Competency-based evaluation tools for integrative medicine training in family medicine residency: a pilot study

Abstract

BackgroundAs more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs) developed for the program.MethodsThe direct observation (DO) and treatment plan (TP) evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP). The OSCE I was implemented first in 2005 (n = 6), revised and then implemented with a second class of IFM participants in 2006 (n = 7). OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6).Data from the initial implementation of these tools are described using descriptive statistics.ResultsResults from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies.ConclusionAs these tools are refined further they will be of value both in improving our teaching in the IFM program and as competency-based evaluation resources for the expanding number of family medicine residency programs incorporating integrative medicine into their curriculum. The next stages of work on these instruments will involve establishing inter-rater reliability and defining more clearly the specific behaviors which we believe establish competency in the integrative medicine skills defined for the program.

Health Care Transitions: A Review of Integrated, Integrative, and Integration Concepts

“…One theme is the use of CAM modalities by medical doctors and the development of "integrative medicine" ("IM") specialties within medicine. 15,16 It appears that there are a variety of motives and risks raised with this model. Another theme focuses on cooperative or coordinated health care delivery between services and providers and focuses on providing the most clinically and cost-effective care to the patient in which multidisciplinary teams work together.…”

Nem-konvencionális gyógymódok a háziorvos szemszögéből

“…Sundberg és mtsai kiemelik az integratív medicina bevezetésének fontosságát [20]. Több tanulmány megjelent, amelyek az integratív medicina szemléletében oktatott családorvos-rezidensek gyó-gyítómunkájának hosszú távú eredményeit vizsgálják [21,22]. A képzés eredményeként javult a rezidensek körében az integratív medicina megítélése és javult a pá-ciensekkel kialakított kapcsolat minősége is [23].…”

Lösungsvorschläge für Probleme in der integrativmedizinischen Weiterbildung von Ärzten an anthroposophischen Kliniken Deutschlands und der Schweiz

“…IM spielt neben der klinischen Forschung zunehmend auch in der medizinischen Ausbildung eine relevante Rolle [3], wobei die Qualität einer Weiterbildung in IM unseres Wissens bisher nur in einem amerikanischen Onlineprogramm untersucht worden ist [4]. Ein Hauptelement der IM liegt in der Synthese von rationalen, konventionellen und komplementärmedizinischen Methoden in der medizinischen Praxis [5].…”