Spiritual care is a fundamental aspect of caring and compassionate nursing/midwifery practice. However, nurses/midwives consistently report feeling unprepared to provide spiritual care for various reasons. A key reason appears to be the lack of structured spiritual care education in undergraduate nursing/midwifery curricula. Between 2016 and 2019, the three-year, European EPICC project ('Enhancing nurses' and midwives' competence in Providing spiritual care through Innovative education and 'Compassionate Care') sought to address gaps in nursing/midwifery competence in spiritual care. A key project output, and the focus of this paper, is the EPICC Gold Standard Matrix for Spiritual Care Education ('EPICC Matrix'), which depicts the complex array of factors hindering/facilitating the development of nursing/midwifery spiritual care competency. The EPICC project followed two major studies that identified factors contributing to nursing/midwifery spiritual care competency development. This evidence, along with the mixed methods focus of the EPICC project to enable co-projection of its outputs informed the development of the EPICC Matrix. The EPICC Matrix was considered to represent 'the cultural, social and political environment in which spiritual care competency develops' in student nurses/midwives. The EPICC Matrix illustrates spiritual care educational considerations during the process of selecting suitable nursing/midwifery students; through the specific aspects of the teaching and learning environment, the student as a person, and the clinical environment in which spiritual care competency develops; and finally, how the student is assessed as competent in providing spiritual care. Recent research supports the use of the EPICC Matrix in undergraduate nursing/midwifery curricula and strengthens the case for support of the other EPICC project outputs, including: the EPICC Spiritual Care Education Standard, EPICC Adoption Toolkit, and the continuation of the EPICC Network. Further testing of the EPICC Matrix to determine its relevance in different cultural/professional contexts within and outside of Europe would be welcomed.

Spirituality is embedded in nursing and midwifery practice and within the role of nurses and midwives. As a result, spirituality is an important element in nursing and midwifery education and practice, an area which has largely been ignored, in spite of the constant call of Professional Bodies for spiritual care competence in the provision of holistic care. This review aimed to analyze the existing literature and research to define competency and identify the key issues around the demand for competencies and education in spiritual care in nursing and midwifery. A search for articles in English was carried out using various search engines, using keywords: ‘competence, competency, definition, nursing, midwifery practice’. The findings showed that consensus on the definition of competency is still inconsistent. The majority of literature acknowledges the dimensions of knowledge, skills and attitudes which support the three components in Bloom’s Taxonomy namely, the cognitive, affective and psychomotor domains. Competence in spiritual care is guided by Benner’s theory: From novice to expert. Key issues were identified explaining the demand for competence in spiritual care such as, the complexity of spirituality and spiritual care which requires formal integration of spiritual care within the curricula by incorporating both the ‘taught’ and ‘caught’ perspectives of teaching and learning. Assessment of competence in nursing/midwifery education demands the formulation of generic and specific competencies oriented towards knowledge, skills and attitudes towards spiritual care. Thus, further research is suggested to develop a framework of competencies to be achieved by undergraduate and postgraduate students.