Complementary and Alternative Medicine Education: Students' Perspectives

American Journal of Pharmaceutical Education, 2003 by Dutta, Arjun P, Miederhoff, Patrick A, Pyles, Michael A

Objectives. The objective of this study was to determine the attitudes and beliefs of pharmacy students that prompt them to take an elective course in complementary and alternative medicine (CAM) while in pharmacy school.

Methods. A questionnaire was administered to 90 third-year pharmacy students, 55% of whom were taking the elective course. The questionnaire was designed to assess student attitudes towards CAM in 5 areas: future concerns for professional competence, personal interest, personal experience, beliefs, and philosophical congruence. Students taking the elective course were compared with students not taking the course for the 5 areas.

Results. The 2 student groups differed in their personal interests and beliefs.

Conclusions. Belief system and personal interest were found to be significant motivating factors for selecting an elective in CAM among the pharmacy students surveyed.

Keywords: alternative medicine education, motivation, student knowledge, cultural belief

INTRODUCTION

Alternative medicine or therapies are not widely taught in medical schools in the United States (US) or available at US hospitals/health care facilities.1 Complementary and alternative medicine (CAM) includes but is not limited to homeopathic medicine, chiropractic medicine, Chinese medicine, the prescribing of megavitamins, magnetic therapy, Ayurveda, aromatherapy, naturopathy, and African medicine. Over the past decade, the use of alternative medical practices and treatments has dramatically increased in the US.2 Patients are willing to spend out-of-pocket dollars for CAM therapies, and in recent years, the amount spent on CAM therapies rivals that spent on primary physician services.2 To keep up with the demand for CAM information, in 1992 the US Congress established the Office of Alternative Medicine (OAM), currently named National Center for Complementary and Alternative Medicine (NCCAM), to study unconventional medical practices.3 A possible reason for this shift from conventional to unconventional medicine is the perspective that Western medicine lacks "caring for the whole patient."4 Others have attributed the widespread use of CAM by consumers to their value systems, beliefs, and philosophical orientations towards life in general, rather than to dissatisfaction with conventional medicine.5

In an attempt to meet the overwhelming demand for information and education about alternative therapies, US medical schools have increased the number of CAM courses offered.6'7 This overwhelming increase in the demand for CAM therapies also adds a new dimension to the traditional role of a pharmacist. It is important for pharmacists to be aware of patients' use of CAM therapies. Many patients do not routinely tell their physicians about alternative medicine use nor do physicians routinely ask about it.8 This makes the pharmacist's involvement in CAM use by consumers even more critical. In a solicited report to the American Board of Internal Medicine, Dr. Eisenberg of the Harvard Medical School, mentioned the need to include pharmacists in the medical decision-making process for nutraceuticals that are either prescribed or recommended to patients.9 To keep abreast of information in this burgeoning field, the American Pharmaceutical Association is encouraging pharmacists to advance their knowledge in CAM through continuing education and even provides support for such education.10 In an effort to integrate CAM education early in pharmacy school, Kouzi calls for developing a curriculum that incorporates CAM as an integral part of the pharmacy curriculum.11

The need to integrate alternative medicine in pharmacy curricula has also been acknowledged by schools of pharmacy. A survey of pharmacy schools by Rowell and colleagues found that 72% of the schools offered coursework in some area of CAM.12 In keeping with its role of training pharmacy students with up-to-date skills, the School of Pharmacy at Virginia Commonwealth University (VCU) began offering an elective course in CAM in the spring of 1997. The pharmacy curriculum at VCU requires that pharmacy students in their third year of study take elective courses as a part of their didactic coursework. Fifty of the 90 students (in their third year of the curriculum at VCU) enrolled in an elective course in alternative medicine. The remaining 40 students enrolled in other (approved) electives of their choice within the university.

This raised an important question: What motivates pharmacy students to take an elective in CAM? We believe that it is very important to understand, from the students' perspective, the direction in which the profession of pharmacy is or should be headed with respect to CAM. Additionally, since some students selected this elective course in alternative medicine as opposed to one of the other electives, this allowed us to draw some comparisons between 2 groups of pharmacy students (those taking the elective course versus those who did not) in terms of their attitudes and professional beliefs regarding alternative therapies.