FIELD EDUCATION ADVANCED STANDING REQUEST FORM For Clinical Pastoral Education Units Name__ehitip a, yor Student LD. 368763690 Address__P.0.5. 93261 Pasadena, CA 91109 Phone _(526)-032-685 Thave completed the following course in Clinical Pastoral Education and ‘am applying for Advanced Standing credit and for Field Education credit. Name of Institution: univers M@91S@'cS99F8Fnia, Los Angelese ‘Address: 10833 LeConte Ave.'12-237 CHS, L.A. CA90095 <1733 HAI Supervisor's Name: _p. wvier/p. povd = Dates Attended: 8-98 thru 11-98 Credit Hours: _1_8 credit hours for one [1] unit of CPE 12 credit hous for two (2] oF more units of CPE understand this ezedit will be granted following the submission of a copy of my final evaluation and a verification letter by my CPE supervisor. student Signatare_/ Date Requested credit is approved by Office of Field Education. Director of Field Education Date, Please return this form to the Field Education Office FULLER THEOLOGICAL SEMINARY 135 North Oakland, Pasadena, CA 91182 (626) 584-5377 oeamt a8, mor Sar Bey ray e194 90” amanon “PL ge? VLOOED JORG JOG, 2 LIND 3d9 SNO eo speounanter ty pang luca Gpecprafeper voy MOM “¥ dT THe Pig MIO JON JORG, tof WeHprTO0YS 2p fo prpeen ayn Piper poyg Ypres 9 2 YL WDOQ, JUsoUyS 7? puougenlag, “0 2yywOH, wowPastual Care Depart OK ens A, 12.27 5 lesiepes ck 3-173 3-296 FIO Association for Clinical Pastoral Education Confidential Student Evaluation Studont: Philip A. Kok Center; UCLA Medical Center Unit: Fall, 1998 Supervisor: Elizabeth Boyd, ACPE Associate Supervisor Introduction: Philis a single, European-American Christian Reformed seminarian in his thirties, He has done graduate theological work at Calvin College in Michigan and Fuller Seminary in southern California. Phil has ‘done missionary work in Central America, worked as a counselor in @ Christian psychiatric hospital and taught high school students. After ‘comp eting this unit of CPE, he planed to return to graduate school ‘The Center: The UCLA Mecical Center, Westwood campus, is rated the best medical center in the west, With 711 licensed beds, itis the primary teaching and rasaarch center for the Sehocls of Medicine, Dentietry, and Nursing. More than 660 fulltime faculty are jeined by 470 medicel residents ‘and a staff of 3,700 in providing tertiary medical care 2s well as pioneering work in the specially areas of heart, liver, and pancreas transplantation, cardiae surgery, geriatric medicine, neurosurgery, encolegy, and psychiatry ‘The UCLA Neuropsychiatric Hospital (NPH) provides comprehensive. inpatient and outpatient services for a wide variety of psychiatric, emotional ‘and developmental disorders. Patient care services include comprehensive rogrems in geriatric, adult, adolescent and child psychiatry. Individual Programs target problems such as eating disorders, depression and anxiety, Sbsessive compulsive disorder, schizophrenia and seizure disordersLosated in the heart of Santa Monica with 963 licensed beds is UCLA. Healthcare's community hospital. Specialties include orthopedics, ‘reproductive, maternal and child medicine. Its highly acclaimed Rape Treatment Center includes Stewart House, @ nationally renowned center for cate and treatment of abused children. ‘The Clinical Responsibilities: Phils peer group consisted of four chaplain ‘residents and another full ime chaplain intern. A second peer group of four ‘extended students began their six month program at the beginning of this Unt. Staff in the department included a Supervisor, an Associate Supervisor, a Supervisor in Training, an administrative specialist, a rabbi and a Roman Catholic pr ‘The students were assigned to medical or psychiatric units at UCLA Medical Center’s Westucod or Santa Monica campus where they were responsible for providing pastoral care to patients, families, and staff on an interfaith basis. They became integral parts ofthe intercisciplinary teams on their Unis. They made frequent patient visits, took part in unit team mostings: \whenever possible, and wrote chart notes on significant patient encounters. In addition, they rotated On-Call responsibility, responding to pastoral emergencies 24 hours/day, 7 dayshveek throughout the Westwood campus. ‘The CPE students also conducted interfaith worship experiences for patients, staff members and peers. Periodically, they offered "Teas for the Sour, an hour of spiritual renewal for unit staff. Phil's assigned units were 3 Pediatric unit and the 3 E and W Pediatric Intensive Care units, along withthe 7E Plastic Surgery /Orthopedic unit ‘The Curriculum: The students and their supervisors met together weekly for didactics and spiritual reflection, Phil and his peers met with their ‘supervisor for case conferences (verbatim processing), story theology iscussions, end interpersonal relations/open group sessions weekly. He: hac wockly individual time with his supeivisur. Didactics included Working with Jewish Patients, Working with Catholic Patients, Working with Muslim Patients, Pastoral Visitation, Chaplains and Social Workers, Ministry in the Emergeney Department, Spiritual Assessments and Charting, Theology of Suffering, Jung Applications to CPE, Family Systems, and The Process of Grieving Phil wrote seven verbatims of his pastoral visits, ona mere than was Tequired, and one story theology vignette. Phil reed and wrote reports on {wo books, Hospital Ministry: The Role of the Chaplain Today, edited by Lawrence Holst, and The Presence of God in Pastoral Care, by Wayne Oates. There are various other reporting requirements which Philcompleted, such as monthly statistics of pastoral visits, weekly reflections on progress and daly logs, ‘The Peer Group: Phils resident peers included a Conservative Jewish seminarian in her third unit of CPE, an African-American Methodist minister inher second unit, 2 European-American Protestant minister ordained for the Oceanview Community Church in his second unit, and a European- ‘American Calvary Chapel seminarian in his fist unit. The other chaplain inter was @ European-American Presbyterian seminarian in her first unit, The peers ranged in age from their thirties to their fies, Learning Goals: Phil chet the folowing learning goals for tis unit of training: ‘Ta maintain steady progress in pastoral care proficiency regarding patient care regarding working with staff regarding procedures and rules ‘Te combine pastoral care with integral theology. Pril dropped an additional goal regarding conflict resolution, when he decided it was not something of sufficient interest to him. ‘This evaluation is based on the Objectives for: contained in The Standards of the A.C.P.E., 1997, 290.1 To become eware of oneself as a minster and the ways one's ministry affects persons ard to develop the skils fo provide intensive and extonsive pastoral care and counseing to persons in thar rises ond) situator In te early part of the unit, Phil's pastoral vjits often consisted of of evaluative questions and then an offering of pastoral department He seldom made eye contact with the patient but kept his eyes on} Census sheet. As Phil made the transition from his role as a ps) counselor collecting patient information, to his role as the chaplain, he spent ‘more time being with the patient, By the end of the unit, he was beginning to allow himself to be moved emotionally by the patient's situation. Once he ‘said in a peer group session that the child/patient had reminded him of his G47 childhood, Phi ci not ciscuss his childhood withthe group then &¢Phil chose becoming @ more skilled pastoral care giver as his overarching ‘goal for the unit. He wrote & verbatims, two more than were required. He \wrole about situations that genuinely puzzled him, in order to maximize his learning. Early in the unit he was defensive when he presented, but within @ few weeks he became more available for learning. He listened intently when ‘others presented their verbatims, but seldom got verbally involved in the processing 2303 To utilize the support, confrontation and clarification of the peer group for he integration of personal attributes and pastoral functioning At the beginning ofthe unit, Phil kept his head down and occasionally wrote in his notebook during group sessions. To his credit, he put the book away 1nd occasionally made eye contact alter being asked to do so, About rmidunit his peers confronted him about his lack of participation and their sense that he was angry about something regarding them. He assured his Peers that he was being attentive, though he seldom spoke. He denied being angry. He made an effort to spend some time with each of his peers, 's0 that they could get to know him. However, over the course of the unit he ‘Spent relatively litle time outside of group with his peers. Phil learned to receive the feedback of his peers when he presented \verbatims. During the middle of the unit, he had something to add when others were presenting, though he often spoke only after being prompted to speak. On a number of occasions he requested for information about ‘procedures and policies in open group sessions. Only once did he talk ‘about a situation he was facing, the nearly simultaneous death of two Pediatric patients. ‘Typical ofthe evaluations he racsived from his peers is the folowing Brug your verbal, can el tat you have realy made an efoto ten othe last one, Forte last verbaim, you were able ta arielate more en you felge, theological concerns, and questions than you did on your rt one. The ay to steno theinpuof ers ad aol to you wom vain, and you have gone iat wel ‘group, you are ait and dont parpate often verbal. However, aga, Lee kan to casieraton some of he comments he group has made, ahd YoU cemto be making an foro patpate mere ately. tapprecate hat prtspabon, ‘uri mos! of tn wnt. you nave expressee mainly heughs I hope tal yu wl someday feet more contonabie expressing your folngs e wel 230.4 To utilize individual and group supervision for personal and professional growth and for developing the capacity to evaluate one’s ministry.Phil brought some patient encounters to individual supervision for discussion, He took responsibility for learning policies and procedures, which was consistent with his goals for the unit. At times he did not take responsibilty for other learning, but blamed me when something was neglected. For example, | suggested we could go over his entire weekly ist Of patient visits in the next supervisory session. When he did not include that on his agenda sheet the following week, I chose nt remind him of it He took this as evidence of my lack of competence, Phil's peers and supervisor took the extra time needed to understand his rnon-narrative style and abbreviations. For example, we spent two hours with nim, processing his final evaluation, when we spent 1-1 1/2 hours with ‘each of the other students’ evaluations. ‘Phil was able to answer more fully ‘rally than he had in waiting, 230.5 To develop the abilty to make optimum use of one's religious heritage, theological understanding, and knowledge of the behavioral ‘sciences in pastoral ministry to persons and groups. Phil made an effort to a personal stance that integrated his Chvistian Reformed faith with spiritually supporting patients of different faiths without trying to convert them, A times rather than attempting to care for the religious/spiritual needs of a non-Christian patient himself, he would refer the patient to a chaplain ofthat faith. 230.8 To become aware of how one’s attitudes, values, and assumptions atfect one’s ministry and to acquire a self-knowledge which permits pastoral care to be offered within one's strengths and weaknesses. ‘Near midunit Phil and his peers took the Myers-Briggs Personality inventory. He tested as an INTP, Knowledge of his type assisted his peers in relating to Phil, Ho is an intensely private person who did mast of his reflecting internally, making it difficult for me to comment on this CPE objective. 290.7 To become aware of the pastoral role in interaiscipinary relationships nd to work effectively as a pastoral member of an interdisciplinary team. Phil made some effets to be known on his units. The secular culture of UCLA was new for him, as his earlier hospital work had been in a Christian selting, He felt at times like a guest on his assigned units, yet recognized that his role was partially that of hospitality. He enjoyed being on the units ‘a5 a presence, quite a different role from his previous position as a teacher.Phil attended interdisciplinary rounds on his units, but, according to the ‘evaluation written by the unit director and clinical nurse specialist on the Pediatric unt, “he does not interact in rounds or with staff, He seems nice ‘and approachable." They gave Phil scores of 2 (where 5 is the highest sscote)in 7 ofthe 8 categories they were asked to rank. The unit director of the Pediatric ICU returned the evaluation unmarked, saying tht she had not ‘observed him. He got higher marks on the PlasticSurgery /Orthopedicunit (3-3, 34's and a § for developing an effective referral system of staff to tell him about patient needs) 2308 To become eware of how social conditions and structures affect the lives of self and others and to effectively address these issues in ministry. Phil worked with people from a number of cultures and noticed such things 1s the difficulties non-English-speaking families had in getting the care they needed. 2309 To develop the capacity fo utilze one’s pastoral and prophetic ersvecties in a variety of functions such as: preaching, teaching, leadershio, ‘management, pastoral care, and, as appropriate, pastoral counseling. Phil lead interfaith services whenever he was the chaplain on-duty on ‘Sundays. He also took his tum leading the chaplains in interfaith reflection ‘on Monday mornings. Conclusion: Phil was faithful tothe tasks of seeing patients and completing his written CPE assignments. | cory that he has earned 1 unit of CPE. | Urge Phil to get help with his communication skills before applying for more cre, ‘This evaluation should be read in conjunetion with Phil's own evaluation of this CPE uni. Signat Date UCLA Medical Conteris acredted for CPE and Superisory CPE by the Association for tiniest Pastoral Education, Inc, 1549 Ciamont Road, Suite 103, Decatur, GA 20038, Prone: (408) 320-1472,11-27-98 To: Supervisors (Boyd, Myler) From: Phil A. Kok ob 93261 Pasadena, CA’ 91109 While it did not feel *safe* at the time to speak about some concerns which arose during the quarter, please be aware that student isiwas concerned. that there were some violation(s) of student rights during the quarter, especially #6, #9, & and #10 of PC policy #110 (p39). How and when this will be addressed/resolved needs to be considered = Phil A. Kok