---

Purpose/Aim: This was a curriculum innovation and evaluation project to facilitate: (1)the development of professional social responsibility learning modules spiritual competency; and (2)evaluation of competencies in the clinical setting through chart audits. Description: Like many programs, Nurse Practitioner (NP) students at Arizona State University have rotated to sites for clinical practice that serve vulnerable populations. The first step in this project was to develop course modules and assignments for advanced practice students that would provide a foundation of knowledge and skills for work with underserved populations and assist them in critically looking at their own values and attitudes. The modules and assignments were then followed by student seminars and guest speakers to address each competency as described by NONPF.

Sample Module Objectives: Assesses the influence of clients' spirituality on their health care behaviors and practices.

Outcomes/conclusions: Both quantitative and qualitative analysis was done by chart audit and reflective journal review respectively. A chart audit of 114 patient encounters by 13 FNP students revealed that only 10% documented cultural competencies and only 5% documented spiritual competencies. A barrier to documentation of competencies was assessed to be due to the limitations of the medical record system, especially if a computerized system. The qualitative analysis revealed that students believed that they had made positive changes in developing cultural and spiritual competence skills through class and clinical experiences.