Rita Benn

Core Competencies in Integrative Medicine for Medical School Curricula: A Proposal

The authors present a set of curriculum guidelines in integrative medicine for medical schools developed during 2002 and 2003 by the Education Working Group of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) and endorsed by the CAHCIM Steering Committee in May 2003. CAHCIM is a consortium of 23 academic health centers working together to help transform health care through rigorous scientific studies, new models of clinical care, and innovative educational programs that integrate biomedicine, the complexity of human beings, the intrinsic nature of healing, and the rich diversity of therapeutic systems. Integrative medicine can be defined as an approach to the practice of medicine that makes use of the best-available evidence taking into account the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of both conventional and complementary/alternative approaches. The competencies described in this article delineate the values, knowledge, attitudes, and skills that CAHCIM believes are fundamental to the field of integrative medicine. Many of these competencies reaffirm humanistic values inherent to the practice of all medical specialties, while others are more specifically relevant to the delivery of the integrative approach to medical care, including the most commonly used complementary/alternative medicine modalities, and the legal, ethical, regulatory, and political influences on the practice of integrative medicine. The authors also discuss the specific challenges likely to face medical educators in implementing and evaluating these competencies, and provide specific examples of implementation and evaluation strategies that have been found to be successful at a variety of CAHCIM schools.

INCORPORATING INTEGRATIVE HEALTH SERVICES IN SOCIAL WORK EDUCATION

More than one third of Americans practice complementary and alternative medicine (CAM). Social workers continue to provide most first-line health, mental health, and psychological referral and direct practice services in the United States, despite a lack of systematic education and training opportunities in CAM. Schools of social work are appropriate venues for providing regular and continuing educational opportunities. The gap between education and practice can be addressed in social work curricula by (1) addressing integrative health from a general systems perspective, (2) reaffirming the role of social workers in health care, and (3) providing opportunities to develop competence with a simple yet conceptually integrated CAM-based skill set. Several content approaches and suggestions for curricula deployment are provided, including stand-alone courses, curricular infusion strategies across core areas of social work education, and location of curricular homes across college and university departments.

P02.24. Reducing stress and cultivating well being in educators and parents with special needs children: effects of a mindfulness training program

Purpose Parents and teachers of children with developmental challenges and special learning needs face unique socialemotional challenges in caregiving. Stress associated with their roles has been shown to impact parents’ and special educators’ health and well-being, as well as the quality of their parenting and teaching. In this paper, we report results of a pilot study conducted to investigate the efficacy of mindfulness based training program (MT) in facilitating improvement in caregiver mental health. Using a RCT waitlist design, 70 parents and educators of children with special needs were randomized to participate in a 9 session, 36 hour group-based MT program called SMART (Stress Management and Relaxation Techniques). This program, based on MBSR, included content on emotion theory and regulation, forgiveness and compassion, and application practices specific to caregiving/teaching.

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

Public Health and Preventive Medicine Meet Integrative Health: Applications of Competency Mapping to Curriculum Education at the University of Michigan

The University of Michigan School of Public Health Preventive Medicine Residency (UMSPH PMR) Integrative Medicine Program (IMP) was developed to incorporate integrative medicine (IM), public health, and preventive medicine principles into a comprehensive curriculum for preventive medicine residents and faculty. The objectives of this project were to (1) increase the preventive medicine workforce skill sets based in complementary and alternative medicine and IM that would address individual and population health issues; (2) address the increasing demand for evidence-based IM by training physicians to implement cost-effective primary and secondary prevention services and programs; and (3) share lessons learned, curriculum evaluations, and best practices with the larger cohort of funded IM PMR programs. The UMSPH PMR collaborated with University of Michigan IM faculty to incorporate existing IM competencies with those already established for preventive medicine and public health residency training as the first critical step for IMP curriculum integration. Essential teaching strategies incorporated didactic and practicum methods, and made use of seasoned IM faculty, along with newly minted preventive medicine integrative teaching faculty, and PMR resident learners as IM teachers. The major components of the IMP curriculum included resident participation in IMP Orientation Sessions, resident leadership in epidemiology graduate IM seminars, resident rotations in IM month-long clinical practicums, resident participation in interprofessional health system-wide IM clinical case conferences, and PMR faculty enrollment in the renowned Faculty Scholars Program in Integrative Healthcare. This paper describes the novel interdisciplinary collaborations and key curriculum components that resulted in the IMP, as well as evaluation of strengths, weaknesses, and lessons learned.

OA05.02. Relationships among well-being and wellness behaviors over time in residents in eight family medicine residencies

Methods Residents in the 2011 graduating class of the IMR (n=56) were assessed at the beginning of PGY2 and PGY3 and at graduation. Measures were self-administered online and included established measures of wellbeing: perceived stress, burnout (emotional exhaustion, depersonalization), depression, and satisfaction with life. Wellness behaviors assessed included restful sleep, nutrition, physical activity, mind-body activities, being in nurturing relationships, being outdoors in nature, and alcohol use. Stepwise regression analysis examined relationships between wellness behaviors and each wellbeing measure at each timepoint.

Integrative Oncology Scholars Program: A Model for Integrative Oncology Education

OBJECTIVES Oncology providers are often confronted by patients who use complementary or alternative therapies, but have limited knowledge or confidence on how to advise patients on appropriate use. Despite this, there are few opportunities for oncology providers to learn about complementary or alternative therapies, while at the same time there is a high demand for integrative oncology (IO) training. To address a gap in IO educational opportunities, and particularly for nonphysicians, we created the Integrative Oncology Scholars (IOS) Program. The programs goal is to train 100 IO leaders and facilitate partnerships between them and complementary practitioners. DESIGN Four iterations of a year-long National Cancer Institute-funded educational program that combines in-person team-based learning and eLearning to teach the evidence, application, and philosophy supporting IO. SETTINGS In-person sessions take place at the University of Michigan, and eLearning is implemented using a Canvas website (Instructure, Inc., Salt Lake City, UT). SUBJECTS Nurses, social workers, physician assistants, psychologists, physicians, pharmacists, and physical/occupational therapists with active oncology practices. Educational intervention: Four cohorts of 25 oncology providers per year will learn the evidence base for complementary and alternative approaches to a wide number of oncology topics, including symptom control, dietary supplements commonly used by cancer patients, diet, and the utility of specific integrative approaches for common oncology side-effects such as fatigue. OUTCOME MEASURES A mixed methods approach will be used to evaluate overall IOS Program progress and individual scholars impact on IO research, education, and clinical endeavors. RESULTS The first cohort of 25 IOS has been recruited and their education will begin in Summer 2018. Scholars come from 13 states and represent 23 different healthcare systems. CONCLUSIONS The IOS Program has the potential to increase the number of trained IO providers, educators, and researchers in the United States.

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).