Integrative Medicine MEDICAL SCHOOL CURRICULUM USC

Report
Integrative Medicine
MEDICAL SCHOOL CURRICULUM
USC KECK SCHOOL OF MEDICINE
Armaity Vaghaiwalla Austin , MD MPH FAAFP
Associate Clinical Professor
Department of Family Medicine
USC Keck School of Medicine
Contact Email
Armaity Vaghaiwalla Austin , MD MPH FAAFP
[email protected]
KECK SCHOOL OF MEDICINE, USC
Co- Presenters
Ali Arastu, MS4
Caryn Brenn, MS4
Lia Jacobson, MS4
Sara Ptasnik, MS2
Kristen Roehl, MS2
Lisa Schamber, MS2
Elaine Yang, MS2
KECK SCHOOL OF MEDICINE, USC
IM Curriculum at KSOM
• PPM Selective – Year II
• Clinical Selective – Year IV
• Student Programming
PPM Selective - Year II
● 6 sessions in the fall (12-hr curriculum)
● Each session incorporates 2 topics
● Integrative physician speakers
● Student case presentations
Topics in PPM Selective
● Introduction to E-W Medicine
● TCM – Acupuncture & Herbalism
● Homeopathy
● Guided Imagery
● MBSR
● Yoga
● Ayurveda
● Chumash Herbal Medicine (“Hike & Healing”)
● Patient Perspective
Feedback on PPM Selective
◦ IM PPM Selective for past two years,
consistently among the highest rated
selective, may be expanded to two
concurrent sessions due to popular demand
◦ Student research project about CAM
attitudes surveyed students before and after
taking the course
PPM – INTEGRATIVE MEDICINE
IM. SELECTIVE, MS2COURSE STATS
PPM – INTEGRATIVE MEDICINE
IM. SELECTIVE, MS2
Scale:
5
Excellent
4
Very Good
3
Average
2
Below
Average
1
Needs
Improvement
List 3 most important learning
points from your IM Selective
experience.
What was the best part of the
IM Selective experience?
Student Experience:
Sara Ptasnik
Survey of Medical Students’
Attitudes Towards CAM
(Fall 2011)
Caryn Brenn, MSIV
Demographics
• 178 second year Keck medical students (MS2)
• 24 years old
• 51.1% male
• 27 students enrolled CAM selective
• 151 students enrolled other selectives
Survey Questions
• 9 questions from the validated CAM Health Belief
Questionnaire (CHBQ)1
– 7 point Likert scale
– 1=“Absolutely disagree”, 7=“Absolutely agree”
– Midpoint 36, Maximum 63
•
•
•
•
•
1Lie,
Personal use of CAM therapies
Frequency of use
Plan to use CAM in future medical career
Opinion of CAM education
Resources used
D., & Boker, J. (2004). Development and validation of the CAM Health Belief Questionnaire (CHBQ) and CAM use
and attitudes amongst medical students. BMC Med Educ, Vol 4(1), 2.
Results
• Hypothesis confirmed
Total CHBQ score
Pre
Post
Average
Difference
p-value
CAM
selective
(n=24)
46.25 (+ 5.09)
52.17 (+ 4.61)
+5.92
0.00001
Other
selective
(n=137)
42.69 (+ 6.86)
42.04 (+ 6.91)
-0.65
0.098
Results: Secondary FindingsAll students
(n=161), Pre survey
• 88.7% of all students personally use one or
more form(s) of alternative therapy
Results: Secondary FindingsAll students
(n=161), Pre survey
• 92% of students agree that CAM education should
be a component of medical school education
• 82% of students plan to refer CAM therapies
• 61% of students gained baseline knowledge of
CAM from word of mouth or social media
– 17% from previous CAM education
– 6% from scholarly and medical journals
Clinical Selective - Year IV
● 4 weeks in length
● Faculty: Armaity V. Austin, MD, MPH, FAAFP
● “Prevention and Wellness”
Wellness Assessment
Curriculum of Clinical Selective
• NUTRITION
Macronutrients
Micronutrients
Dietary Supplements
• PHYSICAL ACTIVITY
• MIND-BODY
Stress Management
• SLEEP
• ENVIRONMENTAL HEALTH
• SPIRITUALITY
• MOTIVATIONAL INTERVIEWING
Student Experiences:
Ali Arastu
Lia Jacobson
Student Programming
● Integrative Medicine Club
●Student President Sylvia Charles
(Psychiatry Intern @ UCSF) and CoPresident Ali Arastu inherited Integrative
Medicine Club as first year medical students
●Implemented Weekly Yoga Sessions
●Introduced Meditation to Campus for
students
●Began working to provide student input in
IIH
Integrative Health Interest Group (IHIG)
Interdisciplinary, Longitudinal, Co-Sponsored, Interinstitutional
1. Year II PPM co-facilitation (student leaders)
2. Ongoing involvement with IIH
● Student liaison; monthly breakfast seminars
● Research & physician mentors
Integrative Health Interest Group (IHIG)
3. Student wellness
● “Wellness Wednesdays” in the quad
● Weekly yoga class
● Mindfulness at ECSHC
K
IHIG: Events in Spring 2014
● Women’s Health
Symposium
● Research Lunch Talk
● IIH Research
Symposium
● BeWellKeck Kick-Off
Extravaganza
● Pet Therapy Day
IHIG: Goals & Opportunities
● Expand interdisciplinary involvement
● Increase events in the fall semester
● Increase attendance at Wellness Wednesday
events, in conjunction with the BeWellKeck
initiative
● Develop a sustainable funding mechanism to
allow hands-on workshops, outside
practitioners, and food at events
Mindfulness Meditation for Medical Students:
A Pilot Research Study
• Can the use of a mobile application to deliver 10-20
minutes of daily guided mindfulness meditation help
medical students reduce stress and improve overall
wellbeing?
General Well-being Scale
Perceived Stress Scale
Five-Facet Mindfulness Questionnaire
Feasability
Results
• 74% of Intervention group used the Headspace app
○ Number of days used: M=11.97, SD=7.76, range=28
• 54% continued to use Headspace after the initial 30-day
intervention period
• Perceived Stress decreased for Intervention, but not
Control, over 60 days
○ Well-being did not significantly increase across both
groups
○ Mindfulness increased across both groups for subscales
of Observing, Acting with Awareness, and Non-reacting
Interinstitutional Programs: Goals
● Increased opportunities for interdisciplinary
education
● Enhancement of self-care knowledge and practice
● Regional and national connections among M.D.,
D.O., and N.D. medical students interested in
Integrative Medicine
● Community of like-minded medical students to
optimize future collaboration in patient care
Interinstitutional Programs: SoCal
● IMMSA-SC: Integrative Medicine Medical
Student Association – Southern California
Chapter
● Bastyr University California
● David Geffen School of Medicine at UCLA
● Western University of Health Sciences
● UC San Diego School of Medicine
● Keck School of Medicine of USC
● UC Irvine School of Medicine
● Symposium/retreat in the works...
Interinstitutional Programs: National
● LEAPS into IM: Leadership and Education
Program for Students in Integrative Medicine
Jun 2014 @ Kripalu Center for
Yoga & Health, Berkshires, MA
Interinstitutional Programs: National
● HEART-IM: Humanistic Elective in Activism,
Reflective Transformation, and Integrative Medicine
Mar 30 – Apr 24, 2014 @ Quaker Center, Ben Lomond, CA
Interinstitutional Programs: National
● NSCIM: National Student
Conference on Integrative
Medicine
Oct 26-27, 2013 @
Northwestern University,
Chicago, IL
Interinstitutional Programs: National
● AHIMSA: American Holistic &
Integrative Medical Student
Association
- Standardized materials for
curriculum development and
student programming
- Regional recruitment/outreach
- Student-run integrative medicine
journal
Challenges for IM Curriculum in
Medical Schools
•
•
•
•
Time/ Curriculum
Faculty Development
Inter-professional Education
Resources: Financial
Integrative Medicine at KSOM:
Future
•
•
•
•
•
Consortium
Institute of Integrative Health (IIH)
Education – MS4 Selective
Research
Clinical
Integrative Medicine at KSOM:
Future
Thoughts/Suggestions?
Integrative Medicine
MEDICAL SCHOOL CURRICULUM
USC KECK SCHOOL OF MEDICINE
Armaity Vaghaiwalla Austin , MD MPH FAAFP
Associate Clinical Professor
Department of Family Medicine
USC Keck School of Medicine

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