Armaity Vaghaiwalla Austin , MD MPH FAAFP Associate Clinical Professor Department of Family Medicine USC Keck School of Medicine Integrative Medicine MEDICAL SCHOOL CURRICULUM USC KECK SCHOOL OF MEDICINE
Feb 25, 2016
Armaity Vaghaiwalla Austin , MD MPH FAAFPAssociate Clinical Professor
Department of Family MedicineUSC Keck School of Medicine
Integrative MedicineMEDICAL SCHOOL CURRICULUMUSC KECK SCHOOL OF MEDICINE
Ali Arastu, MS4Caryn Brenn, MS4
Lia Jacobson, MS4
Sara Ptasnik, MS2Kristen Roehl, MS2
Lisa Schamber, MS2Elaine Yang, MS2
KECK SCHOOL OF MEDICINE, USC
Co- Presenters
• PPM Selective – Year II
• Clinical Selective – Year IV
• Student Programming
IM Curriculum at KSOM
●6 sessions in the fall (12-hr curriculum)●Each session incorporates 2 topics●Integrative physician speakers●Student case presentations
PPM Selective - Year II
● Introduction to E-W Medicine●TCM – Acupuncture & Herbalism●Homeopathy●Guided Imagery●MBSR●Yoga●Ayurveda●Chumash Herbal Medicine (“Hike & Healing”)●Patient Perspective
Topics in PPM Selective
◦ IM PPM Selective for past two years, consistently among the highest rated selective, may be expanded to two concurrent sessions due to popular demand
◦ Student research project about CAM attitudes surveyed students before and after taking the course
Feedback on PPM Selective
PPM – INTEGRATIVE MEDICINE IM. SELECTIVE, MS2COURSE STATS
PPM – INTEGRATIVE MEDICINE IM. SELECTIVE, MS2
Scale: 5 4 3 2 1
Excellent Very Good Average Below Needs Average Improvement
List 3 most important learning points from your IM Selective experience.
What was the best part of the IM Selective experience?
Student Experience: Sara Ptasnik
Survey of Medical Students’ Attitudes Towards CAM
(Fall 2011)
Caryn Brenn, MSIV
Demographics
• 178 second year Keck medical students (MS2)• 24 years old• 51.1% male
• 27 students enrolled CAM selective• 151 students enrolled other selectives
Survey Questions
• 9 questions from the validated CAM Health Belief Questionnaire (CHBQ)1
– 7 point Likert scale– 1=“Absolutely disagree”, 7=“Absolutely agree”– Midpoint 36, Maximum 63
• Personal use of CAM therapies• Frequency of use• Plan to use CAM in future medical career• Opinion of CAM education• Resources used
1Lie, D., & Boker, J. (2004). Development and validation of the CAM Health Belief Questionnaire (CHBQ) and CAM use and attitudes amongst medical students. BMC Med Educ, Vol 4(1), 2.
Results
• Hypothesis confirmed
Pre Post Average Difference
p-value
CAM selective(n=24)
46.25 (+ 5.09) 52.17 (+ 4.61) +5.92 0.00001
Other selective(n=137)
42.69 (+ 6.86) 42.04 (+ 6.91) -0.65 0.098
Total CHBQ score
Results: Secondary FindingsAll students (n=161), Pre survey
• 88.7% of all students personally use one or more form(s) of alternative therapy
Results: Secondary FindingsAll students (n=161), Pre survey
• 92% of students agree that CAM education should be a component of medical school education
• 82% of students plan to refer CAM therapies
• 61% of students gained baseline knowledge of CAM from word of mouth or social media– 17% from previous CAM education– 6% from scholarly and medical journals
●4 weeks in length
●Faculty: Armaity V. Austin, MD, MPH, FAAFP
●“Prevention and Wellness”
Clinical Selective - Year IV
Wellness Assessment
• NUTRITIONMacronutrientsMicronutrientsDietary Supplements
• PHYSICAL ACTIVITY• MIND-BODY
Stress Management• SLEEP• ENVIRONMENTAL HEALTH• SPIRITUALITY• MOTIVATIONAL INTERVIEWING
Curriculum of Clinical Selective
Student Experiences: Ali Arastu
Lia Jacobson
Student Programming
●Integrative Medicine Club●Student President Sylvia Charles (Psychiatry
Intern @ UCSF) and Co-President Ali Arastu inherited Integrative Medicine Club as first year medical students●Implemented Weekly Yoga Sessions●Introduced Meditation to Campus for
students●Began working to provide student input in
IIH
Integrative Health Interest Group (IHIG)
1. Year II PPM co-facilitation (student leaders)2. Ongoing involvement with IIH
● Student liaison; monthly breakfast seminars● Research & physician mentors
Interdisciplinary, Longitudinal, Co-Sponsored, Interinstitutional
Integrative Health Interest Group (IHIG)
3. Student wellness● “Wellness Wednesdays” in the quad● Weekly yoga class● Mindfulness at ECSHC
K
IHIG: Events in Spring 2014
● Women’s Health Symposium
● Research Lunch Talk● IIH Research
Symposium● BeWellKeck Kick-Off
Extravaganza● Pet Therapy Day
IHIG: Goals & Opportunities
● Expand interdisciplinary involvement● Increase events in the fall semester● Increase attendance at Wellness Wednesday
events, in conjunction with the BeWellKeck initiative
● Develop a sustainable funding mechanism to allow hands-on workshops, outside practitioners, and food at events
Mindfulness Meditation for Medical Students: A Pilot Research Study
• Can the use of a mobile application to deliver 10-20 minutes of daily guided mindfulness meditation help medical students reduce stress and improve overall wellbeing?
General Well-being ScalePerceived Stress ScaleFive-Facet Mindfulness Questionnaire
Feasability
Results • 74% of Intervention group used the Headspace app
○ Number of days used: M=11.97, SD=7.76, range=28• 54% continued to use Headspace after the initial 30-day
intervention period• Perceived Stress decreased for Intervention, but not Control,
over 60 days○ Well-being did not significantly increase across both groups○ Mindfulness increased across both groups for subscales of
Observing, Acting with Awareness, and Non-reacting
Interinstitutional Programs: Goals
●Increased opportunities for interdisciplinary education
●Enhancement of self-care knowledge and practice●Regional and national connections among M.D.,
D.O., and N.D. medical students interested in Integrative Medicine
●Community of like-minded medical students to optimize future collaboration in patient care
Interinstitutional Programs: SoCal
●IMMSA-SC: Integrative Medicine Medical Student Association – Southern California Chapter●Bastyr University California●David Geffen School of Medicine at UCLA●Western University of Health Sciences●UC San Diego School of Medicine●Keck School of Medicine of USC●UC Irvine School of Medicine
●Symposium/retreat in the works...
Interinstitutional Programs: National
●LEAPS into IM: Leadership and Education Program for Students in Integrative Medicine
Jun 2014 @ Kripalu Center for Yoga & Health, Berkshires, MA
●HEART-IM: Humanistic Elective in Activism, Reflective Transformation, and Integrative Medicine
Mar 30 – Apr 24, 2014 @ Quaker Center, Ben Lomond, CA
Interinstitutional Programs: National
●NSCIM: National Student Conference on Integrative Medicine
Oct 26-27, 2013 @ Northwestern University, Chicago, IL
Interinstitutional Programs: National
● AHIMSA: American Holistic & Integrative Medical Student Association
- Standardized materials for curriculum development and student programming
- Regional recruitment/outreach- Student-run integrative medicine
journal
Interinstitutional Programs: National
Challenges for IM Curriculum in Medical Schools
• Time/ Curriculum
• Faculty Development
• Inter-professional Education
• Resources: Financial
Integrative Medicine at KSOM: Future
• Consortium
• Institute of Integrative Health (IIH)
• Education – MS4 Selective
• Research
• Clinical
Integrative Medicine at KSOM: Future
Thoughts/Suggestions?
Armaity Vaghaiwalla Austin , MD MPH FAAFPAssociate Clinical Professor
Department of Family MedicineUSC Keck School of Medicine
Integrative MedicineMEDICAL SCHOOL CURRICULUMUSC KECK SCHOOL OF MEDICINE