Article Text

  1. A. R. Hoellein1,
  2. J. F. Wilson1,
  3. M. J. Lineberry1,
  4. S. A. Haist1
  1. 1University 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 tends to be heterogeneous and 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 (SPs) 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 three other novel WSs were randomized for delivery to half of the rotational groups. The CAM WS incorporates four SP cases representing different clinical challenges (chiropractic, acupuncture, and dietary supplement counseling). A faculty preceptor facilitates group discussion of sensitive approaches to the problems. Participating students are also provided a 44-page CAM reference. All students in every rotation group are assigned CAM readings. At the end of the 4 weeks, all students take a 100-item written examination (seven CAM questions) and a nine-station SP examination (one CAM station) including a post-SP encounter open-ended written exercise. Scores on the written examination CAM items, CAM SP checklist, and CAM open-ended written exercise of workshop participants and nonparticipants were analyzed with simple means, standard deviations, and multiple regression approaches solving for performance on a preventive medicine checklist and USMLE Step 1 scores.

Results The CAM WS was delivered to 12 of the 24 rotation groups during the 2004-2006 academic years. Ninety-two students participated in the workshop and 94 did not. Workshop participants performed significantly better than nonparticipants on the CAM-specific SP checklist items (15.7 ± 6.4 vs 9.9 ± 6.6, F = 36.7, p < .0001), post-SP encounter written exercise (6.1 ± 2.1 vs. 5.1 ± 2.1, F = 14.3, p < .0001), and seven CAM written examination items (5.9 ± 0.8 vs 5.3 ± 1.1, F = 18.6, p < .0001).

Conclusions Students participating in a 4-hour SP workshop exhibit superior CAM knowledge as assessed by SP checklist, open-ended exercises, and multiple-choice items. It appears that practice with SPs assists in acquisition and application of CAM knowledge and solidifies CAM attitudinal and deferential counseling skills.

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