The following are worthy of further investigation: whether the pilot study findings hold in student samples from more diverse cultural backgrounds; whether students' perceptions of spirituality can be broadened to include the full range of spiritual needs patients may encounter and whether their competence can be enhanced by education to better equip them to deliver spiritual care; identification of factors contributing to acquisition of spiritual caring skills and spiritual care competency.

We have provided the first international evidence that perceived spiritual care competence is developed in undergraduate nursing and midwifery students and that students' perceptions of spirituality and personal spirituality contribute to that development. Implications for teaching and learning and student selection are discussed. The study is limited by attrition which is common in longitudinal research.

Healthcare professionals need to be sensitive to the individual experiences of women awaiting breast cancer surgery to give support to ease their situation. Setting the date for surgery will alleviate anxiety. Follow-up studies about the potential impact of presurgery experiences on later experiences of living with breast cancer and intervention studies are needed.

The aim of this study was to develop a consensus-based Spiritual Care Education Standard for undergraduate N/M students to use in undergraduate programmes. Design: Mixed methods were used consisting of qualitative and quantitative methods based on the principles of Delphi research. Methods: The sample consisted of a total of 58 (N = 58) participants from 21 European countries. Data collection was conducted from June 2017-February 2019 and took place in facilitated iterative action learning cycles and online surveys. Data were analysed by descriptive statistics and qualitative analysis. Consensus was stated by >90% agreement. Results: The process resulted in an EPICC Spiritual Care Education Standard consisting of the following four spiritual care competences: Intrapersonal spirituality, Interpersonal spirituality, Spiritual care: assessment and planning, Spiritual care: intervention and evaluation. For every competence, learning outcomes were described in knowledge, skills and attitudes. Conclusion: This Standard guides N/M spiritual care education, student assessment and research. It can be the starting point for discussing spiritual care competences in other healthcare professions. Follow-up research should focus on implementation of the standard and on assessment of students' spiritual competence. Impact: The Standard guides curriculum and programme development. The Standard guides students in performing their learning process. The Standard provides a frame of reference for policy making and follow-up research.

Background: The spiritual part of life is important to health, wellbeing and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. Aim: to explore factors contributing to undergraduate nurses'/midwives' perceived competency in giving spiritual care. Design: a pilot cross-sectional, multinational, correlational survey design. Method: Questionnaires were completed by 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 countries in 2010. Bivariate and multivariate analyses were performed. Results: Differences between groups were small. Two factors were significantly related to perceived spiritual care competency: perception of spirituality/spiritual care; student's personal spirituality. Students reporting higher perceived competency viewed spirituality/spiritual care broadly, not just in religious terms. This association between perceived competency and perception of spirituality is a new finding not previously reported. Further results reinforce findings in the literature that own spirituality was a strong predictor of perceived ability to provide spiritual care, as students reporting higher perceived competency engaged in spiritual activities, were from secular universities and had previous healthcare experience. They were also religious, practised their faith/belief and scored highly on spiritual wellbeing and spiritual attitude/involvement. Conclusions: The challenge for nurse/midwifery educators is how they might enhance spiritual care competency in students who are not religious and how they might encourage students who hold a narrow view of spirituality/spiritual care to broaden their perspective to include the full range of spiritual concerns that patients/clients may encounter. Statistical models created predicted factors contributing to spiritual care competency to some extent but the picture is complex requiring further investigation involving a bigger and more diverse longitudinal sample. 2006-10. British Journal of Nursing 20 (12), 743-749 Cockell, N., and McSherry, W., 2012. Spiritual Table 1 The tools need to include psychometric support with citations. Subscales need to be conceptually defined to provide further insight into the findings. ABSTRACT Background: The spiritual part of life is important to health, wellbeing and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. Aim: to explore factors contributing to undergraduate nurses'/midwives' perceived competency in giving spiritual care. Design: a pilot crosssectional, multinational, correlational survey design. Method: Questionnaires were completed by 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 countries in 2010. Bivariate and multivariate analy...