Abstract
ObjectivesThis scoping review explores the extent to which undergraduate medical education have incorporated complementary and alternative medicine in their curricula and evaluates the teaching, delivery and assessment approaches used. MethodsERIC, Ovid Medline and Pubmed databases were searched with keywords related to “complementary and alternative medicine” and “undergraduate medical education” for relevant articles published until August 2020. Data extraction included the presence/absence of complementary and alternative medicine integration, program duration, instructor background, and assessment methods. ResultsOf 1146 citations, 26 met the inclusion criteria. Complementary and alternative medicine teaching in undergraduate medical education was widely inconsistent and not well aligned with clearly identified aims and objectives. Various complementary and alternative medicine disciplines were taught, demonstrated or observed, and several programs included teaching on evidence-based medicine. Educational outcomes mainly assessed student satisfaction and learning through self-evaluation and rarely assessed for effectiveness with regards to changing clinical practice or impacts on patient outcomes. ConclusionsInconsistencies in complementary and alternative medicine teaching and assessment in undergraduate medical education reflect the lack of defined graduate competencies. An evidence-based medicine component of an educational program is a potential solution to overcoming breadth and content challenges. Curriculum developers would be better guided with research that determines if complementary and alternative medicine program design, content and assessment influence clinical practice and/or patient outcomes.
Highlights
Medical educators encounter various challenges incorporating complementary and alternative medicine (CAM) teaching into undergraduate medical education (UGME)
The specific research questions we sought to answer were: 1. do UGME programs teach students about CAM and, if so, which CAM disciplines do UGME programs teach students? 2. what teaching and learning approaches do UGME use to teach students about CAM? and; 3. how are UGME students assessed about their knowledge of CAM? In addition to these questions, this review evaluated the effectiveness of CAM teaching in the included studies, using the Kirkpatrick Hierarchy for Assessing Educational Outcomes.[5,6,7]
Articles that did not clearly describe the characteristics of CAM teaching within the UGME curricula were excluded, as were general articles about CAM in medical education, and proposals for CAM curricula without implementation and opportunity for subsequent evaluation
Summary
Medical educators encounter various challenges incorporating complementary and alternative medicine (CAM) teaching into undergraduate medical education (UGME). The term CAM relates to the use of non-mainstream practices, either together with conventional medicine (complementary), or in place of it (alternative).[1] Common complementary health approaches include the broad descriptors of natural products (herbs, vitamins, minerals, probiotics), and mind and body practices (yoga, chiropractic, osteopathic manipulation, meditation, acupuncture, breathing exercises). In addition to the enormous breadth of CAM, there exists a degree of uncertainty around the validity and efficacy of many widely used therapies.[2] Whereas conventional western medicine defines ‘best practice’ based on empirical trials utilising large patient populations, many CAM therapies boast an individualised approach where the practitionerpatient interaction is therapeutic rather than the therapy itself.[2] This poses a considerable challenge for educators tasked with determining the necessary acquisition of CAM knowledge and skills in UGME
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