Mary P. Guerrera

CAM Education: Promoting a Salutogenic Focus in Health Care

INTRODUCTION Complementary and alternative medicine (CAM) education has created a focus that not only brings awareness of various CAM therapies to conventional medical education but also highlights how these therapies can bring insight toward improved health care. METHODS A survey of CAM educational leaders at institutions awarded grants for incorporating CAM education into medical curricula was performed to address how CAM education can improve health care delivery in America. RESULTS Five (5) core themes were noted to be successful in achieving this goal. These included (1) education on the importance of relationship-centered care, (2) understanding holism, (3) the promotion of self-reflection and self-care, (4) collaboration with CAM providers to enhance communication, and (5) the need for faculty development in CAM. CONCLUSIONS In discussing these themes, this paper explores how a shift in medical education toward a focus of understanding what is needed for the creation of health (salutogenesis) can bring balance to a curriculum that is currently weighted in teaching about the creation of disease (pathogenesis). Potential benefits, including reduced health care costs and improved quality of life for learners, are discussed.

RECOMMENDED INTEGRATIVE MEDICINE COMPETENCIES FOR FAMILY MEDICINE RESIDENTS

BACKGROUND The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. METHODOLOGY In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. RESULTS In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. CONCLUSIONS This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care.

Increasing Resident Recruitment into Family Medicine: Effect of a Unique Curriculum in Integrative Medicine

INTRODUCTION Healthcare reform is highlighting the need for more family practice and other primary care physicians. The Integrative Medicine in Residency (IMR) curriculum project helped family medicine residencies pilot a new, online curriculum promoting prevention, patient-centered care competencies, use of complementary and alternative medicine along with conventional medicine for management of chronic illness. A major potential benefit of the IMR program is enhanced recruitment into participating residencies, which is reported here. METHODS Using an online questionnaire, accepted applicants to the eight IMR pilot programs (n = 152) and four control programs (n = 50) were asked about their interests in learning integrative medicine (IM) and in the pilot sites how the presence of the IMR curriculum affected their ranking decisions. RESULTS Of residents at the IMR sites, 46.7% reported that the presence of the IMR was very important or important in their ranking decision. The IMR also ranked fourth overall in importance of ranking after geography, quality of faculty, and academic reputation of the residency. The majority of IMR residents (87.5%) had high to moderate interest in learning IM during their residency; control residents also had a high interest in learning IM (61.2%). CONCLUSIONS The presence of the IMR curriculum was seen as a strong positive by applicants in ranking residencies. Increasing the adoption of innovative IM curricula, such as the IMR, by residency programs may be helpful in increasing applications of competitive medical students into primary care residencies as well as in responding to the expressed interest in learning the IM approach to patient care.

Integrative medicine increasing in family medicine residency programs

To the Editor: We commend and strongly support the effort of the Journal of the American Board of Family Medicine ( JABFM ) and the American Board of Family Medicine to address the issue of redesigning Family Medicine (FM) residency. Such forward and creative thinking has become essential in a

Healing With the Needles

A child’s spontaneous desire to help her mother during an office visit prompts me to reflect upon the multidimensional nature of healing and how, as family physicians, we often encounter these unique moments in our day-to-day practice.

P04.39. Leadership and education program for students in integrative medicine: LEAPS into IM.

Purpose To present preliminary data from LEAPS into IM, the Leadership and Education Program for Students in Integrative Medicine, an innovative program designed to foster the development of the next generation of medical student leaders in Integrative Medicine (IM). Medical students selected from across North America engaged in hands-on and didactic IM education, leadership skills, self-care, and community building curricula with leading experts serving as teachers/mentors. Our goal was to evaluate LEAPS impact on several IM related behaviors in participants immediately following and several months after the program.

P05.34. Well-being and wellness behaviors among family medicine residents: an exploratory descriptive study

Methods FM residents in the 2011 graduating class (n=56) were assessed at four time points, the beginning of each of the three years of residency and at graduation. Measures were self-administered online and included established measures of well-being: perceived stress, burnout (emotional exhaustion and depersonalization), emotional intelligence (empathy and perspective taking), depression, positive and negative affect, satisfaction with life, mindfulness, gratitude, and a measure of wellness behaviors (sleep, nutrition, physical activity, mind-body activities, being in nurturing relationships, being outdoors in nature, and alcohol use).

Complementary and Alternative Medicine: The Who, What, Why, Where, and When of an Evolving New Area of Health Care

Summary Complementary and alternative medicine is being used by an increasing number of patients. Physicians will be better able to serve their patients by further understanding this complex field. The following article is intended as an introduction to and overview of complementary and alternative medicine, and provides information on prevalence, definition and categories, reasons for use, and helpful resources.