Lie Désirée, Boker John
Department of Family Medicine and the CAM Education Task Force, College of Medicine, University of California, Irvine, USA.
BMC Med Educ. 2004 Jan 12;4:2. doi: 10.1186/1472-6920-4-2.
The need for Complementary and Alternative Medicine (CAM) and holistic approaches in allopathic medical school curricula has been well articulated. Despite increased CAM instruction, feasible and validated instruments for measuring learner outcomes in this content area do not widely exist. In addition, baseline attitudes or beliefs of medical students towards CAM, and the factors that may have formed them, including use of CAM itself, remain unreported.
A 10-item measure (CHBQ--CAM Health Belief Questionnaire) was constructed and administered to three successive classes of medical students simultaneously with the previously validated 29-item Integrative Medicine Attitude Questionnaire (IMAQ). Both measures were imbedded in a baseline needs assessment questionnaire. Demographic and other data were collected on students' use of CAM modalities and their awareness and use of primary CAM information resources. Analysis of CHBQ items was performed and its reliability and criterion-related validity were established.
Response rate was 96.5% (272 of 282 students studied). The shorter CHBQ compared favorably with the longer IMAQ in internal consistency reliability. Cronbach's coefficient alpha was 0.75 and 0.83 for the CHBQ and IMAQ respectively. Students showed positive attitudes/beliefs towards CAM and high levels of self-reported CAM use. The majority (73.5%) of students reported using at least one CAM modality, and 54% reported using at least two modalities. Eighty-one percent use the internet as a primary source of information for CAM.
The CHBQ is a practical, valid and reliable instrument for measuring medical student attitudes/beliefs and has potential utility for measuring the impact of CAM instruction. Medical students showed a high self-reported rate of CAM use and positive attitudes towards CAM. Short, didactic exposure to CAM instruction in the first year of medical school did not additionally impact these already positive attitudes. Unlike the IMAQ, which was intended for use with physicians, the CHBQ is generic in design and content and applicable to a variety of learner types. Evaluation measures must be appropriate for specific CAM instructional outcomes.
在对抗疗法医学院课程中，补充和替代医学（CAM）及整体方法的需求已得到充分阐明。尽管CAM教学有所增加，但在这一内容领域，用于衡量学习者成果的可行且经过验证的工具并不广泛存在。此外，医学生对CAM的基线态度或信念，以及可能形成这些态度或信念的因素，包括CAM自身的使用情况，仍未得到报道。
构建了一份包含10个条目的量表（CHBQ——CAM健康信念问卷），并与先前经过验证的包含29个条目的综合医学态度问卷（IMAQ）同时施测于连续三个班级的医学生。这两个量表都包含在一份基线需求评估问卷中。收集了学生使用CAM方式的人口统计学及其他数据，以及他们对主要CAM信息资源的知晓和使用情况。对CHBQ条目进行了分析，并确定其信度和效标关联效度。
回复率为96.5%（282名研究学生中的272名）。较短的CHBQ在内部一致性信度方面与较长的IMAQ相比表现良好。CHBQ和IMAQ的Cronbach's系数α分别为0.75和0.83。学生对CAM表现出积极的态度/信念，且自我报告的CAM使用率较高。大多数（73.5%）学生报告使用过至少一种CAM方式，54%报告使用过至少两种方式。81%的学生将互联网作为CAM信息的主要来源。
CHBQ是一种用于测量医学生态度/信念的实用、有效且可靠的工具，在测量CAM教学的影响方面具有潜在效用。医学生自我报告的CAM使用率较高，且对CAM持积极态度。医学院第一年对CAM教学进行简短的讲授式接触并未额外影响这些本已积极的态度。与旨在供医生使用的IMAQ不同，CHBQ在设计和内容上具有通用性，适用于多种学习者类型。评估措施必须适合特定的CAM教学成果。
