Abstract:

Public health research reports rising popularity of complementary and alternative medicine (CAM) and increasing prevalence of CAM use. Many patients utilise conventional and CAM approaches concurrently, a fact that demands comprehensive CAM-related knowledge on behalf of the healthcare practitioners. Worldwide, there are many productive efforts to include CAM in undergraduate and postgraduate medical curriculum despite the philosophical differences between the orthodox and CAM approaches.

Integrative medicine (IM) is the multidisciplinary territory that has the humanistic and pragmatic potential to mediate and to mix CAM with conventional therapies, health promotion and research. The idea of IM is powerful because it is cost-effective and supported by the patients’ organisations. However, the incorporation of IM into the curriculum is managed in miscellaneous ways by the different academic institutions. Hence, the introduction of IM in education has to pass through needs assessment and to be managed in the context of the national educational system.

The aim of this report is to present the preliminary results of a mixed-methods research study titled “IM - holistic conceptual model, scientific and educational approaches”. The project has received Ethical approval and the design has been presented during the EDULEARN21 conference.

Methods: Within the multistage research process were applied systematic search in PubMed and PAHO VHLibrary; purposeful content analysis of IM-definitions; conceptual modelling; a needs assessment sociological survey among medical and pharmacy students, general practitioners and pharmacists.
Preliminary results: Herewith are presented the results from the first two phases of this project. In Bulgaria, IM is officially accepted term but underinvestigated realm. Therefore, a conceptual model was designed for educational, research and policy reasons.

The model is sustained by three characteristics: process; structure; philosophy and values. It incorporates five building blocks: medical education which values holistic health; conventional medical ptactice; individualized CAM; evidence-based IM-research; health promotion and prevention. Three principles enable the model: coherence - building blocks synergy; heterogeneity - “integrative” means bringing together equal but different components; cost-efficiency and effectiveness.

The preliminary results from the questionnaire survey (May-Oct. 2021) prove high interest in CAM and IM. Out of 393 participants 208 are students and 185 professionals (114 family doctors). The attidutes vary from scepticism to enthusiasm. Although above 90 % (171/185) of the professionals and above 69% (144/208) of the students have already used CAM for cure and prevention, above 80% need more information regarding CAM methods. Both, professionals and students agree that there is a need to incorporate CAM as a part of IM in undergraduate and postgraduate education. However, they believe that CAM needs more research and should be taught evidence-based.

Conclusions: The next study steps will follow the objectives to develop a set of IM-competences and a model of a training program in IM. Increasingly, the academic accuracy imposes the use of the term “healthcare” as opposed to a more narrow focus on “medicine”. Integrative healthcare reflects the social needs and provides the whole continuum of care, cure and prevention. Higher educational programs need to consider these healthcare trends.

Keywords:

Integrative medicine and health, research project, health promotion, education, complementary and alternative medicine (CAM), Medical University of Varna.