ABSTRACT
BACKGROUND: Although many Americans utilize complementary and alternative medicine (CAM) services and products, few medical school curricula consistently provide instruction in counseling patients on the use of CAM or strategies for identifying credible evidence on the safety and effectiveness of CAM therapies. METHODS: This is a mixed methods study. A sustainable, mandatory, half-day CAM immersion curriculum for graduating medical students is described. Student comfort talking with patients about CAM, their willingness to refer patients to a CAM provider, and adequacy of the CAM curriculum was assessed. RESULTS: Students who participated in this mandatory curriculum, rated the medical school curriculum in CAM as more adequate than students at other medical schools without a mandatory curriculum. Students' narrative comments indicate the curriculum impacts students knowledge about CAM, patient use of CAM, and personal practice with CAM in the future. CONCLUSIONS: The timing of the CAM curriculum near to graduation, students' personal exploration of several CAM modalities through immersion, and student interaction with community CAM providers are aspects of the curriculum that make the curriculum successful and memorable.
Subject(s)
Complementary Therapies , Curriculum , Education, Medical, Undergraduate , Integrative Medicine/education , Mandatory Programs , Schools, Medical , Students, Medical , Clinical Competence , Complementary Therapies/statistics & numerical data , Curriculum/standards , Humans , Physician-Patient Relations , Surveys and QuestionnairesABSTRACT
BACKGROUND: A causal link between stress and work-related musculoskeletal disorders of the upper extremities (WRUEDs) has been established, but there is less evidence for a beneficial effect of stress reduction interventions on WRUED symptoms and incidence. METHODS: Searches of Medline, Ergonomics Abstracts, and Psychlit from 1990 to 2001 identified studies that either targeted stress and measured WRUED outcomes, or described other interventions with both stress and WRUED outcomes. RESULTS: Workplace interventions, including discrete improvements in technology, work organization and ergonomics, and more comprehensive approaches can reduce levels of stress. In a few studies, these interventions have been associated with decreases in WRUED symptoms. Similar effects are noted in stress-related interventions targeting individuals before WRUEDs have appeared, and at several stages of these conditions. CONCLUSIONS: Health care providers can recognize stress-WRUED interactions through careful, directed inquiry. Both individual as well as workplace-targeted interventions, delivered in the primary care setting or workplace, may be helpful. Future research priorities include prospective studies of well-defined interventions, with ample measures of subject, intervention and workplace characteristics that can impact outcomes, and adequate follow-up to determine sustained effects.
