P03.12. Use of the electronic medical record to teach complementary and alternative medicine: what's the impact?

Purpose

Although some progress has been made in recent years, training in how to counsel patients effectively on complementary/alternative medicine (CAM) is not widely integrated into undergraduate medical education. Our purpose in this study was to evaluate the impact of a teaching intervention utilizing the electronic medical record (EMR) as a point-of-care learning tool on students’ attitudes and knowledge of CAM and on their self-reported competence in counseling patients on this subject.

Methods

Students are oriented to the EMR by the preceptor and provided with a one-hour didactic centered on CAM. This lecture orients students to available CAM modalities; discusses evidence-based medicine and CAM; surveys herbs and supplements with supporting evidence; and finishes with a case-study illustrating how CAM can be brought into a patient encounter, using CAM “smartphrases,” which are essentially premade templates readily accessible in the EMR. These smart-phrases provide a real-time reference for students during their patient encounters. Pre- and post- surveys consisting of nine questions using a likert scale examined changes in students’ attitudes about, and use of CAM. These surveys were given anonymously to our medical students. A group of similar medical students who did not rotate here were also given the same surveys, thus representing a control group.

Results

Among the 27 students in our intervention group, we saw an increase of 48% and 43% in the number of students who felt comfortable counseling patients on fish oil and probiotics, respectively. Among the 38 students in our control group, no significant differences were observed.

Conclusion

Results of this small sample pilot study suggest that CAM lectures plus EHR-based CAM assessments and tools can increase student comfort with counseling on probiotics and fish oil. The fact that this effect was not seen for acupressure and mind-body interventions suggests a different intervention may be needed.