1. Armaity Vaghaiwalla Austin, MD MPH FAAFP Associate Clinical Professor Department of Family Medicine USC Keck School of Medicine Integrative Medicine MEDICAL SCHOOL CURRICULUM USC KECK SCHOOL OF MEDICINE

2. Armaity Vaghaiwalla Austin, MD MPH FAAFP avaustin@usc.edu KECK SCHOOL OF MEDICINE, USC Contact Email

3. Ali Arastu, MS4 Caryn Brenn, MS4 Lia Jacobson, MS4 Sara Ptasnik, MS2 Kristen Roehl, MS2 Lisa Schamber, MS2 Elaine Yang, MS2 KECK SCHOOL OF MEDICINE, USC Co- Presenters

4. PPM Selective – Year II Clinical Selective – Year IV Student Programming IM Curriculum at KSOM

5. ● 6 sessions in the fall (12-hr curriculum) ● Each session incorporates 2 topics ● Integrative physician speakers ● Student case presentations PPM Selective - Year II

6. ● Introduction to E-W Medicine ● TCM – Acupuncture & Herbalism ● Homeopathy ● Guided Imagery ● MBSR ● Yoga ● Ayurveda ● Chumash Herbal Medicine (“Hike & Healing”) ● Patient Perspective Topics in PPM Selective

9. ◦IM PPM Selective for past two years, consistently among the highest rated selective, may be expanded to two concurrent sessions due to popular demand ◦Student research project about CAM attitudes surveyed students before and after taking the course Feedback on PPM Selective

10. PPM – INTEGRATIVE MEDICINE IM. SELECTIVE, MS2 COURSE STATS

11. PPM – INTEGRATIVE MEDICINE IM. SELECTIVE, MS2 Scale: 5 4 3 2 1 Excellent Very Good Average Below Needs Average Improvement

12. List 3 most important learning points from your IM Selective experience.

13. What was the best part of the IM Selective experience?

14. Student Experience: Sara Ptasnik

15. Survey of Medical Students’ Attitudes Towards CAM (Fall 2011) Caryn Brenn, MSIV

16. Demographics 178 second year Keck medical students (MS2) 24 years old 51.1% male 27 students enrolled CAM selective 151 students enrolled other selectives

17. Survey Questions 9 questions from the validated CAM Health Belief Questionnaire (CHBQ) 1 –7 point Likert scale –1=“Absolutely disagree”, 7=“Absolutely agree” –Midpoint 36, Maximum 63 Personal use of CAM therapies Frequency of use Plan to use CAM in future medical career Opinion of CAM education Resources used 1 Lie, D., & Boker, J. (2004). Development and validation of the CAM Health Belief Questionnaire (CHBQ) and CAM use and attitudes amongst medical students. BMC Med Educ, Vol 4(1), 2.

18. Results Hypothesis confirmed PrePostAverage Difference p-value CAM selective (n=24) 46.25 (+ 5.09)52.17 (+ 4.61)+5.920.00001 Other selective (n=137) 42.69 (+ 6.86)42.04 (+ 6.91)-0.650.098 Total CHBQ score

19. Results: Secondary Findings All students (n=161), Pre survey 88.7% of all students personally use one or more form(s) of alternative therapy

20. Results: Secondary Findings All students (n=161), Pre survey 92% of students agree that CAM education should be a component of medical school education 82% of students plan to refer CAM therapies 61% of students gained baseline knowledge of CAM from word of mouth or social media –17% from previous CAM education –6% from scholarly and medical journals

21. ●4 weeks in length ●Faculty: Armaity V. Austin, MD, MPH, FAAFP ●“Prevention and Wellness” Clinical Selective - Year IV

22. Wellness Assessment

23. NUTRITION Macronutrients Micronutrients Dietary Supplements PHYSICAL ACTIVITY MIND-BODY Stress Management SLEEP ENVIRONMENTAL HEALTH SPIRITUALITY MOTIVATIONAL INTERVIEWING Curriculum of Clinical Selective

24. Student Experiences: Ali Arastu Lia Jacobson

25. Student Programming ● Integrative Medicine Club ●Student President Sylvia Charles (Psychiatry Intern @ UCSF) and Co- President Ali Arastu inherited Integrative Medicine Club as first year medical students ●Implemented Weekly Yoga Sessions ●Introduced Meditation to Campus for students ●Began working to provide student input in IIH

26. Integrative Health Interest Group (IHIG) 1. Year II PPM co-facilitation (student leaders) 2. Ongoing involvement with IIH ●Student liaison; monthly breakfast seminars ●Research & physician mentors Interdisciplinary, Longitudinal, Co-Sponsored, Interinstitutional

27. Integrative Health Interest Group (IHIG) 3. Student wellness ●“Wellness Wednesdays” in the quad ●Weekly yoga class ●Mindfulness at ECSHC K

28. IHIG: Events in Spring 2014 ●Women’s Health Symposium ●Research Lunch Talk ●IIH Research Symposium ●BeWellKeck Kick-Off Extravaganza ●Pet Therapy Day

29. IHIG: Goals & Opportunities ●Expand interdisciplinary involvement ●Increase events in the fall semester ●Increase attendance at Wellness Wednesday events, in conjunction with the BeWellKeck initiative ●Develop a sustainable funding mechanism to allow hands-on workshops, outside practitioners, and food at events

30. Mindfulness Meditation for Medical Students: A Pilot Research Study Can the use of a mobile application to deliver 10-20 minutes of daily guided mindfulness meditation help medical students reduce stress and improve overall wellbeing? General Well-being Scale Perceived Stress Scale Five-Facet Mindfulness Questionnaire

31. Feasability

32. Results 74% of Intervention group used the Headspace app ○Number of days used: M=11.97, SD=7.76, range=28 54% continued to use Headspace after the initial 30-day intervention period Perceived Stress decreased for Intervention, but not Control, over 60 days ○Well-being did not significantly increase across both groups ○Mindfulness increased across both groups for subscales of Observing, Acting with Awareness, and Non-reacting

33. Interinstitutional Programs: Goals ●Increased opportunities for interdisciplinary education ●Enhancement of self-care knowledge and practice ●Regional and national connections among M.D., D.O., and N.D. medical students interested in Integrative Medicine ●Community of like-minded medical students to optimize future collaboration in patient care

34. Interinstitutional Programs: SoCal ●IMMSA-SC: Integrative Medicine Medical Student Association – Southern California Chapter ● Bastyr University California ● David Geffen School of Medicine at UCLA ● Western University of Health Sciences ● UC San Diego School of Medicine ● Keck School of Medicine of USC ● UC Irvine School of Medicine ●Symposium/retreat in the works...

35. Interinstitutional Programs: National ● LEAPS into IM: Leadership and Education Program for Students in Integrative Medicine Jun 2014 @ Kripalu Center for Yoga & Health, Berkshires, MA

36. ● HEART-IM: Humanistic Elective in Activism, Reflective Transformation, and Integrative Medicine Mar 30 – Apr 24, 2014 @ Quaker Center, Ben Lomond, CA Interinstitutional Programs: National

37. ● NSCIM: National Student Conference on Integrative Medicine Oct 26-27, 2013 @ Northwestern University, Chicago, IL Interinstitutional Programs: National

38. ● AHIMSA: American Holistic & Integrative Medical Student Association - Standardized materials for curriculum development and student programming - Regional recruitment/outreach - Student-run integrative medicine journal Interinstitutional Programs: National

39. Challenges for IM Curriculum in Medical Schools Time/ Curriculum Faculty Development Inter-professional Education Resources: Financial

40. Integrative Medicine at KSOM: Future Consortium Institute of Integrative Health (IIH) Education – MS4 Selective Research Clinical

41. Integrative Medicine at KSOM: Future Thoughts/Suggestions?

42. Armaity Vaghaiwalla Austin, MD MPH FAAFP Associate Clinical Professor Department of Family Medicine USC Keck School of Medicine Integrative Medicine MEDICAL SCHOOL CURRICULUM USC KECK SCHOOL OF MEDICINE