Article Text

  1. A. R. Hoellein,
  2. J. F. Wilson,
  3. M. J. Lineberry,
  4. S. A. Haist
  1. University of Kentucky, Lexington, KY


Background As the use of complementary and alternative medicine (CAM) has increased in the general population, medical students and medical educators have responded with CAM interest groups and CAM curriculum. However, formal CAM instruction varies and is especially less structured in the southeastern US. The purpose of this study is to determine the impact of a CAM workshop (WS) using standardized patients (SP) on knowledge and clinical skills of third-year medical students.

Methods A 4-hour CAM WS was developed as part of a new curriculum for a required third-year 4-week primary care internal medicine clerkship. The CAM WS and other novel WS were randomized for delivery to half of the rotational groups. The CAM WS incorporates four SP cases representing different clinical challenges (chiropractic, acupuncture, dietary supplement counseling). A faculty preceptor facilitates group discussion of sensitive approaches to the problems. Participating students are provided a 44-page CAM reference and all students are assigned CAM readings. At the end of the 4 weeks, all students take a 100-item written exam (seven CAM questions) and nine-station SP exam (one CAM station) including a post-SP encounter open-ended written exercise. Scores on the written exam CAM items, CAM SP checklist, and CAM open-ended written exercise of workshop participators and nonparticipators were analyzed with simple means, standard deviations, and multiple regression approaches controlling for USMLE Step 1 scores and preventive care SP station checklist scores.

Results The CAM WS was delivered to 6 of the 12 rotation groups during the 2004-2005 academic year. Forty-eight students participated in the workshop and 49 did not. Workshop participants performed significantly better than nonparticipants on the seven CAM written exam items (5.8 6 0.73 vs 5.2 6 1.2, F = 7.7, p = .007) and the post-SP encounter written exercise (92.4 6 7.4% vs 88.3 6 8.5%, F = 6.3, p = .014). There was no signficicant difference (p = .963) between the groups on the SP-checklist.

Conclusions Students participating in a 4-hour SP workshop exhibit superior CAM knowledge as assessed by open-ended and multiple-choice exercises. It appears that CAM attitudinal and deferential counseling skills are easily integrated into basic interviewing; however, practice with SPs does assist in acqusition and application of CAM knowledge.

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