Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

Abstract

Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies.

Use and acceptance of complementary and alternative medicine among medical students: a cross sectional study from Palestine

“…Educating health-care professionals about CAM has an important role in ensuring patients’ safety and improving patients care. To that end, educational initiatives have been carried out in some countries and surveys coming from these countries have been showing a rising prevalence of CAM education in medical schools and residency programs [60–66]. It was also reported that the registration in a CAM course can positively impact knowledge and attitude regarding CAM [67].…”

Family Medicine Resident Perspectives on Curricula in Herbal Medicine

“…This answers concerns expressed at both the MSE and GME level that one of the top barriers to integrating CAM content into the curriculum is finding time for it. 12,20 Limitations This study was limited by lack of a comparison group due to pre/ post single-group design. It is not clear that the changes in attitudes or intentions were attributable to the educational content itself.…”

“…16 Although GME on CAM has expanded in FMRs and improved resident knowledge in programs incorporating this training, other surveys show that only 5% of FM residents feel comfortable advising patients on CAM. [10][11][12]17 Less improvement has been made at the MSE level, with consequent reports that medical students are not comfortable counseling patients about CAM. 7,15,16 These data suggest that the US medical education system has done a poor job incorporating National Academy of Medicine recommendations.…”

“…Due to previously reported medical student and resident discomfort advising patients about CAM, we hypothesized that residents perceive MSE and GME on supplements as inadequate; however, we hypothesized that residents would identify a greater need for supplement education in MSE, given recent GME expansion of supplement education without corresponding expansions in MSE. 7,[10][11][12][15][16][17][18] Based on principles from the theory of reasoned action (TRA), a well-established theory of human motivation and behavior, we hypothesized that both perceived faculty norms and resident attitudes would influence resident intentions and behavior. 19 Finally, we evaluated perceived utility of an innovative workshop in improving resident knowledge about supplements and intentions to address supplements with patients, hypothesizing that our curriculum would improve confidence about supplements and increase the proportion of residents intending to address supplements with patients.…”

“…10 Consequently, the proportion of family medicine residencies (FMRs) including curricula on CAM has increased from 28% in 1995 to 44% in 2013, and 89% of CAM courses include training on supplements. [11][12] Despite increasing graduate medical education (GME) on supplements, the proportion of patients discussing supplements with their physician has remained low. Sixty-three percent to 72% of patients using supplements in 2008, up to 80% in 2017 report that they do not discuss them with their physician.…”