National Education Dialogue
Prepares for Integrated Healthcare Training
In June 2005, more than 70 healthcare educators gathered at Georgetown
University for a meeting that could change the course of U.S. healthcare.
Participants came from conventional medicine and a wide range of Complementary
and Alternative Medicine (CAM) disciplines such as chiropractic medicine,
acupuncture, and naturopathic medicine. Their goal: to create common
ground in shaping healthcare education and the next generation of healthcare
At present, most education for healthcare practitioners takes place in independent
silos. Each profession is trained in its own methods and philosophy, with perhaps
a brief overview course to survey other disciplines. While students are in
school, they don't have any opportunity to study or work alongside other disciplines.
Is it any surprise that they finish training without the skills needed to function
as part of an integrated team?
At "The National Education Dialogue to Advance Integrated Health Care:
Creating Common Ground," representatives of the licensed CAM disciplines
and educators from a broad cross-section of conventional medical institutions
met together for the first time to discuss issues in integrated healthcare
education. Their goal was to find ways of educating students who will be trained
to work collegially with other disciplines, each discipline contributing its
unique viewpoint and expertise.
IOM Committee Chair Praises NED Work
In January 2005, the Institute of Medicine (IOM) of the National Academies
released its landmark report on CAM usage, "Complementary and Alternative
Medicine in the United States." Citing widespread use of CAM, the report
calls for "comprehensive care that is safe and effective, care that
is collaborative and interdisciplinary, and care that respects and joins
effective interventions from all sources." Care should be based on continuous
healing relationships, the report said, customized to meet patient needs
and values, and marked by cooperation among clinicians, evidence-based decision
making, shared knowledge, and the free flow of information.
Stuart Bondurant, MD, chair of the committee that wrote the IOM report on
CAM, and executive dean of Georgetown University Medical Center, keynoted
calling education the major factor that will shape integrative medicine over
the next decade. "CAM use is widespread, and here to stay," he said. "Our
ultimate goal should be to create a healthcare delivery system that is comprehensive,
patient-centered, evidence-based and cost-effective. What you are doing here,
this great collaborative work, is one of the most important things anyone can
do to implement our report."
Face-to-Face Communication is Key
The National Education Dialogue (NED) is a project of the Education Task Force
of the Integrated Healthcare Policy Consortium. Work began in March 2004,
with a series of task forces addressing aspects of the project.
Participants in the June meeting included representatives of conventional academic
medical centers as well as licensed CAM disciplines such as chiropractic, acupuncture,
naturopathic medicine, massage therapy, and direct-entry midwifery. In addition,
diverse fields including nutrition, holistic nursing, social work, occupational
therapy, yoga. and homeopathy were represented.
Perhaps the most valuable aspect of the meeting was the continuous, informal
sharing of information and experience among people who have had few opportunities
to meet face-to-face. The chairman of the Association of Chiropractic Colleges,
Frank Zolli, DC, EdD, said, "This is the first time in thirty years I've
been in a room with so many medical doctors while the decibel level remained
relatively normal. I've realized that we're all in this together, despite our
differences. We all have to deal with the same issues as we provide care for
NED participants heard detailed reports about current collaborations between
CAM and conventional schools, with supportive materials to aid in applying
these examples in their own communities. For example, at the University of
Minnesota, all first-year medical students experience a half-day immersion
in traditional Chinese medicine. At the Southwest College of Naturopathic Medicine,
students work in community clinics alongside physicians, residents, and medical
students from the University of Arizona.
Most NED participants are committed to inter-institutional and multidisciplinary
work. "We realized that many of the participants are a few steps ahead
of their disciplines," comments NED director John Weeks. "In addition
to fostering new relationships and providing educators with tools for change,
NED must also engage in the more fundamental work of raising consciousness.
One of our planned 'next steps' will be a campaign to increase awareness throughout
the disciplines about the importance of all healthcare professions learning
to work better within integrated teams."
NED Report Summarizes Priorities and Looks to the Future
Now a 64-page NED Progress Report (March 2004 – September 2005) has been
published, allowing those who did not attend the meeting to share in its cutting-edge
thinking about current healthcare education and ways to improve that education.
Meeting participants developed several recommendations for the future education
of health professionals. They include the following:
- Facilitate development of inter-institutional
relationships and geographically based- groupings of conventional
and CAM institutions
and disciplines in diverse regions. Promote student and faculty
exchanges, create new clinical opportunities, facilitate integrated
and residency programs, and provide opportunities for students
to audit classes and share library privileges.
- Create resource modules
on teaching about distinct CAM, conventional
and emerging disciplines (approved by the disciplines), which
can be used in a variety of formats – from supporting materials
in such areas as definitions and glossaries, to full curricular
- Share educational and faculty resources and information
on inter-institutional relationships, including samples of existing
agreements and existing
educational resources, through development of a web site.
multi-disciplinary work to create a concise statement of core values,
which have resonance across the disciplines
and can guide
efforts to create quality integrated healthcare education.
develop and sponsor continuing education initiatives designed to
draw participants from diverse disciplines.
- Create collaboratively
developed educational resources to prepare students and practitioners
to practice in integrated
- Assist individuals with making institutional
changes by offering support for leadership in change creation.
for overcoming the challenges of prejudice, ignorance,
and cultural diversity.
- Develop an outline of skills
and attitudes appropriate for those involved in collaborative integrated
- Explore third-party clinical sites that serve
the underserved, such as community health centers, as
developing clinical education in integrated
During the coming year, NED plans to continue work towards these
goals. Its planning team has developed a two-year timeline, which will
carry the work through September 2007, and they are seeking project
support. While the planning team anticipates smaller meetings of ten
to 20 educators to work on specific projects during 2006, the earliest
date for a larger, second national NED meeting would be spring, 2007.
To contact NED director John Weeks: firstname.lastname@example.org
To download a
copy of the recently released NED progress report, go to www.ihpc.info
The Integrated Healthcare Policy Consortium, NED's parent organization,
works to identify important policy directions in healthcare, build
and provide a forum in which key stakeholders in integrated care can communicate
effectively. Currently IHPC has four task forces, working on issues such
as access and delivery, education and training, a federal office,
For more information, contact IHPC Executive Director Janet Kahn, PhD,
The recently released progress report, "The National
Education Dialogue to Advance Integrated Health Care: Creating Common Ground," offers
a wealth of useful information that will interest anyone who cares about
including the following:
- Data from Internet-based survey of 158 institutions
and programs on current inter-institutional relationships between
and conventional integrative medicine programs (Appendix 2)
of inter-institutional and interdisciplinary relationships explored
at the NED meeting (Appendix 3)
- Outline for educational resources
to be developed to enhance collaborative care (Appendix 5)
working document on core shared values (Appendix 7)
of eight CAM disciplines (Appendix 10)
Elaine Zablocki is the former editor of CHRF
News Files and Alternative
Medicine Business News.