Efficacy of structured spiritual care education program on nurses' spiritual well-being and clinical competence: a randomized controlled trial

BACKGROUND: Spiritual care is a key component of holistic nursing practice, yet many nurses feel insufficiently prepared to provide it effectively. This study aimed to evaluate the effect of a structured spiritual care education on nurses' spiritual well‐being and clinical competence. METHODS: This randomized controlled trial was conducted on 120 female nurses working in a specialized hospital in Iran from March 2024 to January 2025. Participants were randomly assigned in a 1:1 ratio to the intervention (n = 60) and control (n = 60) groups using block randomization with a block size of four and allocation concealment via sequentially numbered, opaque, sealed envelopes. The intervention group received a four‐session structured spiritual care education program based on interactive lectures, scenario‐based learning, and reflective discussions using the Gibbs reflective cycle, while the control group received routine training. Outcomes included spiritual well‐being (measured by the Spiritual Well‐Being Scale) and clinical competence (measured by the Clinical Competence Questionnaire), assessed at baseline, immediately post‐intervention, and at two‐month follow‐up. RESULTS: After the intervention, the intervention group showed significantly higher spiritual well‐being scores compared to the control group, including both religious and existential dimensions (p < 0.001). Clinical competence scores were also significantly higher in the intervention group across most domains, including clinical care, interpersonal relationships, legal‐ethical practice, professional development, and teaching‐coaching (all p < 0.001). These improvements were sustained at the two‐month follow‐up. Effect sizes ranged from small to large, and mixed repeated‐measures analysis confirmed a significant group × time interaction (p < 0.001), indicating greater improvement in the intervention group over time. CONCLUSION: Structured scenario‐based spiritual care education can effectively improve nurses' spiritual well‐being and clinical competence. We recommend integrating such programs into nursing education and continuing professional development. TRIAL REGISTRATION: Retrospectively registered in the Iranian Registry of Clinical Trials (IRCTID:IRCT20220927056047N2; https://en.irct.ir/trial/89352) on 2026‐05‐02.