Pediatric Integrative Medicine in Residency (PIMR): Description of a New Online Educational Curriculum

Abstract

Use of integrative medicine (IM) is prevalent in children, yet availability of training opportunities is limited. The Pediatric Integrative Medicine in Residency (PIMR) program was designed to address this training gap. The PIMR program is a 100-hour online educational curriculum, modeled on the successful Integrative Medicine in Residency program in family medicine. Preliminary data on site characteristics, resident experience with and interest in IM, and residents’ self-assessments of perceived knowledge and skills in IM are presented. The embedded multimodal evaluation is described. Less than one-third of residents had IM coursework in medical school or personal experience with IM. Yet most (66%) were interested in learning IM, and 71% were interested in applying IM after graduation. Less than half of the residents endorsed pre-existing IM knowledge/skills. Average score on IM medical knowledge exam was 51%. Sites endorsed 1–8 of 11 site characteristics, with most (80%) indicating they had an IM practitioner onsite and IM trained faculty. Preliminary results indicate that the PIMR online curriculum targets identified knowledge gaps. Residents had minimal prior IM exposure, yet expressed strong interest in IM education. PIMR training site surveys identified both strengths and areas needing further development to support successful PIMR program implementation.

National Landscape of Interventions to Improve Pediatric Resident Wellness and Reduce Burnout

“…22 Institutional investments in faculty development through retreats and use of online wellness curricula are needed to not only model wellness behavior for residents but also to improve the sustainability of current resident wellness initiatives. 10,23 Acknowledgment of burnout from the American Academy of Pediatrics 3 has led to curricular development such as the Pediatric Integrative Medicine in Residency program, 24 which uses a combination of online and onsite experiential instruction on resident self-care, burnout, and mindfulness in medicine and the Resilience in the Face of Grief and Loss Curriculum. 25 Online training in mindfulness, such as the Ohio State University's online Mind-Body Skills Training course for health professionals, has demonstrated immediate improvement in mindfulness in trainees.…”

Pediatric Integrative Medicine

“…49 Since 2012, a growing number of academic pediatric integrative medicine programs have offered a complementary therapy curriculum to medical students and residents as part of their standard medical education. 9 In the United States, board certification in integrative medicine is now offered to eligible candidates through the American Board of Physician Specialties. 50…”

“…Despite high demand for integrative care, 42 a lack of systematic education about the safety and effectiveness of complementary and integrative therapies in pediatrics still exists. 9 One example of educational initiatives underway in pediatric integrative medicine to fill this gap is the Pediatric Integrative Medicine in Residency program, a 100-hour online educational curriculum that was implemented as a pilot in 5 pediatric residency training programs in the United States, and in 2016 it reached >500 residents nationally and internationally. 9 Osteopathic physicians receive extensive training in integrative medicine with regard to osteopathic principles and osteopathic manipulative treatment (OMT).…”

“…8 National initiatives to introduce pediatric integrative medicine into conventional pediatric residency training include programs such as the Pediatric Integrative Medicine in Residency program through the University of Arizona, initiated in 2012. 9 Other teaching initiatives are underway through the American Academy of Pediatrics (AAP) Section on Integrative Medicine and through academic institutions affiliated with the Academic Consortium for Integrative Medicine and Health (ACIMH), a prestigious organization of more than 65 medical schools that offer integrative medicine research, education, and clinical initiatives (eg, Harvard, Yale, Duke, Stanford). 10 This Clinical Report serves as an update to the original 2008 statement on complementary medicine.…”

Addressing Adverse Childhood Experiences Through the Affordable Care Act: Promising Advances and Missed Opportunities

“…Increasingly, health professions' training and continuing education are incorporating a focus on mindfulness, selfawareness, and self-healing, which should also help alleviate the impact of trauma on providers giving care. 70,71…”