This document outlines an integrative curriculum model developed at the University of Michigan to incorporate Complementary and Alternative Medicine (CAM) into their medical school curriculum. It describes goals to expand physician knowledge of CAM theories and research, develop respect and skills for communicating with patients about CAM, and use CAM for self-care. The model includes new curriculum units, courses, modules, and clinical experiences involving CAM. Evaluation found students had increased understanding and interest in CAM after the introductory unit. The model aims to prepare future physicians and researchers to address increasing patient CAM use.

1. AN INTEGRATIVE
CURRICULUM MODEL:
Incorporating CAM
Within an Allopathic Curriculum
Rita K. Benn, Ph.D., Sara L. Warber, M.D.
University of Michigan
Complementary & Alternative Medicine Research Center
Department of Family Medicine

2. Rationale
• Increased patient use of CAM without
disclosing such information to physicians
• Physicians have limited knowledge base of
CAM
• Physician and medical students attitudes
towards CAM correlate with educational
exposure

3. USF Survey Results
Most students agreed that traditional medicine
could benefit from CAM but
• only 1/4 students would refer for CAM
• 2/3 students understood principles of only
4/10 CAM modalities
• 40% would dissuade their patients
from using chiropractic care.

4. CAM in Medical Schools
• 75/125 offer some form of CAM training
• 83% of courses are electives
• 31% incorporate CAM into other courses

5. GOALS
Knowledge
• To expand physician base of information on
theory and practice of CAM
• To provide research based evidence for
efficacy and safety of CAM

6. Professional Behaviors
• To instill an attitude of openness & respect
for CAM
• To develop skills for:
– communicating information about CAM to
patients
– coordinating health care with CAM
practitioners
– use CAM for personal self-care

7. Plans for UM Medical
Curriculum
• New curricular units within existing courses
and clerkships
• New web case-based modules
• New clinical electives
• New clinical assessment stations
• Faculty development in CAM

8. Introductory CAM Module in M1
Goals:
• To identify common forms of CAM
• To become aware of reasons for patient use
of CAM
• To experience/observe the clinical practice
of a CAM modality
• To observe and reflect on differences among
CAM practices and between CAM and
conventional medicine.

9. CAM Unit: First Semester M1
• Lecture — An overview of CAM modalities
and evidence surrounding its efficacy
• Readings — Several general articles on
CAM and specific modality-related to their
field visit
• Field Visit — Students observe/or
experience the practice of a CAM modality
• Small Groups — Students reflect on their
experiences and discuss the readings.

10. Evaluation of CAM Unit
Student Opinions of CAM After CAM Unit
0 10 20 30 40 50 60 70 80 90 10
0
I Now Understand Why It's Important
For A Physician To Understand CAM
I See the Value of Introducing This Unit
As A MI Student
As A Result of This Unit, I Would Like
to Expand My Knowledge of CAM
Percent In Agreement

11. CAM Selective Courses - M1
• Mind-Body Medicine for Care of Self
and Patient
• Understandings of Health and Disease
in the Classic Medical Systems of Asia
• The Role of Spirituality in Medicine
• Nutrition and Chronic Disease

12. Evaluation of Selectives
Mean Ratings
(1-low, 5-high) Mind-
Body
Medicine
Spirituality
in Medicine
Oriental
Medicine
Nutrition
& Chronic
Medical
Care
All
Selectives
Disease
Increased my interest in
this topic.
4.53 4.36 4.18 4.40 4.26
I have a broader
understanding of this
topic.
4.46 3.92 4.18 4.60 4.31
Increased my
understanding of the
relationship between
medicine and society.
4.23 4.36 3.94 4.40 4.19
Overall the quality of
teaching during this
course was
4.38 3.67 3.71 4.40 4.19
Overall, this course was 4.38 3.83 3.65 4.20 4.01
I would recommend
having this course
4.54 4.46 3.82 4.60 4.31

13. Future First Year Plans
• An Overview Lecture in Four Required
Courses:
– Pharmacology
– Immunology
– Host Defense
– Anatomy
• Two Panel Case Based Presentations
Focused on Herbs and Nutrition

14. Second Year Curriculum
Integration Plans
• CAM and Nutrition Content in all Courses
• Case Based Presentations
• Integrative Case for Standardized Patient
Interview
• Practice-based Modules in Alternative
Medicine and Spiritual History Taking

15. Web-Based Materials and
Consultation: Third year
• Standard Integrative Case Materials in all
Clerkships
• Case Consultation On-line with CAM
Faculty
• Packets of Readings

16. Fourth Year Electives
• Clinical Electives
-Complementary Medicine
-Specialized Topic Area Electives
• Science in the Clinic Research Elective

17. Faculty Development:
CAM Faculty Scholars Program
Three components:
• One day a month of CAM Content
• Individual Mentoring by CAM affiliate
faculty
• Educational Project

18. Medical Curriculum Evaluation
• Student Performance in Courses
• Course Evaluations
• Pre-Post Learner Attitudes and Knowledge
• Fourth Year Clinical Competence
• Qualitative Study of Physician Growth

19. Related Program Initiative
Interdisciplinary Graduate
Certificate Program
• Enrolled in Masters/Doctoral Program in
Schools of Pharmacy, Social Work, Nursing
and Public Health
• Three additional core courses
-Clinical Complementary Therapies
(Nursing School)

20. Challenges
• Building Relationships with Faculty Course
Directors
• Shifting Academic Faculty Attitudes about CAM
• Expanding Academic Faculty CAM Knowledge
• Engaging Faculty in Interdisciplinary
Collaboration
• Cultivating value in students for self-
reflection/self-care
• Developing Capacity for Clinical CAM Electives

21. Facilitating Factors
• Medical Education Administration Support
• NIH, Foundation, and Donor Funds
• CAM Research Center Grant
• Quality Courses and Positive Student
Evaluation
• Expansive Community Network of
Reputable CAM Providers

22. Conclusions
• Model program
• Curricular innovations
• Benchmarking quality education
• Preparation of health care professionals
and researchers of the future