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整合医学:一项运用体验式学习和概念转变教学方法的专业发展计划的实施与评估

Integrative medicine: implementation and evaluation of a professional development program using experiential learning and conceptual change teaching approaches.

作者信息

Hewson Mariana G, Copeland H Liesel, Mascha Edward, Arrigain Susana, Topol Eric, Fox Joan E B

机构信息

The Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

Patient Educ Couns. 2006 Jul;62(1):5-12. doi: 10.1016/j.pec.2006.03.005.

Abstract

OBJECTIVE

To meet the increasing patient interest in complementary and alternative medicine (CAM), conventional physicians need to understand CAM, be willing to talk with their patients about CAM, and be open to recommending selected patients to appropriate CAM modalities. We aimed to raise physicians' awareness of, and initiate attitudinal changes towards CAM in the context of integrative medical practice. We developed and implemented a professional development program involving experiential learning and conceptual change teaching approaches.

METHODS

A randomized controlled study with a pre-post design in a large academic medical center. The 8-hour intervention used experiential and conceptual change educational approaches. Forty-eight cardiologists were randomized to participant and control groups. A questionnaire measured physicians' conceptions of, and attitudes to CAM, the likelihood of changing practice patterns, and the factors most important in influencing such changes. The questionnaire included an embedded control question on a topic that was not the focus of this program. We administered the questionnaire before (pretest) and after (posttest) the intervention. We compared differences in pre- and post-intervention scores between the participant (N = 20) and control (N = 16) groups. We used both groups to identify factors that influenced their practice patterns. The study was NIH-funded and IRB-exempt.

RESULTS

Both groups initially had little knowledge about, and negative attitudes to CAM. The participant group had significant positive changes in their conceptions about, and attitudes to CAM after the program, and significant improvements when compared with the control group. Participant physicians significantly increased in their willingness to integrate CAM in their practices. Physicians (combined groups) rated research evidence as the most important factor influencing their willingness to integrate CAM. They requested more research evidence for CAM efficacy, and more information on non-conventional pharmacology. Participants reflected enthusiasm for the experiential program.

CONCLUSIONS

The participants were able to experience the positive effects of selected CAM modalities. It is possible to increase physician knowledge and change attitudes towards integrative medicine with an eight-hour intervention using experiential and conceptual change teaching approaches.

PRACTICE IMPLICATIONS

Professional development on integrative medicine can be offered to medical practitioners using experiential learning and conceptual change teaching approaches, with the help of local CAM practitioners.

摘要

目的

为满足患者对补充和替代医学(CAM)日益增长的兴趣,传统医生需要了解CAM,愿意与患者谈论CAM,并愿意将选定的患者推荐至合适的CAM治疗方式。我们旨在提高医生对整合医学实践背景下CAM的认识,并引发其态度转变。我们开发并实施了一个涉及体验式学习和概念转变教学方法的专业发展项目。

方法

在一家大型学术医疗中心进行一项采用前后测设计的随机对照研究。8小时的干预采用了体验式和概念转变教育方法。48位心脏病专家被随机分为参与组和对照组。一份问卷测量了医生对CAM的概念、态度、改变执业模式的可能性以及影响此类改变的最重要因素。问卷包含一个关于非本项目重点主题的嵌入式控制问题。我们在干预前(前测)和干预后(后测)发放问卷。我们比较了参与组(N = 20)和对照组(N = 16)干预前后得分的差异。我们利用两组来确定影响其执业模式的因素。该研究由美国国立卫生研究院资助且获机构审查委员会豁免。

结果

两组最初对CAM的了解都很少且态度消极。参与组在项目结束后对CAM的概念和态度有显著的积极变化,与对照组相比有显著改善。参与项目的医生将CAM整合到其实践中的意愿显著增强。医生(合并组)将研究证据评为影响其整合CAM意愿的最重要因素。他们要求提供更多关于CAM疗效的研究证据以及更多关于非传统药理学的信息。参与者对体验式项目表现出热情。

结论

参与者能够体验到选定的CAM治疗方式的积极效果。通过使用体验式和概念转变教学方法进行8小时的干预,有可能增加医生的知识并改变其对整合医学的态度。

实践意义

在当地CAM从业者的帮助下,可采用体验式学习和概念转变教学方法为医生提供整合医学方面的专业发展培训。

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