Complementary and Alternative Medicine Education for Medical Profession: Systematic Review

Nana K Quartey,Sian M Griffiths,Polly H X Ma,Vincent C H Chung

doi:10.1155/2012/656812

Abstract

Purpose. To help integrate traditional, complementary and alternative medicine (TCAM) into health systems, efforts are being made to educate biomedical doctors (BMD) and medical students on TCAM. We systematically evaluated the effect of TCAM education on BMD and medical students' attitude, knowledge, and behavior towards TCAM utilization and integration with biomedical medicine. Methods. Evaluative studies were identified from four databases. Methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Study outcomes were classified using Kirkpatrick's hierarchy. Results. 3122 studies were identified and 12 studies of mediocre quality met inclusion criteria. Qualitative synthesis showed usage of diverse approaches including didactic, experiential learning, varying length, teacher background and intensity of exposure. More positive attitudes and improved knowledge after intervention were noted especially when teachers were BM trained. However, few studies assessed behavior change objectively. Finally, longer-term objective outcomes such as impact on patient care were not assessed. Conclusions. Lack of use of objective and reliable instruments preclude firm conclusion on the effect of TCAM education on study participants. However, positive changes, although mostly subjectively reported, were noted in most studies. Future evaluation should use validated or objective outcome assessments, and the value of using dual trained instructors.

Highlights

It is estimated that over 80% of the populations of lowincome countries are using herbal medicine as part of basic healthcare [1], and the use of traditional, complementary, and alternative medicine (TCAM) is increasing in high-income countries [2]
One of the major policy directions is to strengthen the communication between biomedical doctors (BMDs) and TCAM providers (TCAMP), as well as to develop appropriate TCAM training programs for BMD and medical students [4]
The goals of TCAM education were to equip BMD and medical students with the following competencies: (i) know how to ask patients about their use of TCAM; (ii) be familiar with the most commonly used forms of TCAM so BMD can discuss these practices with their patients; (iii) be able to refer interested patients to reliable sources of information; (iv) know how to obtain reliable information about the safety and efficacy of TCAM [6]

Summary

Introduction

It is estimated that over 80% of the populations of lowincome countries are using herbal medicine as part of basic healthcare [1], and the use of traditional, complementary, and alternative medicine (TCAM) is increasing in high-income countries [2]. In 2008, the WHO Congress of Traditional Medicine promulgated the Beijing Declaration. It regards the formulation of TCAM policies as a responsibility of governments worldwide and has reemphasized the importance of integrating TCAM amongst the member states’ health system. The goals of TCAM education were to equip BMD and medical students with the following competencies: (i) know how to ask patients about their use of TCAM; (ii) be familiar with the most commonly used forms of TCAM so BMD can discuss these practices with their patients; (iii) be able to refer interested patients to reliable sources of information; (iv) know how to obtain reliable information about the safety and efficacy of TCAM [6]. Evaluators of TCAM education have highlighted the difficulties in examining the effects of initiatives in changing BMD and medical students’ attitude, knowledge, behavior, and skills related to TCAM [7], and so far a systematic review on the topic has not been published [8]

Results

Discussion

Conclusion