The CAM Research Education Partnership Project

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The CAM Research Education Partnership Project

• Bridging Research
• and
• Clinical Practice

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Outline

• NIH NCCAM Education Grant Program
• Dr. Kreitzer
• NWHSU CAM Research Education Partnership Project
• Dr. Evans
• Importance of CAM Research Education Project to
  NWHSU
• Dr. Devries
• BREAK
• Implementation of CAM Research Education Project

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NIH NCCAM Education Grant ProgramFocus and
Lessons Learned

• Mary Jo Kreitzer PhD, RN, FAAN
• Director and Professor
• Center for Spirituality and Healing
• University of Minnesota

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NIH CAM Education Grants History and Lessons
Learned

• Goal Incorporate CAM information into the
  curriculum of health professional schools.
• 15 grants were awarded to medical and nursing
  schools and to the American Student Medical
  Association between 2000-2007. Most of the
  grants were awarded for 5 years.

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General Strategy

• Identify competencies.
• Develop curricula didactic, experiential, and
  on-line
• Integrate content into required curricula.
• Evaluate student achievement.

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Opportunity to Collaborate with CAM Institutions

• University of Minnesota/NWHSU
• Tufts/New England School of Acupuncture
• University of WA/Bastyr University
• Oregon Health and Sciences University/Western
  States Chiropractic, Oregon College of Oriental
  Medicine, and National College of Natural
  Medicine.

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University of Minnesota

• Focus Medicine, Nursing and Pharmacy
• Graduate and undergraduate education
• Didactic, on-line and experiential learning
• Discipline specific and interdisciplinary

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On-line Learning

• 35 hours of on-line education
• Curricular Resources
• Used as required and supplemental material
• Faculty development

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Open Access
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Collaboration with NWHSU

• Medical Students
• TCM
• Manual Healing

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Collaboration with NWHSU

• On-line Modules
• TCM Chris Hafner
• Massage Beth Burgan and Dale Healey
• Chiropractic Larry Kuusisto

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Collaborative Efforts with NWHSU Continue to
Expand

• NIH funded clinical research fellowship program
• Pillsbury Integrated Health Clinic
• Current NIH Education Grant CAM Research
  Education Partnership

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Lessons Learned from R25 Grants

• Integration of content needs to be throughout the
  curriculum and not limited to a particular
  course.
• Faculty Development is key. Faculty need access
  to reliable and effective resources.
• Leadership at all levels student, faculty and
  administration.

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Lessons Learned from R25 Grants

• Most visible and impactful outcome
• Culture Change

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NCCAM CAM Practitioner Research Education Project
Grant Partnership

• Established in 2004 to increase the research
  content in CAM practitioner training in
  accredited schools that offer doctoral degrees in
  a CAM practice.
• Required partnership with a research intensive
  university.

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1st Round of Grant Awards

• Western States Chiropractic College
• Oregon College of Oriental Medicine
• Bastyr University
• AT Still University of Health Sciences
• National University of Health Sciences

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NWHSU 2nd Group of Grants Awarded !!
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National University of Health Sciences

• Chiropractic, Naturopathic and Oriental Medicine
  students
• Curriculum spans 5 trimesters
• Faculty Development workshops, lunch-n-learn
  lectures, on-line journal club and Best of a
  Topic web pages.
• Student mentored research and faculty mentored
  research sabbatical program

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Western States Chiropractic

• Curriculum is woven into multiple courses that
  span the entire 4 years of training.
• Variety of teaching methods didactic, small
  group, on-line.
• Clinic-based strategy patient-based clinical
  questions.
• Faculty Development 20 hour EBP course and
  module on information literacy.

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Oregon College of Oriental Medicine

• Focus building a research culture at OCOM.
• Required course Experience and Evidence in
  Oriental Medicine, two additional research
  courses, and content woven into additional
  courses.
• Faculty Development Research Scholars Program
  receive research training and mentoring support
  as they develop research related learning
  activities for the courses they teach.

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Bastyr University

• Faculty Development Program
• Bastyr Faculty completing a basic clinical
  research certificate program at Univ. of WA
  School of Public Health.
• ND faculty shadow FP faculty to observe how EBM
  is taught.
• FP faculty shadow ND faculty and assist in
  teaching EBM.

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AT Still University

• Faculty Development Program
• Workshops for basic science and clinical faculty
  (who view EBM very differently).
• Partner institution Penn State-Hershey.

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Lessons Learned

• Focus culture change in their institutions and
  professions.
• Faculty development is the most important
  component of their grant effort.

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NWHSUs CAM Research Education Partnership
Project

• Dr. Roni Evans
• Wolfe-Harris Center for Clinical Studies,
• Northwestern Health Sciences University

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Background Timeline
Winter
NCCAM call for proposals
Project Implementation
Spring
NCCAM Review
Proposal Preparation
NCCAM Review
NWHSU Upper Admin
Stakeholder Surveys
Faculty Surveys
Summer
Not Approved
Funding Approved
NWHSU Cabinet
DC Curriculum Committee
Revision
Fall
Project Start Up
Proposal Submitted
Proposal Re-submitted
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Project Overview

• 4 years
• Funded by the National Center for Complementary
  and Alternative Medicine (NCCAM)
• 800,000
• Long Term Objective
• To facilitate Evidence Informed Practice among
  complementary and alternative medicine (CAM)
  practitioners

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Evidence Informed Practice (EIP)
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The Evidence House
Health Services Research
Systematic Reviews
Randomized Controlled Trials
Epidemiology, Observational Research
Laboratory (Physiologic Studies)
Qualitative Studies Case Reports
Jonas WB. The evidence house how to build an
inclusive base for complementary medicine. West
J Med 200117579-80
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Evidence Informed Practice Skills
Clinical Presentation
Skills History, Examination, Clinical
Interpretation
Clinical Expertise
Patient Preferences
Research Evidence
Skills Communication, assessment tools
Skills Efficiently, find, evaluate, Interpret,
apply and communicate
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Project Goals

• To provide students, faculty and practitioners
  with the resources necessary to efficiently and
  effectively achieve evidence informed practice
  (EIP).
• Establish an EIP focused student research
  curriculum
• Establish an EIP focused faculty development
  program
• Establish an EIP focused post-graduate program
• Offer EIP practical experiences
• Employ systematic evaluation
• .for chiropractic, acupuncture/TCM, and
  massage

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Approach

• Collaborative effort research, 3 academic
  programs, U of M
• Each goal addressed by a team responsible to the
  Project Core Team and Advisory Committee
• Focus on learning strategies that are clinically
  relevant, learner centered, interactive and
  promote faculty mentorship
• ADDIE instructional development model1
  Analysis, Design, Development, Implementation and
  Evaluation
• Emphasis on research as a resource, one piece
  of the clinical puzzle
• Providing students, faculty and practitioners
  with the resources needed to use research

1 Dick W, Carey L, Carey J. The Systematic Design
of Instruction. 6th ed. Boston, MA Allyn and
Bacon, 2005.
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Staged Implementation
Introduce EIP to Field Practitioners
Integrate EIP In Clinical Settings

• Analyze needs, competency requirements, map
  curricula
• Design, develop Foundational EIP Courses for each
  program
• Train faculty
• Implement Foundational EIP Courses
• Identify other courses for EIP integration
• Evaluate new courses, project progress

• Analyze needs
• Design, develop, implement post-graduate courses
• Provide resources to field practitoners
• Provide practical training experiences
• Evaluate

Integrate EIP Throughout Curricula

• Analyze needs, interests
• Design, develop, implement instructional units
  for clinic courses
• Provide mentorship, resources to clinic faculty
• Provide practical training experiences
• Evaluate

Build EIP Foundation

• Analyze needs and interests
• Design, develop, implement instructional units
  for other courses
• Implement training and mentorship for
  non-research faculty
• Evaluate

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Why is the CAM Research Education Partnership
Project Important to NWHSU?

• Dr. Renee Devries
• Northwestern Health Sciences University

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Invitation to Participate in Data Collection for
Educational Purposes

• You are invited to participate in a group survey
  regarding common evidence-informed practice (EIP)
  related competencies. This information will be
  used to develop the student research curriculum
  at NWHSU.
• Data will be made available to the CAM Project
  investigators in summary fashion only and you
  will not be able to be identified based on your
  responses. Your participation is voluntary your
  decision will not affect your current or future
  relations with NWHSU.
• If you have questions or concerns, please contact
  Dr. Roni Evans at revans_at_nwhealth.edu.
• By choosing to participate in this data
  collection activity, you are acknowledging
  consent to the above conditions.

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Implementation of the CAM Research Education
Partnership Project
Dr. Roni Evans Wolfe-Harris Center for Clinical
Studies, Northwestern Health Sciences University
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Project Implementation

• Current Focus
• Organizational Structure
• Next Steps
• Timelines
• Faculty Involvement

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Current Focus

• Establish a EIP focused student research
  curriculum
• Establish a EIP focused faculty development
  program
• Establish a EIP focused post-graduate program
• Offer EIP practical experiences
• Employ systematic evaluation

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Organizational Structure
Advisory Committee
Core Team
Team 1 Student Curriculum
Team 2 Faculty Development
Team 3 Post- Graduate
Team 4 Research Experiences
Team 5 Evaluation
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Core Team

• Roni Evans, Principal Investigator, NWHSU
• Mary Jo Kreitzer, Principal Investigator, U of M
• Lori Baldwin, Project Coordintaor
• Louise Delagran, Education Specialist, U of M
• Michele Maiers, Co-Investigator, NWHSU

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Advisory Committee

• Julia Bartlett, Assoc Dean, Chir
• Roni Evans, Dean of Research
• Dale Healey, Dean, Massage
• Mary Jo Kreitzer, U of M
• Mark McKenzie, Dean, MCAOM
• Chuck Sawyer, Provost
• Noni Threinen, Assoc VP Inst Effect
• Consultants
• Gert Bronfort, NWHSU
• Mitch Haas, Western States
• Allen Shaughnessy, Tufts
• David Slawson, U of V

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Team 1 Student Research Curriculum
EIP Foundational Course Instructors

• Michele Maiers
• Co-chair
• Louise Delagran
• Co-chair
• Educational Specialist
• Julia Bartlett, Assoc Dean, Chiropractic
• Renee Devries, DC, DACBR
• Faculty Development Team Representative

• Michele Maiers, DC, MPH
• Lead Instructor
• Research
• Lori Baldwin, MoM, Lic Acc
• ACC/TCM
• Barry Taylor
• Chiropractic
• Kristine Westrom, MD
• Research/Medicine
• TBN
• (Massage)

TBN Faculty Consultants
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Application of ADDIE ModelGoal 1 Student
Curriculum

• DESIGN
• Draft broad EIP competencies
• Map broad EIP competencies to institutional and
  accreditation competencies and learning
  objectives
• Submit to Advisory Committee for approval
• Revise EIP competencies as necessary

• DEVELOP
• From broad competencies, define learning
  objectives for the EIP student research
  curriculum
• Identify Foundational EIP Course learning
  objectives modify as necessary for each academic
  program
• Match learning objectives to instructional
  strategy and delivery methods customize for each
  academic program
• Estimate credit hours, including on-line
• Submit plan to Advisory Committee for approvals
• Revise as necessary
• Develop Foundational EIP Courses
• Create curriculum blueprints for each program to
  identify appropriate courses for EIP integration,
  work with Team 2 (faculty development) to seek
  interested faculty

• ANALYZE
• Assess stakeholders perspectives
• Importance, skill level
• Program goals
• Barriers
• Perspectives What does the EIP CAM provider
  look like?
• Review research-related competencies and
  learning objectives
• Current NWHSU, program and institution wide
• Other institutions
• Accreditation requirements

• IMPLEMENT
• Provide training in how to teach EIP to
  Foundational EIP course faculty
• Coordinate timing, course load of EIP
  Foundational courses with academic programs
• Pilot test new on-line strategies
• Implement Foundational EIP courses in each
  academic program

• EVALUATE
• Identify/develop evaluation tools to assess
  learners
• knowledge
• skills,
• behaviors, and attitudes
• Tools may include survey questionnaires, testing
  instruments, qualitative interviews, focus
  groups, observed structured clinical evaluations
  (OSCEs), etc.

Analyze
Evaluate
Design
Develop
Implement

• SIMILAR APPLICATION OF ADDIE
• MODEL FOR REMAINING GOALS
• Faculty development
• Post-graduate
• Research experiences

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Looking Ahead
Winter
Teams 1, 2 5 begin work
Team 3 begins work
Implement Post-graduate EIP Courses
Team 4 begins work
Integrate EIP into Other Courses
Faculty Surveys
Focus Groups
Spring
Implement Foundational EIP Courses
Training Foundational Faculty
Integrate EIP into Clinical Courses
Faculty EIP Courses, Mentorship
Summer
Fall
All Faculty Workshop
All Faculty Workshop?
2008
2009
2010
2011
Key Team 1Student Curriculum Team 2Faculty
Development Team 3Post-Graduate Team 4Research
Experiences Team 5Evaluation
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Faculty Involvement

• Pre-funding survey of perceived value and own
  skill level
• Post-funding surveys (value, skill level,
  organizational change)
• Focus groups
• Team Members
• Team Consultants
• EIP Integrators

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We look forward to working with you!

• Questions?