Medical Student Attitudes toward Complementary, Alternative and Integrative Medicine

Ryan B Abbott,Babbi Winegarden,Jess Mandel,Laurence Brunton,Ka-Kit Hui,Ron D Hays,Dale Glaser,Michael Goldstein

doi:10.1093/ecam/nep195

Abstract

While the use of complementary, alternative and integrative medicine (CAIM) is substantial, it continues to exist at the periphery of allopathic medicine. Understanding the attitudes of medical students toward CAIM will be useful in understanding future integration of CAIM and allopathic medicine. This study was conducted to develop and evaluate an instrument and assess medical students' attitudes toward CAIM. The Complementary, Alternative and Integrative Medicine Attitudes Questionnaire (CAIMAQ) was developed by a panel of experts in CAIM, allopathic medicine, medical education and survey development. A total of 1770 CAIMAQ surveys (51% of US medical schools participated) were obtained in a national sample of medical students in 2007. Factor analysis of the CAIMAQ revealed five distinct attitudinal domains: desirability of CAIM therapies, progressive patient/physician health care roles, mind-body-spirit connection, principles of allostasis and a holistic understanding of disease. The students held the most positive attitude for the “mind-body-spirit connection” and the least positive for the “desirability of CAIM therapies”. This study provided initial support for the reliability of the CAIMAQ. The survey results indicated that in general students responded more positively to the principles of CAIM than to CAIM treatment. A higher quality of CAIM-related medical education and expanded research into CAIM therapies would facilitate appropriate integration of CAIM into medical curricula. The most significant limitation of this study is a low response rate, and further work is required to assess more representative populations in order to determine whether the relationships found in this study are generalizable.

Highlights

To develop the Complementary, Alternative, and Integrative Medicine Attitude Questionnaire (CAIMAQ), a group was formed consisting of academic clinicians, researchers and students from schools of medicine, public health and traditional oriental medicine having expertise in CAIM, allopathic medicine, medical education and survey development
The results of the analysis suggest that students are more likely to report their complementary and alternative medicine (CAM)-related education adequate further along in their medical education (χ2(3) = 9.41, P = .024, Cramer’s V = 0.074)
The most significant limitation of this study is a low response rate, and further work is required to assess more representative populations in order to determine if the relationships found in this study are generalizable

Summary

Introduction

The term complementary and alternative medicine (CAM) describes a group of health care systems, practices and products not presently considered to be part of allopathic medicine [1]. CAM systems are characterized by a holistic and highly individualized approach to patient care, an emphasis on maximizing the body’s inherent healing ability, involving patients as active participants in their own care, addressing physical, mental and spiritual attributes of a disease, and placing a strong emphasis on preventative medicine [2,3,4,5,6,7]. The Use of CAM in the USA Is Substantial. A recent study of CAM use in the general population reported that in 2007

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