A compelling mash-up of lives, vocations, medical science, traditional theological formation, and novel simulation training is underway at Mundelein Seminary and five other Catholic seminaries in the United States. The goal? Integration of theology and empathic maturity.

by Mark L. Kelly

Tom McElroy served as a youth minister for Grace Missionary Church in Zion, Ill., and worked full-time as a regional trainer for the Tandy Corporation before he found his lifelong vocation as a professional actor.

He has enjoyed a successful stage and radio career in Chicago, including a longstanding gig with Unshackled, an award-winning (and the world’s longest continuously running) radio show on WGN that tells the true stories of people who have come to know Jesus.

While working in West Side Story in 2016 at the Paramount Theater, McElroy commuted into Chicago with a colleague actor who had been doing “standardized patient work” for Chicago Medical School, one of six health professions schools of the Rosalind Franklin University of Medicine and Science. The gig was to portray patients in a range of health care scenarios, while interacting with medical students to hone their clinical skills and, significantly, their interpersonal skills with people in crisis.

Simulation with standardized patients has been a mainstay of medical education for more than four decades, allowing students to practice clinical skills such as history-taking, physical exams, and communications techniques for delivering diagnoses, explanations and, importantly, demonstrating empathy. It is common practice to hire actors who are extensively trained to portray the physical and emotional aspects of patients in various medical settings.

McElroy jumped at the opportunity to play roles that would enrich his growing Catholic faith and provide some flexibility in his working life.

“Actors are like kids that never grew up,” he  says. “It’s just like pretending; as an actor I have to be a good pretender. So I live in that role, and the student also has to live in it with me, just as an audience wants to live in it when I’m on stage. That mutual engagement is powerful.”

“Shepherds after my own heart.”

Today, McElroy describes himself as a devout Catholic and has expanded his repertoire into a novel simulation project that began in 2020 at the University of St. Mary of the Lake/Mundelein Seminary, the major seminary and school of theology for the Catholic Archdiocese of Chicago. This time, the simulations are not for aspiring physicians; instead, they are aimed at seminary students preparing for priesthood.

McElroy’s involvement with the emerging simulation program at Mundelein came about from the spiritual and philosophical insights of the Very Reverend John Kartje, rector/president for Mundelein since 2015. A native of eastern Indiana, Fr. Kartje has an engaging personality and a quick wit, a searching intellect, and a laser-focused dedication to preparing aspiring Catholic priests for the intellectual, spiritual, and – more recently ­– emotional disciplines of the vocation.

As Rector/President of the University of St. Mary of the Lake/Mundelein Seminary since 2015, he has in the past four years gathered a coalescence of innovative thinkers from eclectic disciplines to develop a program of simulation training to foster compassion and the emotional development of the aspiring priests he is shepherding.

Fr. Kartje’s initial academic training is in science and mathematics: he earned a B.A. in Mathematics and a B.S. in Physics before completing his Ph.D. in Astronomy and Astrophysics, all from the University of Chicago. He worked as scientist for a few years while also volunteering through his local parish at the teaching hospital of the University of Chicago. 

“That was when I began to see my faith as a young adult, and recognized the impact it had on people who were – through no choice of their own – in very vulnerable situations,” he says.

He began conversations with a vocation director; after a period of discernment, he entered Mundelein and earned an M.Div. and S.T.B., was ordained a priest of the Diocese of Chicago in 2002, served in a parish for a few years, and eventually earned two advanced theological degrees at Catholic University of America. He joined the faculty at Mundelein in 2013; two years later he was appointed rector/president.

By inclination and academic training, Fr. Kartje is deeply thoughtful about integration  – of disciplines, of faith and reason, and of the physical, emotional, and spiritual health of individuals.

His thinking is rooted in Pope John Paul II’s 1982 apostolic exhortation Pastores Dabo Vobis, the Latin translation of the first words from Jeremiah 3:15 addressing God’s promise to the wayward Israelites: “I will give you shepherds....” John Paul identified four critical dimensions of formation for the making of a good priest: human, pastoral, spiritual, and intellectual, and emphasized human formation as the foundation for the other three.

“Pastores draws heavily on the philosophy of personalism, essentially honoring the other,” Fr. Kartje says. “I would argue that is how Jesus interacts and forms his disciples: talking with them one-on-one, teaching them. And then He sends them out, and takes away their security blankets knowing that once out they are going to be dependent on their interpersonal interactions with other people.”

Pastores provided the bridge from Fr. Kartje’s scholarly training in the sciences to his growing conviction that seminary education should be an integrative experience, blending formal education with the hands-on practice of compassion. Specifically, he had become intrigued by the success of simulations in medical school education, and the similarities of the challenges in preparing caring and competent physicians and those of preparing priests for ministry.

With Pastores as a foundation, Mundelein submitted two successful proposals to the Lilly Endowment’s Pathways for Tomorrow initiative in both Phases I and III. In Phase I, the Seminary analyzed the quality of human formation among priests ordained in the past 10 years, using existing and original research, interviews with recently ordained priests and 50 Catholic bishops, and laity in the Chicago area. It found that respondents “felt largely prepared to preside at liturgy, preach, and share objective theological content, but they did not feel prepared for the more interpersonal aspects of ministry,” including conducting administrative duties, preparing couples for marriage, ministering in multicultural settings, managing stress and time, and “having the kind of practical knowledge that would have really helped them with the realities of parish life.” Moreover, about five percent of the 1,012 respondents said they already were considering leaving the priesthood.

Phase I also gave Fr. Kartje and Mundelein the opportunity to learn more about the success of simulations in medical schools, specifically those at the nearby Rosalind Franklin University of Medicine and Science, a private university in Chicago comprising six colleges whose mission is to “improve the wellness of all people through innovative, interprofessional education....”

Ultimately, the findings from the Phase I study and the reconnaissance at Rosalind Franklin supported Mundelein’s successful Phase III project request: a pilot program to create a simulation lab dubbed Cor luxta Meum (from the second half of Jeremiah 3:15, translated as “after my own heart”).

Present and attentive

Throughout the Lilly application process, Fr. Kartje sought expertise and assistance to inform Mundelein’s emerging ideas and plans for simulation training in the seminary, to create the simulation lab, and to bring the faculty along with a new pedagogical approach. He did not have to look very far.

Marie Pitt-Payne, Ph.D., had been appointed Academic Dean of Mundelein in 2019, after holding the assistant deanship for a year and serving as Associate Director of the Institute for Lay Formation at Saint Mary of the Lake from 2017-18.

A graduate of Thomas Aquinas College with an M.A. from the Franciscan University of Steubenville, Dr. Pitt-Payne was completing her doctoral dissertation from Marquette University at the time of her appointment (she obtained the doctorate in December 2021). The research, she said, began to inform an integrated pedagogical model and personalist philosophy for the formation of clergy, one that would knit together the nature of being human, their development as priests, and their relationship with others and the world.

“I was looking at educational philosophers that could best serve the moment,” she says. “John Paul II is a personalist philosopher, and Pope Francis has forwarded the theme of ‘encounter,’ so I was able to tie the graduate study I was doing with the foundational documents of the seminary.

“Studying those, I also went back about 30 years in the medical research,” she continues. “It was the only educational model I could find that inserted emotion into the education process in a conscious way. In particular, simulation’s deliberate insertion of emotion into the learning process was viewed as a major pedagogical development – not only for improving patient care, but also for improving provider well-being.

“Helping professions are associated with high levels of provider burnout, so the appropriate management of emotion has become a necessary skill for longevity in the profession,” she adds.

Dr. Pitt-Payne sees parallels in the stressors of medical practice and in ministerial occupations, and concluded in her dissertation (titled With Due Respect for Humanity: Engaging Affectivity Through Simulation in Catholic Seminary Formation) that “the simulation method cultivated new levels of emotional self-awareness, introduced a new kind of holistic learning grounded in reality, provided a space to work through fear and self-doubt, and enabled a surprising shift in focus from content delivery to a more fully human personal encounter.”

The range of pastoral encounters spans marital issues, spiritual direction, grief, struggles with Church teaching, to administrative challenges with Church councils and staff meetings.

Significantly, simulations and emotional management strengthen emotional affectivity – the respect for emotion in self and others, she says. That finding dovetails with the Church’s Program of Priestly Formation, which states that “emotional affectivity is determined by a number of indicators, including the ability to live a true and responsible love,” demonstrated through “prudence; vigilance over body and spirit; compassion and care for other; ability to express and acknowledge emotions; and a capacity to esteem and respect interpersonal relationships between men and women.”

The healthcare model

With the academic and philosophical rationale for Cor luxta Meum in place, Mundelein turned its attention to creating a flexible and technologically sophisticated laboratory that would augment priestly formation through simulations. Leaning on the experiences of medical schools, the lab would mimic encounters faced by priests and help to assess and strengthen their affective maturity – “the capacity to responsibly acknowledge what one is feeling (joy, fear, awe, etc.) without being controlled by visceral reactions to those feelings,” according to the grant request.

The lab would create real-life scenarios in a controlled environment, with feedback from a standardized parishioner (SP, modeled on the standardized patient in medical schools), the formation advisor (a member of the Mundelein formation faculty observing the interaction), and the seminarian himself.

“A huge part of simulation is ‘the suspension of disbelief,’” says Fr. Kartje, “to create as realistic an experience as possible.” 

Dr. Pitt-Payne’s longstanding collaborative relationship with the Medical College of Wisconsin through her graduate work at Marquette provided a bridge to the Rosalind Franklin Medical University (RFU) and its six schools in Chicago, which would prove instrumental in the development of a simulation lab at the seminary.

Her colleague at RFU, Jim Carlson, Ph.D., had arrived at Rosalind Franklin University of Medicine and Science (RFU) in 2003 as a practicing physician’s assistant and one of the early professionals in that emerging medical occupation. RFU recruited him to expand its simulation efforts, which had been a part of medical education for several decades “but really began to pick up steam in the early 2000s,” he says.

Today, he is a professor on the faculty of the Physician Assistant program at RFU and Vice President for Interprofessional Education and Simulation, and can look back on a period of rapid growth: Prior to his arrival, RFU was sending students to a simulation lab at the University of Illinois-Chicago, which had one of the first labs in the region. Today, RFU has one of the more robust simulation programs in the region, he says, with about 40,000 hours of learner contact hours in simulation per year.

In late 2019, Dr. Pitt-Payne (in her first year as Academic Dean at Mundelein) reached out to Dr. Carlson to discuss how fostering affective maturity in people studying for health care careers might translate to those pursuing education for religious vocations. Dr. Carlson provided a faculty development session at Mundelein; further discussions continued to explore simulations’ applicability in the two environments, notably in hospital chaplaincy.

“There was a period when students came to the hospital to see real health-care scenarios – people connected to monitors, end-of-life issues, the death of a child,” Dr. Carlson recalls. “Very complex issues where someone might not need just medical care, but spiritual care, as well.”

A first set of case studies had been created when the Covid pandemic struck. The two organizations developed online access through a simulated hospital and continued to explore the efficacy of simulations for seminary students.

A few months later, Dr. Carlson recalls, Fr. Kartje and Dr. Pitt-Payne called to say “they wanted to amplify this and build their own center. They had decided that simulation was not just healthcare related, but also clergy-related: counseling and people-connected kinds of skills brought to bear in a faith-based way.”

The Seeker

Andy Holmes bumped around a bit on his vocational path to Mundelein, where he is Director of the Cor luxa Meum Simulation Center. After graduation from Valparaiso University in 2001, he tried his hand at acting, studied as a seminarian for a single semester at a Lutheran school in St. Louis, taught at a Catholic boarding school, got married, and moved to Wisconsin where he spent 10 years as an English teacher in a public school, taught drama, and coached the soccer team. Ultimately, he became the school’s librarian.

In 2015, he began studies for a Ph.D. in Information Studies, a merger of library and computer sciences, at the University of Wisconsin-Milwaukee, and took a job as a computer technician at the Milwaukee School of Engineering. Its College of Nursing needed technical support for an early simulated hospital, specifically someone who could program servers, mannequins, and the A/V equipment used to augment the students’ academic training. The role evolved, and he began designing aspects of the simulations themselves.

In 2017, Marquette University – which was constructing a new facility for its Physicians Assistant (PA) Studies program – recruited Holmes to help design a simulation lab to enhance its objective structured clinical examinations, essentially a practice run for clinical rotations, with a paid actor in the room portraying a patient with a specific condition. The aspiring PA goes through the steps of taking a history, conducting a physical exam, and providing a diagnosis. The session is typically recorded on audio and video. At the conclusion, the student debriefs with the actor and a faculty observer.

Holmes transferred his Ph.D. program to Marquette and, fatefully, one of his colleague students was Dr. Pitt-Payne, pursuing coursework and research for her dissertation. The two shared their ideas and intellectual interests, and soon Holmes – well-schooled in empathic resonance, affective maturity, and the nuts and bolts of simulation environment ­– was working as one of the initial consultants for Mundelein’s emerging plans for simulation facilities. In 2019, he joined Mundelein full-time.

He has designed the simulation rooms, flexible spaces that can be arranged as a parish office or a medical examination room. Two-way mirrors are used to allow formation faculty to observe, while discreet cameras and microphones record the interactions. 

At the conclusion, the seminarian, the faculty member, and the actor convene to de-brief.

“We’ve had to embrace change leadership principles and practices,” he says. “It’s a pretty big hurdle to ask faculty – who have been almost solely academically focused and able to objectively assess student intellectual progress – to go to a place where there’s almost nothing objective.

“We’re helping them to understand that this is a tool, an instrument that will develop self-awareness and compassion to help these guys in a parish or wherever they may be ministering,” says Holmes.

“I do feel the Holy Spirit’s hand just guiding everything as we bring this out.”

A closely watched experience

The simulation project at Mundelein continues to gather data on its effectiveness, a process that will continue through the remaining years of the grant. RFU’s Dr. Carlson remains engaged as an advisor, as does Dominic Vachon, Ph.D., of the Hillebrand Center for Compassionate Care in Medicine at the University of Notre Dame, whose novel research in biology, neuroscience, and psychology frames the field of compassion science.

Dr. Pitt-Payne has devised quantitative surveys to measure the seminarians’ experiences. Faculty are now writing some of the cases. And seminarians who are engaged in parish life have said “they are surprised by the realism of the simulation experience,” Father Kartje says.

“I think Jesus is a great seminary formator,” he adds. “He recognized that seminary is not just one isolated space. Seminary is wherever the people of God are encountering one another.

Mark L. Kelly is the Consulting Editor for In Trust magazine.

Partner Seminaries

Mundelein Seminary has established partnerships with five Catholic seminaries in the United States as part of the Lilly Endowment Pathways for Tomorrow project.

• Mount Angel Seminary (Oregon)
• Mount St. Mary’s Seminary (Maryland)
• St. Mary Seminary (Ohio)
• St. Paul Seminary (Minnesota)
• St. Vincent de Paul Regional Seminary (Florida)