Incorporating Research Instruction into Complementary and Alternative Medicine (CAM) Training Programs

Executive Summary

Figure 1: Break down of survey respondents

This study reveals the lack of instruction in complementary and alternative medicine training programs and the disconnect between what schools and instructors believe they are teaching and what students are learning. Though many survey respondents said that they were taught these skills, when probed further they didn’t know how to obtain literature or apply what they had learned. 93% of student respondents said that their schools did not have a librarian on staff, or they were unsure if they did.

This report lays out the feasibility of adding additional research skills instruction to the curricula in these programs. One option is the addition of a librarian for professional level instruction in this area. Other options include training staff on how to best introduce or increase these type skills and using short seminar type programs within a broader curriculum to teach students research skills.

Introduction

This feasibility report will examine what is currently being offered in trade schools that instruct Complimentary and Alternative Medicine (CAM) practitioners, and how more research instruction can be added to curricula, as well as the benefits and economic feasibility of adding research instruction.

CAM practitioners, also known as holistic health professionals, in the United States have a wide variety of different licensure and training requirements. Many are unlicensed and regulated. This causes a broad difference in the education they each receive. Because there is not one gold standard, communication between medical professionals can be difficult. Many practitioners are motivated to continue learning and reading about the latest research but are not given the tools to do so competently as a part of their training. Attitudes vary among CAM practitioners (Hadley et al, 2008).  Some are not even aware of the types of evidence-based information available to them or believe it doesn’t apply to their field of practice. Many believe that if all trade schools training CAM practitioners implemented curriculum in research skills this might lessen the gap between practitioners trained in different modalities and in different schools, helping aid communication as well as increasing breadth and depth of knowledge. If all CAM practitioners had more training in this area, I believe it would increase overall competence in CAM practitioners, resulting in increased clientele and respect among other medical fields helping to legitimize their practice.

Criteria Description

Literature was chosen in subjects and fields relevant to the topic. Styles of instruction in research skills was considered when making recommendations on adding more instruction to programs as well as the biases of each perspective.

An online survey was sent through the authors extended network, and respondents were gathered using the snowball method. Survey respondents have met the criteria of either having attended, taught at, or were owners/administrators of CAM trade schools. Or, they were librarians involved in teaching research skills in the areas of medicine, complementary and alternative health or biomedical sciences, with a preference for those who have created curricula in their fields.

Expert interviews of librarians and school administrators helped to inform decisions on how best to teach, the need for additional instruction and the desire of both schools and librarians to improve the student experience by adding more research skills instruction.

Method of Analysis

Current literature on the subject is difficult to find, however what is available as well as similar topics were explored. Disciplines that contributed literature to this subject include, library science, medical education and complementary and alternative medicine.

Perspectives of the research education field (librarians) as well as trade school instructors and administrators were conducted through one-on-one interviews with experts in each field. In addition, a broader survey was sent to students, teachers, administrators and librarians about their opinions on adding research training to CAM curriculum.

Total Survey Participants: 76

Criteria Evaluation Results

Expert Interviews

The first expert interview with Sadie Skeels, liaison librarian for veterinary medicine and biomedical sciences at Colorado State University, reveals that introduction of a new curriculum including research skills and evaluation can be a lot of work but is worth adding to a medical field curriculum. She said that librarians are often fighting to prove their value in higher education. Educators and administrators do not seem to understand the kind of services they offer to students. This diminished their perceived value. She believes that often librarians are confused with libraries, and though they complement one another they are not mutually exclusive. She emphasized the role librarians take in teaching research skills and offering support for research projects and searching for legitimate information.

Both school administrators contacted said that they believe in the importance of research instruction, and that their programs offer sufficient instruction in this area. Neither saw a benefit in professional librarian assistance either due to space, time and/or cost issues. However, they both indicated that they have sufficient libraries for student use, confirming the statement from Ms. Skeels about the confusion between libraries and librarians and the types of services librarians offer.

Literature review conclusions

After a comprehensive investigation into CAM training programs in the United States Burke et. al. concludes that, “Preparing tomorrow’s scholars and clinicians to contribute meaningfully to this emerging healthcare paradigm will require a plan that integrates all elements of higher education (Burke et.al., 2004.)” That includes the kind of research support and instruction typically provided in a university setting.

In a 2007 study, Hadley et al. determine that needs-based assessments should be undertaken by schools providing medical based education. Their findings indicate different levels of evidence-based competency among graduates of medical programs in the UK, but their conclusions can help us to determine an understanding of how students learn and could be a starting point for discovering the needs of CAM students. Competency in interpreting literature translated to competence in practice (Hadley, et al., 2007.)

Varga and Kakuk’s study into complementary and alternative medicine in the European union focuses on the growing field and how the EU has dealt with the shift in needs in CAM education. They believe that the EU set global standards by unifying the education requirements for CAM programs across countries. This is something that has yet to be done in the United States, but has greatly impacted the quality of education across the board for EU countries, and taking the proposed step in adding research education to U.S. CAM schools would help boost the standard of education in this country, getting us closer to the EU’s precedent. The steps the EU has taken to improve CAM instruction are important to understand and consider when attempting to improve education here in the U.S.

Survey results analysis

The majority of respondents were either students/former students in CAM programs (31.6%) or librarians who teach research methods to healthcare/medicine students (51.3%). This result gives us more insight into their perspectives than that of the decision makers in CAM education. It is my hope that the decision makers will take this information into consideration when making choices in curriculum design.

Approximately 39% of students did not feel that they received sufficient training in research skills or answered that they were unsure if their skills were sufficient, and only 13% said they are not interested in learning more research skills. This indicates a strong desire by students to increase research skills instruction and feelings of competency.

Librarians made up the largest number of respondents as mentioned above. Qualification for the survey was dependent on whether they helped to teach and create instruction curriculum in the health sciences in order to obtain the most useful opinions. An overwhelming majority believed that research skills were important in CAM curriculum, and 52.9% said they would be willing to help CAM programs incorporate research instruction with a further 41% answering with a maybe. A further 55% of librarians said they would be willing to work for a CAM school.

All of the instructors that participated said that they believed that research skills are important for student success, and that they themselves read current research in their fields. They also all stated that they teach research skills in their own classes, but that they would be willing to add additional instruction in this area with some desire for more guidance in doing so.

The most interesting results of this survey came from CAM school owners and administrators. This was the category of respondents that was most reluctant to participate and had the fewest respondents. Those that did respond all believed that their schools sufficiently taught research skills, though none of them employed professional librarians. These beliefs are contradicted by the student’s responses concerning adequate research skills instruction and abilities. It is important to note that many of the student respondents did attend schools whose administrators responded.

Survey results (Students)

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Survey results (Librarians)

Figure 5

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Survey results (CAM Instructors)

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Survey results (CAM school administrators and owners)

Figure 9

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Figure 11

Conclusion/Recommendations

Overall, findings indicate that it would be beneficial to both students and schools to incorporate increased levels of research skills instruction into complimentary and alternative medicine trade school programs of all types. Instructors and librarians are willing to assist in making this change, and students desire more instruction in this area. It is the opinion of the author that the best way to do so would be to hire either a consulting librarian with experience in creating such curriculum or to consider adding a librarian to the permanent staff of the school. Though these options can be cost prohibitive for many smaller schools, an alternative would be to offer either short seminars in research instruction or training current staff to better teach these skills. Most librarians at other higher education institutions are willing to do guest lectures or consult with schools on how best to add research instruction to the curriculum, often times these services are free of charge.  Many also offer free online instruction videos through their universities that could be easily utilized.
Bibliography:

Expert Interviews:

Sadie Skeels- Liaison Librarian Veterinary Medicine and Biomedical Sciences, Colorado State University

Laura Cascardi- Founder and Director, Equinox Center for Herbal Studies

Literature review:

Burke, A., Peper, E., Burrows, K., & Kline, B. (2004). Developing the Complementary and Alternative Medicine Education Infrastructure: Baccalaureate Programs in the United States. The Journal of Alternative and Complementary Medicine, 10(6), 1115–1121. https://doi.org/10.1089/acm.2004.10.1115

Hadley, J. A., Wall, D., & Khan, K. S. (2007). Learning needs analysis to guide teaching evidence-based medicine: Knowledge and beliefs amongst trainees from various specialities. BMC Medical Education, 7, 11. https://doi.org/10.1186/1472-6920-7-11

Hadley, J., Hassan, I., & Khan, K. S. (2008). Knowledge and beliefs concerning evidence-based practice amongst complementary and alternative medicine health care practitioners and allied health care professionals: A questionnaire survey. BMC Complementary and Alternative Medicine, 8(1), 45. https://doi.org/10.1186/1472-6882-8-45

Varga, O., & Kakuk, P. (2006). European Union and Alternative Medicine: Some Institutional and Legal Impacts on a Developing Field. Integrative Medicine Insights, 1, 117863370600100. https://doi.org/10.1177/117863370600100003

Appendix

Survey questions 

Section 1 of 5

What is your role in complementary and alternative medicine (CAM)? Please choose the best fit.

Section 2 of 5

Students

Where did you attend school?

Do you feel like your training effectively helped you learn to find and understand the current research in your area of complementary and alternative medicine?

Would you have liked to learn more about researching, research methods and how to find and interpret research in your field during your training?

Are you familiar with the term “Evidence Based Medicine?”

Do you ever read trade publications in your area of practice or study?

Does current research in your field effect how you practice?

Have you ever published or considered publishing in peer reviewed publications in your field?

Would you be interested in taking a class on how to find, interpret, and publish research in your field?

Does your school have a professional librarian?

Section 3 of 5

CAM instructors

Do you teach research skills in classes you teach?

As an instructor, do you feel that research skills are important to your students success?

Would you be willing to incorporate more research based instruction into your current curriculum?

As an instructor do you read current research in your area of expertise?

Section 4 of 5

CAM school administrators

Does your program provide instruction in how to find and understand current research in the student’s field of study?

What is the size of your program(s)?

Does your school employ a librarian?

Do you believe that it is important for students/practitioners to stay on top of current research in their field of study?

If you don’t currently have any research instruction in your program, would you be interested in adding it to the curriculum?

Section 5 of 5

Librarians

Do you instruct students in research skills in medicine, healthcare, alternative and complementary medicine or biomedical sciences?

Do you think research skills are important for students of complementary and alternative medicine?

Would you be willing to help a complementary and alternative medicine program build research skills into their curriculum?

Would you ever be willing to work for a complementary and alternative medicine school?

Do you believe that conventional medicine and complementary and alternative medicine research skills are similar?

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