The Integrator Blog
Home
Share |
about
Contact Me, Experience, Mission, Sabbatical in Central America, plus
Editorial Advisory Board
Columnists
Michael Levin
Taylor Walsh
background resources in PDF
Insurance, Integrative Clinics, Industry Summit Reports, News Files '99-'04
some organization links
Professions, Academia, Research, Policy
some CAM/IM publication links
Electronic, Peer-Reviewed, Blogs, More
Bradly Jacobs, MD, MPH, Revolution Health Blog
supported conference
Institute for Health & Productivity Management - Integrative/Complementary Healthcare
The Future of MD Education: Empathy, Roses and Respect Via Georgetown and U Minnesota Pilots PDF Print E-mail
Written by John Weeks   

The Future of MD Education: Empathy, Roses and Respect Via Georgetown and U Minnesota Pilots

Imagine that all conventional medical students not only receive training in mind-body skills, and learn to practice basic techniques, in their first year of medical school. Now imagine the same set of students are given hands-on experiences of diverse complementary and alternative medicine (CAM) practices as part of a course on comparative systems of medicine.

Image Separate reports of these two educational interventions at Georgetown University and the University of Minnesota, respectively, suggest that combining the two into basic medical school curriculum will begin to create the kind of integrative and self-integrated medical doctor which patients are increasingly desiring.

Georgetown Research: Mind-Body Benefits re Stress, Attentiveness, Empathy

Gregory Wong, MS, and associates at the Georgetown program led by Adi Haramati, PhD, took a group of 111 medical school students through a 2 hour-long course, once a week for11 week. The techniques included breathing, biofeedback, meditation, guided imagery, art therapy and others.


_________________________________

Outcomes of Mind-Body Program for
First year Medical Students


Measured
Pre-
Program 
 Post-
Program 
Mean
  paired
diff. 
Perceived stress scale
16.4
 13.1 -3.2
Felt nervous and stressed
(1-4 scale, 4 highest)
2.7  2.1 
--
Found they "could not cope"
with all they need to do
1.6  1.1 
--
Mindfulness awareness
attention scale
(0-100, 100 best)
 54.8 61.3 
6.5
I tend to walk quickly without
paying too much attention ...
(1-6 scale, 6 most attentive)
 2.9 3.6 
--
I find myself listening with
one ear, doing something else
(1-6 scale, 6 "almost never")
 3.3 3.9 
--
I appreciate my classmates
concerns and struggles
(1-7, 7 "absolutely agree")
 5.5 6.4 
--
I understand what self-
awareness means
(1-7, 7 "absolutely agree")
 5.2 6.0 
--

Gregory Wong, Kamal Shah, Pamela Saunders, Nancy Harazduk, Rochelle Trachtenberg, Michael Lumpkin and Aviad Haramati: "Impact of Mind-Body Skills Groups on Medical Students: Quantitative Analysis of Perceptions of Stress and Mindful Awareness." Presented at the North American Research Conference on Complementary and Integrative Medicine, May 24-27, 2006.

_________________________________

Wong's group concluded that the mind-body skills course may "help advance several desirable educational goals." These include: reduce perceived stress, increase mindfulness, increase self-awareness and foster empathy. The ultimate outcome: the course has become a regular part of first year training at Georgetown University's School of Medicine.

U Minn Partnership with CAM School: Increased Knowledge, Confidence, Mutual Respect


Image
Researcher Karen Lawson, MD
The research project led by Karen Lawson, MD, with the Center for Spirituality and Healing at the University of Minnesota, directed by Mary Jo Kreitzer, RN, PhD, involved a collaborative partnership with Northwestern Health Sciences University (NHSU). NHSU is a regionally-accredited, multi-disciplinary natural health sciences institution with leading programs in chiropractic and acupuncture and Oriental medicine (AOM). 

The study focused on learning about AOM. Students were given course materials and finished web-based modules on AOM prior to filling out a questionnaire. They then traveled to NUHS for a single 90 minute segment in which, in groups of 6-8 students, they revolved through 6 stations, gaining hands-on experience of content which had been covered, didactically, in the modules. 

_________________________________

The Difference Hands-on Experience Can Make:
90 Minute Session of MD Students with
TCM Students at CAM School



Based on self-evaluation of "levels of confidence"
with 0 "low" and 10 "high"

Measured
Pre-
Program 
 Post-
Program 
Correct use of the language
of comparative medicine
2.84
4.47
Knowledge of similarities/differences
among TCM, Ayurvedic medicine and
biomedical systems
2.33
4.03
Knowledge of scope and depth of
training of CAM practitioners
1.99
5.38
Knowledge of the historical and cultural
contexts, diagnostic approaches and
therapeutic applications of TCM
1.69
4.63
(Ability) to speak with patients about
acupuncture and moxibustion
1.82
5.04
(Ability) to speak with patients about
TCM nutrition and herbal medicine
1.69
4.38
(Ability) to speak with patients
and Chinese massage
1.18
5.07

Karen Lawson, Pat Hart, Lixin Zhang: "An Experiential Model for Teaching Comparative Medical Systems." Presented at the North American Research Conference on Complementary and Integrative Medicine, May 24-27, 2006.

_________________________________

Lawson concluded her presentation with quotes from participating medical students, who consistently make this session, through their participation, the most well-attended part of the year-long course. Both studies were funded through R-25 grants from the NIH National Center for Complementary and Alternative Medicine.

Comment: 
I like the basic idea of medical students filling out forms which check on whether they have noticed life, and cared for their fellow students. The test-taking alone probably had a placebo positive effect.

Better yet is to imagine conventional medical students first experiencing a mind-body educational program such as that which Wong described, followed by a hands-on experiential program such as Lawson reported. One can begin to imagine the hatchlings of a new generation
 
One might anticipate
that the mind-body
work would open
students to
understanding CAM
systems, much

as meditation can
open a person to
cognitive restructuring.
 
of medical doctors, respectfully cross-referring to CAM practitioners. One might anticipate that mind-body work would open the these students to understanding the CAM systems, much as meditation can open a person to cognitive restructuring.

Notably, the combined classroom hours involved in these two programs were 23.5 (22 mind-body plus 1.5 "comparative medical systems"). In a world in which course time is at a premium, these represent efficient ways to prepare students to better meet their patients.

From the looks of the first draft of the AMA House of Delegates Resolution #306, from June 2006, the increasingly female set of medical students are calling for significantly increasing CAM-IM education in the medical curriculum. (See  Integrator article.) However, the AMA's gutting of the language recommended by the Student Section, before passing #306 as an apparently token gesture, suggests that it will be some time before organized medicine begins to support either the student-centered or patient-centered education toward which these studies direct us. Wouldn't it be a sweet thing if the AMA came down firmly on the side of students learning to stop, gain some empathy, and smell the roses?

Kudos to the NIH NCCAM for funding these R-25 programs.
< Prev   Next >
Search
Advertisement
Advertisement
Sponsors
Integrative Practitioner
The Westreich Foundation
voluntary contributions
Support the work!
Archive
All Integrator Round-ups
Integrator Top 10 Lists 2006-2015
Issues #140-#142 Oct-Dec 2015
Issues #137-#139 July-Sept 2015
Issues #134-#136 April-June 2015
Issues #131-#133 Jan-March 2015
Issues #127-#130 Sept-Dec 2014
Issues #123-#126 May-Aug 2014
Issues#119-#122 Jan-April 2014
Issues #116-#118 - Oct-Dec 2013
Issues #113-#115 July-Sept 2013
Issues #110-#112 April-June 2013
Issues #108-#109 Jan-March 2013
Issue #105-#107 Oct-Dec 2012
Issues #102-#104 - July-Sept 2012
Issues #99-#101 - April-June 2012
Issues #96-#98-Jan-March 2012
Issues #94-#95 Nov-Dec 2011
Issues #92-#93 Sept-Oct 2011
Issues #90 and #91 - July-Aug 2011
Issues #88 and #89 - May-June 2011
Issues #86 and #87 - March-April 2011
Issues #84 and #85 - Jan-Feb 2011
Issues #82 and #83 - Nov-Dec 2010
Issues #80 & #81 - Sept Oct 2010
Issues #78 & #79 - July August 2010
Issues #76 & #77 - May June 2010
Issues #74 & #75 - March-April 2010
Issues #73 & #73 - Jan-Feb 2010
Issues #69, #70 & #71 - Nov-Dec 2009
Issues #67 and #68 - Sept-Oct 2009
Issues #65 and #66 - July-August 2009
Issues #63-#64 - May-June 2009
Issues #60-#62 - March-April 2009
Issues #57-#59 - Jan-Feb 2009
Issues #55-#56 - Nov-Dec 2008
Issues #51-#54 - Sept-Oct 2008
Issues #47-#50 - July-August 2008
Issues #46 & -#47 - May-June 2008
Issues #43-#45 Mar-April 2008
Issues #41 & #42 - Feb 2008
Issues #39 & #40 - Dec-Jan '08
Issues #37 & #38 - Nov 2007
Issues #35 & #36 - Oct 2007
Issues #33 & #34 - Sept 2007
Issues #30-#32 - July-Aug 2007
Issues #28 & #29 - June 2007
Issues #26 and #27 - May 2007
Issue #25 - April 2007
Issues # 23 & #24 - March 2007
Issues #21 and #22 - Feb 2007
Issues #19 and & 20 - Jan 2007
Issues #17 and #18 - Dec 2006
Issues #15 and #16 - Nov 2006
Issues #13 and #14 - Oct 2006
Issues #11 and #12- Sept 2006
Issues #9 and #10 - Aug 2006
Issues #7 and #8 - July 2006
Issues #5 and #6 - June 2006
Issues #3 and #4 - May 2006
Issues #1 and #2 - April 2006
All Articles by Subject: 2006
All Articles by Subject: Jan-June 2007
IAYT-Sponsored Series on the Future of Yoga Therapy