EBCAM Specific Aims

We propose the Tufts Program in Evidence-Based Complementary and Alternative Medicine (EBCAM) to provide medical students with the knowledge, attitudes and skills they will need to critically evaluate complementary and alternative medical therapies and selectively integrate them into their future practices of allopathic medicine. Complementary and alternative medicine (CAM) has become an increasingly popular health care strategy with more and more practitioners and health care facilities incorporating CAM into their practices and services. In addition, a growing database of CAM information worldwide is supported by research studies conducted at varying levels of scientific rigor. However, many prominent physicians and medical institutions have raised serious concerns about the safety and effectiveness of CAM therapies, often citing the insufficient number and quality of studies conducted to examine the medical and quality of life outcomes of CAM. These contradictory messages leave medical students and most physicians with questions about how CAM does or does not benefit patients. Our long-term objective, therefore, is to develop, implement, and evaluate an interdisciplinary, multi-institutional educational program that takes an evidence-based approach to the integration of CAM into allopathic medical practice, and that prepares students to think critically about reports of effectiveness for all kinds of medical interventions, conventional and unconventional alike.

Through the creation and implementation of an enhanced four-year curriculum, we propose to use an evidence-based medicine (EBM) approach to teach about CAM, particularly in areas where we have unique expertise – nutrition; pain, palliative, and supportive care; and East Asian Medicine (through our affiliation with the New England School of Acupuncture).

Our initiative builds on the following strengths of Tufts University School of Medicine (TUSM) and its partners: (1) The Tufts University Sciences Knowledgebase – TUSK (formerly known as the Health Sciences Database), funded in part by a grant from the National Library of Medicine, is a comprehensive, multimedia, interactive educational system providing curricular support and information management services for the TUSM community. TUSK facilitates unprecedented integration of new and existing curricular content across courses and years, and provides the flexibility needed to integrate EBM and CAM modules throughout the four-year curriculum. (2) The New England Cochrane Center, located at Tufts and funded in part by the Agency for Healthcare Research and Quality, provides substantial and internationally recognized reviews of scientific evidence, including CAM reports. By partnering with their world renowned faculty, we will develop workshops in EBM for faculty, residents, and CAM practitioners. (3) The Jean Mayer USDA Human Nutrition Research Center on Aging and the nation’s only freestanding graduate school of nutrition, the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, provide access to a rich teaching and research faculty who will assist in the development of the EBM and CAM nutrition content. And, (4) TUSM has a close affiliation with the New England School of Acupuncture (NESA), a fully accredited educational institution with an extensive and growing library of CAM resources and expertise in East Asian Medicine.

To accomplish our long-term objectives, EBCAM is organized into four principle, interrelated activities:

TUSM and NESA faculty, with assistance from the New England Cochrane Center faculty, will define the EBM process and develop the EBM teaching “model”.
TUSM and NESA faculty and students will create the CAM Resource Center (CAMRC), an interactive electronic resource that will support an evidence-based approach to CAM. It will include easily searchable, updated CAM information that has been filtered by EBCAM faculty, and will be extensively linked to TUSK and to external sources of evidence-based CAM data.
Based upon the EBM teaching model, TUSM and NESA faculty and TUSM students will identify over courses, clerkships, interclerkships, and electives where CAM material can be integrated directly into allopathic course content, or where links can be made between the allopathic course material available on TUSK and the CAM material available on the CAMRC.
EBCAM will undertake a process and outcomes evaluation of the entire program using a combination of survey and performance data to evaluate student’s knowledge, skills and attitudes toward EBM and toward CAM.

To summarize, the specific aims of this program will be to:

Develop a curriculum with an EBM “theme” across the four-year curriculum.
Create an interactive electronic CAM Resource Center to support the teaching of CAM using the EBM model.
Review the curriculum and integrate selected CAM content into courses, clerkships, interclerkships, and electives, and electronically link course/clerkship material with CAM material contained within the CAM Resource Center.
Provide faculty development in EBM for CAM practitioners and allopathic faculty.
Foster the interchange and sharing of information between physicians and CAM practitioners.
Develop experiences that combine a clinical and research component to expose students to the integration of CAM and allopathic medicine using an EBM model.
Administer a process and outcomes evaluation program to determine the educational effectiveness of EBCAM.

Mary Y. Lee, MD
Principal Investigator
Tufts University School of Medicine