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Integrative Medicine Residency

Maine Medical Center Family Practice Residency Program
Complementary and Integrative Medicine Project

Evaluation

The four project aims and their related benchmarks will be evaluated using both quantitative and qualitative methods. Examples of these are presented in the "Evaluation" column in the Outcomes Table on pages 42-44. Evaluation of the project is designed to measure changes in individual learners' knowledge, attitudes, and competencies as well as system changes within the MMCFPRP relative to acceptance and integration of CAM with conventional medicine. The following section provides more detail regarding which quantitative and qualitative measures will be used, how data will be collected, and the manner in which data will be analyzed and reported.

Aim 1: Development of a CAM curriculum for residents
Data to be collected:
Records and minutes of Advisory Committee (AC) meetings reflecting review and approval of the resident curriculum; a completed resident curriculum document; a list of CAM resources for use in resident education and in patient care; a resident "tracker" (checklist) of knowledge and skills in CAM; resident CAM post-rotation evaluations; surveys of usefulness and applicability to patient care by program graduates.

Methods for data collection and reporting:
Records and minutes of the AC will be included in post-project reports. The resident curriculum will be published in print as well as electronically on the MMC Intranet and on the Internet. The following items will be included in the curriculum: results of the literature review, knowledge, skill and attitude objectives, resident experiences, relevant faculty, and resident evaluation strategies. A list of resources for resident teaching and patient care will be included in the curriculum. It will reflect community practitioners of CAM modalities as well as printed and electronic reference materials appropriate for patient education. A separate list of references for teaching residents about the principles and treatment options of various CAM modalities will be compiled and included in the curriculum. Self-report post-rotation evaluation forms and "trackers" will be completed by residents. Graduates will be surveyed by mail; results of resident and graduate evaluations will be compiled, used to modify the curriculum and included in post-project reports.

Aim 2: Engagement of a faculty expert and development of faculty leaders
Data to be collected:
Faculty expert: Degree of involvement in curriculum development, as a mentor for faculty and resident physicians, and in patient care at the FPC. Degree of satisfaction by faculty and residents with mentoring process. Evidence of CAM teaching at resident conferences. Evidence of research conducted.

Faculty leaders: Assessment of increase in knowledge of selected CAM therapies and integration of CAM with conventional medicine; certification in CAM modality as applicable; evidence of CAM teaching at resident conferences; appointment schedules reflecting scheduled CAM therapies; degree of satisfaction by residents with faculty leaders' involvement in this project.

Methods for data collection and reporting:
Faculty expert: Minutes of AC reflecting involvement in curriculum development. Degree of satisfaction by resident and faculty physicians with mentoring, schedule of resident teaching conferences reflecting presentation of CAM didactic sessions, sample appointment schedule reflecting patient care in CAM modalities, and degree of satisfaction by patients with direct care in CAM modalities will be included in post-project reports. Research proposal(s), results, and associated publications will be included in post-project reports.

Faculty leaders: A self-report by each of four faculty leaders will be obtained which reflects knowledge gained at a national conference in his or her selected CAM modality. A copy of faculty leader certification(s), schedule of resident teaching conferences reflecting CAM didactic sessions, sample appointment schedule reflecting patient visits for CAM treatments by faculty leaders, and results of resident evaluation of faculty involvement in the project will be included in post-project reports. Structured face-to-face interviews with faculty leaders will be conducted pre- and post-project to collect data regarding integration of their CAM modality with conventional medical approaches.

Aim 3: Development of collaborative relationships with CAM practitioners
Data to be collected:
Involvement of CAM practitioners with the AC; degree of satisfaction by faculty leaders and CAM practitioners with their partnerships; degree of satisfaction by residents regarding involvement by CAM practitioners in teaching and patient care; perceptions of nursing staff and patients regarding the availability of CAM therapies at the Family Practice Centers (FPCs).

Methods for data collection and reporting:
Minutes and reports from the AC will reflect the degree of involvement by CAM practitioners. Self-report will be solicited from faculty, residents, nursing staff and patients regarding their perceptions of CAM practitioners teaching and providing care at the FPCs. Teaching conference evaluations will be obtained and summarized from residents in attendance. Quantitative data will be gathered and analyzed regarding number and type of appointments by CAM practitioners at the FPCs. Data will be folded into post-project reports.

Aim 4: Development of an environment conducive to CAM through education
Data to be collected:
Degree of participant satisfaction with each of five educational workshops. Evidence of web site development for CAM resource listing. Pre- and post-project data regarding CAM knowledge, skills, and attitudes and ability to integrate CAM with conventional medicine by faculty, residents, and staff at the FPCs; post-project data regarding patient perceptions of physician knowledge and attitudes towards CAM; evidence of project dissemination within Maine Medical Center, regionally and nationally.

Methods for data collection, analysis and reporting:
Participant reaction will be assessed following each workshop. Results will be compiled and included in post-project reports. URLs of web sites developed and sample content will be included in post-project reports and during dissemination activities.

Quantitative data will be collected on a pre/post-project basis from faculty, residents, and staff. Changes in knowledge, skills, and attitudes will be included in project reports, presentations and articles. Post-project assessment will reflect degree of patient satisfaction with providers' increased knowledge of CAM at the FPCs, increased availability of CAM treatments at the FPCs, and perception of how CAM has been integrated with conventional medicine.

Minutes of the MMC Medical Staff Task Force on CAM and department meetings will be included in post-project reports evidencing dissemination of project process and results to departments outside family practice within Maine Medical Center. Self-report by the program director and faculty expert will reflect attendance at the above mentioned meetings. A conference schedule for regional and national meetings of the Society of Teachers of Family Medicine will indicate presentation of project process and results. An article describing the project, methods used, results, and the degree of success in integrating CAM with conventional medicine in a family practice residency setting will be published in a peer-reviewed journal.

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