strategies for integrating eip into the aom curriculum belinda (beau) anderson, phd, lac academic...
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Strategies for Integrating EIP into the AOM CurriculumBelinda (Beau) Anderson, PhD, LAcAcademic Dean, Pacific College of Oriental Medicine (NY)
Assistant Professor, Albert Einstein College of Medicine
Acupuncturist and Chinese Herbalist, New York University Fertility Center
Pacific College of Oriental Medicine (PCOM) Largest Chinese medicine college in US (~1400 students)
3 campuses – San Diego, New York City, Chicago
Regionally accredited – WASC
Programs AOM – Masters and doctoral degrees Massage therapy – Associates degree Holistic Nursing – Bachelor completion program
Impetus for EIP at PCOM NIH K07 grant (2013-18) ‘Evidence Informed Practice:
Faculty and Curriculum Development’ Modeled on NWHSU EIP NIH R25 project
AOM First Professional Doctorate New EIP competency
Cover today… Baseline EIP knowledge and attitudes of PCOM-NY faculty
and students (survey outcomes)
Needs of faculty and institution for implementation of EIP faculty training and curriculum (survey outcomes)
AOM specific EIP issues
Approach to infusing EIP into the PCOM AOM programs
Baseline EIP Knowledge and Attitudes of PCOM-NY Faculty and Students
Anderson et al 2014. J Altern Complement Med 20(9):705-12
SurveyFaculty Students
# Close-ended Qs* 14 18
Response Rate 89% (102/115) 42% (176/420)
Prior Research Ed. 51% 40%
Prior Res. Ed. Grad Level
41% 34%
* Close-ended questions with 5-point Likert answers (Strongly agree; Agree; Neutral; Disagree; Strongly disagree).
Results expressed as %Agree + Strongly agree
Research LiteracyFaculty Students*
I am comfortable searching the web for relevant scientific literature
77.5 93.3
I am comfortable critically appraising scientific literature
71.6 76.7
I read journal articles weekly 57.8 n/a
* 4th year students who had taken the introductory research course
Faculty: Support for Research Funding and Training
Faculty
It is important that PCOM develop a research agenda and apply for external research funding
89.2
CAM practitioners will benefit from having a strong foundation of training in research methodology and outcomes
78.8
AOM professionals, if appropriately trained, can make a significant contribution to CAM research
95.1
Faculty: Participation in Research Training and EBM Implementation
Faculty
I would be interested in receiving research training 75.5
I would be interested in being on an committee working to introduce research curriculum into the Master’s degree
68.7
I would be interested in incorporating research focused material into the courses and clinics that I instruct
74.5
Value of EBM Faculty 4th Year
Students
Critical evaluation of biomedical research methodology and outcomes is necessary to be able to assess the value and application of biomedical research to the practice of CAM
77.5 56.7
Evidence from well-designed biomedical research clinical trails, where the acupuncture intervention appears appropriate, is useful to an acupuncturist’s clinical practice
74.8 76.7
Defining what successful outcomes look and feel like with patients allows practitioners and patients to agree on what ‘successful’ treatment is, and facilitates patient retention and satisfaction
82.4 76.7
The quality of patient care is improved when practitioners seek out evidence about effective approaches to treating patients
76.5 73.3
The quality of patient care is improved when practitioners assess the outcomes of their treatments and use this knowledge to decide on further treatment strategies
93.1 96.7
Student Survey
Assessing trends as students progress through the 4-year Masters program
Students: Research Value
Q#
1 Biomedical research investigating acupuncture and Chinese herbal medicine is important for patient referral from biomedical practitioners
2 This research is important for the development of greater insurance coverage for acupuncture
3 This research has a positive influence on the public's perception of the profession
1 2 370
72
74
76
78
80
82
84
86
88
90
1st year
2nd year
3rd year
4th year
Survey Question Number (Q#)
% A
gre
e +
Str
on
gly
Ag
ree
Students: Science & Chinese Medicine
Q#
1 I believe acupuncture and Chinese herbal medicine are more of a science than an art**
2 I believe that the scientific method (gathering empirical and measurable evidence) is compatible with the basic principles of Acupuncture and Oriental Medicine*
1 20
10
20
30
40
50
60
70
1st year
2nd year
3rd year
4th year
Survey Question Number (Q#)
% A
gre
e +
Str
on
gly
Ag
ree
**
*
** P for trend = 0.003* P for trend = 0.01
Students: Future Research Interest
Q#
1 I am interested in engaging in acupuncture and/or Chinese herbal medicine research (either full-time or part-time) after I graduate
2 I am interested in doing the Doctoral Program in Acupuncture and Oriental Medicine after I graduate
1 20
10
20
30
40
50
60
70
80
1st year
2nd year
3rd year
4th year
Survey Question Number (Q#)
% A
gre
e +
Str
on
gly
Ag
ree
4th Year Students: Desire for Further Research Training
4th Year Students
I would have liked to have additional research training as part of my Master’s degree
36.7
I would have preferred a greater amount of research material and or assignments in the other courses (biomedical and Oriental medicine) in my Master’s degree
30
Faculty Needs Assessment
Degree of Agreeability
High Low EIP skill importance Compatible with current
perspective Complexity is manageable Involvement Consistent with institutional
values Institutional support, timing,
obligation Low resistance Advantageous
Currently in courses Institutional ability
Themes from open-ended questions
SupportFaculty and students
Research is important to the profession
ConcernsFaculty and Students Biomedical research paradigms are not compatible with Chinese
medicine
Faculty Chinese medicine could get co-opted by biomedicine Research isn't relevant to the practice of Chinese medicine
Students Biomedical research paradigms cannot account for practitioner
intention
AOM Specific EIP Issues
Not based on biomedical model (physiology and pathology) Significant paradigm differences
Acupuncture RCTs – often not useful to clinical practice
Specific issues of the acupuncture RCTs Placebo control Fixed protocol bias Dosage
Pragmatic acupuncture trial is most clinically relevant
Infusion of EIP into AOM Programs
Strategy Train faculty first
NWHSU modules Doctoral upgrade program (3-credit FEIP course)
Faculty driven EIP curriculum development
Start clinic implementation early Outcome measures (MYMOP)
Entry-level Doctoral Degree 189 credits, 3495 hours, 11 trimesters
2 research courses Foundations of EIP (3 credits/45 hours, trimester 3) Clinical Research Design and Statistics (2 credits/30 hours, trimester 7)
Course Category Proportion with EIP content
Biomedicine 100%
Integrated biomed/TCM 100%
Acupuncture 55%
Herbal medicine 65%
Clinical courses & shifts 100%
Overall average 65%
Important takeaways… “Discipline that is 100s of years old (modern science) telling
a discipline that is 1000s of years old (Chinese medicine) how to practice” To what extent is evidence already being used? What are we really trying to promote?
Critical thinking What are the other ways that EIP benefits AOM clinicians?
Practice building $$ Need to assist faculty in incorporating EIP into their courses
Adult and active learning
