Armaity Vaghaiwalla Austin , MD MPH FAAFPAssociate Clinical Professor

Department of Family MedicineUSC Keck School of Medicine

Integrative MedicineMEDICAL SCHOOL CURRICULUMUSC KECK SCHOOL OF MEDICINE

Armaity Vaghaiwalla Austin , MD MPH FAAFPavaustin@usc.edu

KECK SCHOOL OF MEDICINE, USC

Contact Email

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