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.
Highlights
As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows
Results from the implementation of these tools at the Integrative Family Medicine (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
Treatment plan evaluation tool we developed a treatment plan evaluation tool that delineates the specific behaviors and language expected of IFM participants when developing and modifying evidence-based integrative treatment plans for specific patients
Summary
As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. This article describes the ongoing efforts at six residency programs participating in a pilot program in "Integrative Family Medicine" to develop competencies in this area and the tools to measure them effectively. The term CAM has been widely replaced by "Integrative Medicine" (IM), which is defined as "healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative. [2]"
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