AN INTEGRATIVE CURRICULUM MODEL: Incorporating 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

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

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.

CAM in Medical Schools 75/125 offer some form of CAM training 83% of courses are electives 31% incorporate CAM into other courses

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

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

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

Introductory CAM Module in M1 Goals: 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.

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.

Evaluation of CAM Unit

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

Evaluation of Selectives

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

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

Web-Based Materials and Consultation: Third year Standard Integrative Case Materials in all Clerkships Case Consultation On-line with CAM Faculty Packets of Readings

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

Faculty Development: CAM Faculty Scholars Program Three components: One day a month of CAM Content Individual Mentoring by CAM affiliate faculty Educational Project

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

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)

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

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

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