Abstract:

Integrative medicine (IM) is holistic by nature and interdisciplinary by content. IM is a new field in medical education, which unites on a scientific basis ideas and practices of western conventional medicine (WCM), complementary and alternative medicine (CAM), and health promotion (HP). Although IM is more than just the sum of WCM, HP and CAM, most research in the field of IM focuses on the integration of CAM both into the main healthcare system and into the medical education. The social debate is about how much, which CAM-methods and when CAM should be included in the medical and pharmaceutical trainings.

Every third citizen in the European Union, part of which is Bulgaria, is using CAM and the healthcare professionals have to meet these growing needs gaining adequate knowledge and competences. The aim of the study is twofold. First, to assess needs for CAM education as a part of IM by evaluating and comparing the current knowledge, attitudes, behaviours and interests of medical and pharmacy students, general physicians and pharmacists. Secondly, to develop an expert understanding as a prerequisite for future national consensus on the place of IM in the undergraduate curriculum and in the postgraduate specialisations in Bulgaria. The accepted CAM-frame is based on earlier research experiences.

Design and methods: The presented research is a part of a larger post-doctoral project on the concept of IM, which applies integrative exploratory sequential mixed-methods design. Herewith is outlined the part of the research protocol that involves quantitative (four questionnaires) and qualitative (Delphi technique) methods.

Four versions of a questionnaire have been developed for the four target groups: medical and pharmacy students, general physicians and pharmacists. The core of the questionnaire consists of five parts:
1) Awareness of CAM methods;
2) Attitudes and behaviors related to CAM;
3) Interests and training needs regarding CAM;
4) Awareness of IM concept;
5) Sociodemographic data of the participant.

Specifically, the questionnaire’s differences are in the context of medical and pharmaceutical care. Around 150 participants for every target group are expected to fill in the questionnaire.

The respondents will be invited to participate through the following communication channels: the web-based group platforms of the medical and pharmacy students at Medical University of Varna, Bulgaria and the Blackboard university platform. The Association of Medical Students in Bulgaria will host the specific questionnaire at their website. The Regional Pharmaceutical Chamber in Varna will host the questionnaire for the pharmacists. Paper version of the questionnaire will be distributed among the general physicians in order to reach higher respondents’ rate.

The statistical analysis will be performed with IBM SPSS Statistics v.25 (bivariate correlation, cross-tabulation). The results obtained will be considered as statistically significant if the p-value is <0.05.

The project will start after an Ethical approval according the rules of Medical University of Varna.

Conclusion:
IM could provide solutions for the growing healthcare expenditures and the rising needs of individualised and holistic care. Definitely, the development of training programmes in IM have to be preceded by needs assessment and scientifically-based content balancing between WCM, HP and CAM. IM could be a reasonable, diplomatic and sustainable health and wellbeing strategy.

Keywords:

Integrative medicine, academic research project, health promotion, education, complementary and alternative medicine (CAM), Bulgaria.