Complementary medicine literacy education and curricula development for medical education

Introduction and Objective: In Australia and overseas, use of complementary medicines (CMs) is high and there is an increasing amount of high-quality research available to support this use. Because of CM’s popularity, medical practitioners are increasingly placed in a position of needing to be CM literate. Without active inquiry and involvement by medical practitioners regarding CM use, patients will continue to seek practices without appropriate medical guidance. However, despite growing expectations from patients, the level of, and need for, CM education within medical education (ME) in Australia is largely unknown. The objective of this study was to explore CM literacy education development in Australian medical curricula and generate theory about the processes involved. Methodology: This research utilised a constructivist grounded theory method. The theoretical framework, underpinned by symbolic interactionism and social constructivism, provided a rich and powerful means of understanding need for, and processes of, CM education through interpretations of core stakeholders’ (medical students) curriculum experiences. Thirty medical students from metropolitan and rural campuses and clinical schools across the top 10 ranked Australian university medical schools in five states and one territory participated. Data were generated from 30 in-depth semi-structured one-on-one interviews with medical students, contemporaneous field notes and analytic theoretical memos. Data analysis was conducted concurrently and simultaneously with data generation so that theory construction was progressively guided by the data. Use of reflexive memos, theoretical sampling, the constant comparative method, data categorisation and finally, data abstraction, resulted in development of the constructivist grounded theory (CGT) for the topic of inquiry. Findings: In this study, the central problem is described as ensuring that medical students become CM literate while they undertake their ME. The basic social process (core category) constructed to deal with this problem is conceptualised as practical CM education development. Six interrelated categories represent various strategies participants identified. The first category, clarifying CM terminology ambiguity, explicates CM terminological difficulties, categorisations, and value implications intrinsic within medicine. The second category, exploring the extent of CM education, explores the scope of, and extent to which, Australian medical students are being educated about CMs in their curriculum. The third category, determining the need for CM education, highlights student-identified need for CM education in Australian medical schools. The fourth category, identifying key influences impacting on CM education, identifies key macro-level influences, including issues of socialisation and enculturation, as well as meso-level organisational factors found to impact CM teaching in medical curricula. The fifth category, identifying key facilitators enabling CM education, explicates key institutional enablers identified to facilitate CM education development in medical curricula in the Australian context. The final category, identifying baseline CM literacy educational needs, encompasses key elements of educational requirements and key strategies identified for integrating CM education in medical curricula. Conclusion: The CGT of practical CM education development offers a theoretical account of CM education development within medical curricula in Australia. The primary goal of CM education is not to create CM experts or practitioners, but rather to facilitate informed advisers. The dilemma facing many medical educators is how such information can be incorporated into an already dense curriculum. The CGT demonstrates that complex dynamics exist between socio-political expectations and ME realities that govern health care in practice. A collaborative and integrative approach to CM education is flexible, inclusive, and socially relevant, and has a substantial and far-reaching contribution to make to the quality of primary health care. The findings of the study contribute significantly towards a body of knowledge that may result in better educational reform and practice guidelines for medicine