, http://www.unionchurch.com/archive/062198.html 1999.
4. Ted Reve and Tracy Trothen, Listening to the Students: An Evaluation of Educational and Pastoral Functioning Developments by Basic Supervised Education Students, A Report for the Canadian Association for Pastoral Practice and Education, January 1999, p. 44.
5. Report of Workshop Group #4, Levels of Clinical Pastoral Training, Institute of Pastoral Care 1961 Fall Conference p. 97.
Albert Meiburg, Methods of Clinical Pastoral Education, Trends in C.P.E. Objectives-Methods-Standards, Proceedings of the Seventh National Conference On Clinical Pastoral Education Washington, DC, 1960, p. 80.
6. Agnes Barry, Creating for Learning: Verbatim Alternatives, Journal of Supervision and Training in Ministry, 1983, p. 56.
7. Gene Fowler, Studying Pastoral Care in Congregations: A Hermeneutical Approach, Journal of Pastoral Care, 1998, Vol. 52, No. 4, p. 326.
8. What? No Verbatim? Yes! Read On!, CASC/ACSS Newsletter, September 1998, p. 1.
9. Russell Burck, Pastoral Expressionism: Verbatims in the Pastoral Paradigm, Journal of Supervision and Training in Ministry, 1980, Vol. 3, (198), p. 48-49.