Spiritual Conversations in Healthcare  

A Winsome Approach to Communicating the Gospel in Clinical Settings with the Engel Scale

Using the Engel Scale to Communicate the Gospel in a Clinical Setting

The Engel Scale is a powerful tool for healthcare workers who wish to effectively communicate the gospel in a clinical setting. It helps assess a person’s spiritual journey, guiding when and how to introduce faith-based concepts. Of course there is no absolute path that every believer takes to the gospel. Each person has their own unique experience and story and may skip a level and move forward or backward on the scale. But for those of us wondering what to do next in helping faith to grow, it can provide a help and a tool to gently encourage our own spiritual walk and that of those we meet. Understanding where a person falls on the scale—from no awareness of God to mature disciple—enables healthcare workers to speak to spiritual growth and spiritual needs in a compassionate, winsome way. This ensures the healthcare workers efforts align with the person’s openness to the gospel.

Building Curiosity and Trust

In the clinical environment, initial stages of evangelism (e.g., -12 to -8 on the Engel Scale) involve building rapport through compassionate care. Many patients start as cynics or skeptics, having little or no awareness of God. Healthcare workers can plant seeds of faith by addressing larger life questions and demonstrating the love and care modeled by Christ. Simple gestures like kindness, listening, and sharing personal faith experiences can awaken curiosity. The goal at these early stages is not to overwhelm but to spark interest, laying a foundation for future conversations.

Engaging in Spiritual Conversations

As patients move from stages -7 to -3, they begin exploring the general meaning of Christianity and its relevance to their lives. In these stages, healthcare workers can gently offer answers to spiritual questions that naturally arise in conversations about health and wellness. For example, when a patient is facing a difficult diagnosis, you can point to hope in faith or share how spiritual strength helps you navigate challenges. It’s essential not to rush or force decisions but rather to create a safe space for open dialogue.

Identifying the Right Time and Place

Not every stage of the Engel Scale is best pursued in a clinical setting. Once a patient begins seriously considering commitment to Christ (stages -2 to 0), it may be more appropriate to encourage further exploration in non-clinical environments such as the home, a community health program, or a church. During these stages, patients need time for reflection, and environments that support discipleship are crucial. Healthcare workers can recommend local faith communities, Bible studies, or even chaplaincy services to help patients feel supported.

Guiding New Believers

After conversion (stages +1 to +5), healthcare workers should transition from evangelism to discipleship. This involves helping new believers integrate into the body of Christ, fostering spiritual growth, and encouraging them to serve others. The clinical setting can still be a place of encouragement, but much of their spiritual development will occur within the community, church, or small groups. As a healthcare worker, you can follow up by guiding them toward fellowship and mentoring opportunities that nurture their growth.

Discernment in Evangelism

The Engel Scale serves as a guide to discern the appropriate time and place for sharing the gospel in a clinical setting. Healthcare workers must respect the patient’s emotional, physical, and spiritual readiness, using wisdom to determine when to encourage further exploration of faith and when to offer resources outside the clinic. By understanding the patient’s stage in their spiritual journey, you can extend appropriate invitations to community programs, faith-based health initiatives, or church events that align with their spiritual needs.

Conclusion

The Engel Scale provides a structured approach to spiritual care in healthcare settings, helping workers recognize where a patient is in their faith journey and what kind of spiritual encouragement is appropriate. It empowers healthcare professionals to plant seeds of faith, nurture curiosity, guide toward commitment, and ultimately foster spiritual growth, whether in the clinic or beyond. When used thoughtfully, the Engel Scale is a valuable tool for sharing the gospel in a way that respects both the individual’s spiritual journey and the healthcare context.

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If you would like a PDF of the adapted scale you may download a copy here: