Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act - a nationwide survey of German Medical Universities

Exploring Medical Students' Knowledge and Perceptions of Physical Medicine and Rehabilitation Specialty in Qassim University

Objectives: Physical Medicine and Rehabilitation (PM&R) is a medical branch that aims to manage, prevent, and diagnose people who are disabled due to disease, disorder, or injury. The purpose of this study is to explore the level of awareness and scope of the PM&R specialty among medical students. Methods: A cross-sectional study was carried out at Qassim University, Saudi Arabia, with 287 medical students. Cochran's method was used to establish the sample size of 287 medical students with a 5% margin of error and a 95% confidence level. An online survey was conducted among undergraduate students at Qassim University's Medical College. SPSS was utilized to study the characteristics of the population demographics. An independent t-test was used to calculate the significant values of each questionnaire. A significant value of <0.05 was considered as a significant value. Results: Among 287 medical students, 38.5% of students agreed to PM&R course inclusion in the undergraduate curriculum. 78.8% of students agreed with no specialization in PM&R, and 60.8% agreed that the lack of PM&R in Saudi area hospitals contributed to less recognition. Overall, medical students had low to moderate knowledge of PM&R. Conclusion: The study presents the need to train medical students in PM&R during their medical studies, develop more recognition, and integrate musculoskeletal and physical checkup skills among medical students. Moreover, it should have a practical implication across the nation so that more medical students develop knowledge and skills.

Naturopathy, complementary and integrative medicine in medical education - position paper by the GMA Committee Integrative Medicine and Perspective Pluralism

Background

A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process.

Objective

The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training.

Method

The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine.

Results

First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice.

Conclusion

Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies.

Evaluation of physical medicine and rehabilitation course for undergraduate medical students: A mixed-methods study

BACKGROUND

The objective was to evaluate an innovative physical medicine and rehabilitation (PMR) course for undergraduate students of Tehran University of Medical Sciences and their attitude and knowledge change following course participation.

MATERIALS AND METHODS

Ninety-one medical students filled the knowledge, attitude, and satisfaction forms pre- and postintervention. Nineteen medical students, two faculty physiatrists, two residents, two physical therapists, and two occupational therapists participated in the focus groups.

RESULTS

We found significant attitude improvements. They declared the usefulness of PMR course for undergraduate. Moreover, they agreed that physiatrists could be first choice for refer of musculoskeletal patients and they preferred PMR as future career after course experience. Also, they preferred to refer musculoskeletal patients including carpal tunnel syndrome, frozen shoulder, nonspecific low back pain after course participation. We found a good relationship between attitude and practice scores (r = 0.543, P = 0.000); in fact, students' attitude would strongly predict their practice through a model involving age, satisfaction, and exam scores (R ² = 0.356, B = 0.35 [0.06], and P = 0.000).

CONCLUSION

We found that internship training course might be an effective method of teaching PMR. Improving attitude toward the field of PMR and patient referral practice, career choice and disability perceptions of undergraduates is concluded in this study. Investigation of the advantages of such courses in larger studies with longer follow-up time-points is highly recommend.

Findings from a three-round Delphi study: essential topics for interprofessional training on complementary and integrative medicine

Background

Integrating complementary medicine into medical care promotes patient-oriented care. A well-informed and collaborative professional healthcare team is essential for effective and patient-safe implementation of these methods. At present, the skills for patient counseling, therapy and care regarding complementary medicine vary among the professional groups involved. Professionals generally feel that they are not sufficiently qualified in this area. Curricular concepts for Complementary and Integrative Medicine (CIM) are virtually non-existent in undergraduate interprofessional training. The aim of this study is to initiate a consensus-building process between various experts (professionals, students, patient and faculty representatives) in order to identify which topics should be the focus of such a curriculum.

Methods

A three-round Delphi study was carried out from March 2018 to March 2019 to compile the experience and knowledge of experts in the field of integrative patient care and interprofessional education. Sixty-five experts from Germany and German-speaking Switzerland with various professional backgrounds and experiences were asked to name general content, therapy methods and treatment reasons which should be addressed in interprofessional seminars. In the subsequent rounds these were rated on a seven-point Likert scale. The ratings were assigned to relevance groups and discussed in a final workshop in July 2019.

Results

The response rates for the three rounds were 76% (n = 50), 80% (n = 40) 90% (n = 36); and 21% (n = 11) for the final workshop. The experts suggested that topics could be aligned along the most common treatment reasons such as insomnia, generalized pain, fatigue and back pain. However, it is important that students also receive an overview of the evidence base for different therapeutic concepts, especially in the field of classical natural medicine, acupuncture and mind-body medicine, and that they get an overview of the effects and interactions of frequently used procedures.

Conclusion

Consensus was reached among the various experts on the most important topics for an interprofessional CIM curriculum. The systematic evaluation of the topics in this study can help to create a curriculum that achieves a high level of acceptance among teachers, lecturers and students, and thus facilitates implementation at universities and medical faculties.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-020-03140-x.

Evaluation of pioneering introduction of integrative and prophetic medicine education in an Arabic medical school (Taibah University, Saudi Arabia): 10 years' experience

Objective

To assess physicians' attitudes toward integrative medicine (IM), including prophetic medicine (PM), combining the best of modern medicine with the best of alternative and complementary medicine. Most physicians are unfamiliar with IM and PM and may thus be against them and it may communicate that to the public.

Methods

Taibah University (Saudi Arabia) is the sole university in the Arab world with an educational medical course in IM and PM. We assessed IM scientific knowledge and students’ feedback regarding course contents, course design, and teaching methods. A questionnaire was administered to medical students who attended the course.

Results

A total 650 students (264 men, 386 women) participated in the study; 83% considered the IM (including PM) education beneficial. Among them, 49.6% (range, 60% to 100%) reported that they gained medical benefit from studying IM, and 74% expressed strong positive attitudes toward studying IM. Among participants, 65.8% agreed with the current course topics, without the need to add or delete any topics; 95% of students were satisfied with IM and PM education. Students' interest in the branches of IM included all IM subspecialties.

Conclusion

IM and PM education should be globally generalized to all medical students, physicians, and health practitioners, particularly in Arabic universities.

Komplementäre und Integrative Medizin in der Facharztweiterbildung Allgemeinmedizin: Ergebnisse einer Bedarfserhebung bei Ärzten in Weiterbildung

Hintergrund: Inhalte aus den Bereichen der klassischen Naturheilverfahren und Komplementärmedizin sind im Rahmen der ärztlichen Approbationsordnung curricular verankert. Im Gegensatz dazu werden in den Weiterbildungsordnungen zum Facharzt für Allgemeinmedizin keine komplementärmedizinischen Inhalte abgebildet. Bisher ist nicht bekannt, ob Ärzte in Weiterbildung (ÄiW) zum Facharzt für Allgemeinmedizin innerhalb ihrer Weiterbildung mit komplementärmedizinischen Verfahren in Kontakt kommen und ob sie solche erlernen bzw. erlernen möchten. Das Ziel der vorliegenden Studie war die Erhebung der Einstellung zum und des Weiterbildungsbedarfs im Bereich Komplementärmedizin bei ÄiW zum Facharzt für Allgemeinmedizin. Methoden: In Rahmen einer Querschnittsstudie erfolgte eine Fragebogen-gestützte Umfrage unter ÄiW zum Facharzt für Allgemeinmedizin innerhalb des Weiterbildungsprogramms «Verbundweiterbildungplus Baden-Württemberg». Diese wurde onlinebasiert initiiert und durch eine papierbasierte Umfrage komplettiert. Ergebnisse: Insgesamt nahmen 138 Teilnehmer der Verbundweiterbildungplus Baden-Württemberg an der Umfrage teil. Der Gesamtrücklauf betrug damit 28%. Dabei zeigte sich, dass die Teilnehmenden ein hohes Interesse an Komplementärmedizin hatten. Gleichzeitig gaben sie an, Unsicherheiten sowohl inhaltlicher als auch formaler Art wahrzunehmen (z.B. Evidenz der einzelnen Methoden und Kostenübernahme durch gesetzliche Krankenkassen). Die große Mehrheit der befragten Ärzte befürwortete, dass in der Weiterbildung zum Facharzt Allgemeinmedizin Kompetenzen aus dem Bereich Komplementärmedizin vermittelt werden. Schlussfolgerungen: Vor dem Hintergrund der weiten Verbreitung komplementärmedizinischer Methoden im hausärztlichen Alltag muss diskutiert werden, ob im Rahmen der Weiterbildung zum Facharzt für Allgemeinmedizin Basiskompetenzen für diesen Bereich definiert werden sollten. Diese könnten beispielsweise in das «Kompetenzbasierte Curriculum Allgemeinmedizin» der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM) einfließen.