Abstract:

Background:
The application of qualitative Delphi techniques in educational and health-related research has been increasingly recognized and expanded. With their flexibility and proven effectiveness, Delphi approaches can unravel the “Gordian knot” of complex educational challenges by fostering convergence among diverse expert perspectives. One such challenge is the gap between the growing demand for complementary and alternative medicine (CAM) and its limited supply, mainly due to medical professionals’ reluctance and insufficient, unregulated CAM education.
The aim of this paper is to present the use of a specific approach - Dynamic Delphi (DD) - at the higher-education level. Conducted between February and May 2022, the DD sought to achieve understanding and consensus among pre-identified expert educators (EE) in medicine, pharmacy, and public health on integrating CAM into Bulgarian higher education. It represented the third phase of a broader academic project focused on introducing the concept of integrative medicine (IM) in Bulgaria. IM emerged globally as a movement to integrate CAM into modern healthcare, yet IM remains largely unfamiliar locally.

Methodology:
Due to COVID-19 restrictions, the classic multi-round Delphi was adapted into a single-round, semi-structured format with feedback. Three EE panels - national policy, institutional, and teaching - were formed, each relatively homogeneous by expertise while maintaining anonymity. Participants were invited according to defined selection criteria. Data were gathered online through DD-forms including informed consent, demographic, and thematic questionnaires.

Results and Discussion:
Twenty-one of twenty-four invited experts participated, contributing insights that informed CAM educational models. Consensus across panels supported including CAM in university curricula. Evidence-based CAM training was recommended mainly as an elective in undergraduate programs and as certified postgraduate courses in institutional settings. Experts highlighted the need for well-trained teachers and interdisciplinary teamwork in developing integrative CAM disciplines. Such collaboration is essential for building complex competences. They emphasized that teaching CAM within the IM framework enables constructive collaboration among conventional and CAM preventive and therapeutic methods. A key outcome of the DD was a refined, context-sensitive IM definition: “IM is a modern field of medicine aimed at improving physical, mental, emotional, and social health through balanced, person-cantered use of evidence-based conventional and CAM methods, together with preventive and health-promoting approaches. It views the human organism as an integrated unity of cells, organs, and systems in functional interaction.”

Conclusion:
In times of digital progress and social transformation, evolutionary reform in medical and pharmaceutical education is essential to prepare professionals capable of meeting patients’ and consumers’ needs. IM can harmonize conventional medicine with validated traditional practices not only in healthcare but also in higher education. While no universal IM educational model exists - since medical education reflects cultural and historical determinants - the presented DD design provides a replicable framework for similar contexts, promoting continuous dialogue among science, education, and holistic healthcare.

Keywords:

Dynamic Delphi, Integrative Medicine, Complementary and Alternative Medicine (CAM), Health Promotion, Higher Medical Education, Qualitative Research, Public Health, Curriculum Development, Bulgaria.