AN INTEGRATIVE CURRICULUM MODEL: Incorporating CAM Within an Allopathic Curriculum

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AN INTEGRATIVE CURRICULUM MODELIncorporating
CAM Within an Allopathic Curriculum

• Rita K. Benn, Ph.D., Sara L. Warber, M.D.
• University of Michigan
• Complementary Alternative Medicine Research
  Center
• Department of Family Medicine

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Rationale

• Increased patient use of CAM without disclosing
  such information to physicians
• Physicians have limited knowledge base of CAM
• Physician and medical students attitudes towards
  CAM correlate with educational exposure

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USF Survey Results

• Most students agreed that traditional medicine
  could benefit from CAM but
• only 1/4 students would refer for CAM
• 2/3 students understood principles of only 4/10
  CAM modalities
• 40 would dissuade their patients from using
  chiropractic care.

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CAM in Medical Schools

• 75/125 offer some form of CAM training
• 83 of courses are electives
• 31 incorporate CAM into other courses

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GOALSKnowledge

• To expand physician base of information on theory
  and practice of CAM
• To provide research based evidence for efficacy
  and safety of CAM

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Professional Behaviors

• To instill an attitude of openness respect for
  CAM
• To develop skills for
• communicating information about CAM to patients
• coordinating health care with CAM practitioners
• use CAM for personal self-care

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Plans for UM Medical Curriculum

• New curricular units within existing courses and
  clerkships
• New web case-based modules
• New clinical electives
• New clinical assessment stations
• Faculty development in CAM

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Introductory CAM Module in M1Goals

• To identify common forms of CAM
• To become aware of reasons for patient use of CAM
• To experience/observe the clinical practice of a
  CAM modality
• To observe and reflect on differences among CAM
  practices and between CAM and conventional
  medicine.

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CAM Unit First Semester M1

• Lecture An overview of CAM modalities and
  evidence surrounding its efficacy
• Readings Several general articles on CAM and
  specific modality-related to their field visit
• Field Visit Students observe/or experience the
  practice of a CAM modality
• Small Groups Students reflect on their
  experiences and discuss the readings.

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Evaluation of CAM Unit
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CAM Selective Courses - M1

• Mind-Body Medicine for Care of Self and Patient
• Understandings of Health and Disease in the
  Classic Medical Systems of Asia
• The Role of Spirituality in Medicine
• Nutrition and Chronic Disease

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Evaluation of Selectives
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Future First Year Plans

• An Overview Lecture in Four Required Courses
• Pharmacology
• Immunology
• Host Defense
• Anatomy
• Two Panel Case Based Presentations Focused on
  Herbs and Nutrition

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Second Year Curriculum Integration Plans

• CAM and Nutrition Content in all Courses
• Case Based Presentations
• Integrative Case for Standardized Patient
  Interview
• Practice-based Modules in Alternative Medicine
  and Spiritual History Taking

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Web-Based Materials and Consultation Third year

• Standard Integrative Case Materials in all
  Clerkships
• Case Consultation On-line with CAM Faculty
• Packets of Readings

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Fourth Year Electives

• Clinical Electives
• -Complementary Medicine
• -Specialized Topic Area Electives
• Science in the Clinic Research Elective

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Faculty DevelopmentCAM Faculty Scholars Program

• Three components
• One day a month of CAM Content
• Individual Mentoring by CAM affiliate faculty
• Educational Project

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Medical Curriculum Evaluation

• Student Performance in Courses
• Course Evaluations
• Pre-Post Learner Attitudes and Knowledge
• Fourth Year Clinical Competence
• Qualitative Study of Physician Growth

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Related Program Initiative Interdisciplinary
Graduate Certificate Program

• Enrolled in Masters/Doctoral Program in Schools
  of Pharmacy, Social Work, Nursing and Public
  Health
• Three additional core courses
• -Clinical Complementary Therapies (Nursing
  School)

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Challenges

• Building Relationships with Faculty Course
  Directors
• Shifting Academic Faculty Attitudes about CAM
• Expanding Academic Faculty CAM Knowledge
• Engaging Faculty in Interdisciplinary
  Collaboration
• Cultivating value in students for
  self-reflection/self-care
• Developing Capacity for Clinical CAM Electives

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Facilitating Factors

• Medical Education Administration Support
• NIH, Foundation, and Donor Funds
• CAM Research Center Grant
• Quality Courses and Positive Student Evaluation
• Expansive Community Network of Reputable CAM
  Providers

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Conclusions

• Model program
• Curricular innovations
• Benchmarking quality education
• Preparation of health care professionals and
  researchers of the future