Active student involvement in integrative clinical care—A qualitative and quantitative study on learning experiences, professional development and progress in competencies in integrative medicine

Abstract

Introduction Teaching and Learning Integrative Medicine (IM) faces the challenge to integrate different health concepts including those of biomedical care and of CAM. Students have to learn about specific powers and limits of different methods of IM and how to use these together to heal and preserve health of the patient's body, mind and spirit. The aim of our study was to see how learning and professional development of final-year medical students was affected by active student participation in integrative clinical care during their 16 weeks rotation in internal medicine. Method, setting and subjects Based on the concept of legitimate peripheral participation by Lave and Wenger, a Clinical Education Ward for Integrative Medicine (CEWIM) was established. Final year medical students were integrated in a ward where conventional medicine is complemented by Anthroposophic Medicine including the use of conventional treatment, natural and anthroposophic remedies, physical and art therapies and biographic counseling. Students were participants of the program “Integrated Curriculum for Anthroposophic Medicine” (ICURAM), which is integrated into the medical curriculum of 6 year duration at the University of Witten/Herdecke in Germany. Twelve final year medical students who participated at CEWIM were interviewed (4 individual interviews, 2 focus groups) regarding their learning experiences and their professional development. Additionally, students rated their competencies in IM before and after their rotation. Results A qualitative analysis of the interviews showed that being responsible for patients under structured supervision is seen to be a powerful motivation for active learning and professional development. Working and reflecting with peers as well as being mentored were essential aspects and gave important support for personal development. According to quantitative analysis of self-evaluation students made significant progress in diagnostic and therapeutic competencies in internal medicine as well as in practicing specific aspects of IM like using different healing methods and learning to assess their specific powers and limitations. Conclusion Active participation in integrative clinical care for final year medical students seems to offer good opportunities for learning IM including personal and professional development of the learners.