RESUMEN
BACKGROUND: Increasing numbers of patients seek information about complementary and alternative medicine (CAM) from their primary physicians. We sought to evaluate our 4-year old curriculum integrating mainstream and CAM care for common outpatient pediatric problems within a family medicine residency. DESIGN: Cross-sectional survey. METHODS: Subjects included current (1998) third-year residents and recent graduates from our program and nearby University of Washington-affiliated family medicine residency programs. The survey included items on training experiences, knowledge, attitudes and behavior regarding CAM. RESULTS: Among the 18 respondents from our program and 21 from comparison programs, the average age was 32 years and one-third were male. Over 80% of respondents felt that residencies should provide training in CAM. Substantial numbers of respondents from all programs recommended CAM therapies to patients in the past year. All respondents had recommended special diets and nutritional supplements; more than 50% recommended herbal remedies, acupuncture, meditation or progressive relaxation, massage or home remedies. Respondents from all groups had similar attitudes and knowledge about integrative medicine; those from the intervention program were more likely than comparison respondents to agree that their residency training had prepared them to answer patients' questions about CAM (50% vs. 19%, p = 0.04). CONCLUSIONS: Primary care residents increasingly seek training to answer patients' questions and are already recommending a variety of CAM therapies. Primary care residencies need to develop and evaluate responsible, evidence-based curricula integrating mainstream and CAM therapies.
Asunto(s)
Terapias Complementarias/educación , Curriculum , Educación de Postgrado en Medicina , Internado y Residencia , Pediatría , Adulto , Niño , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Pediatría/métodos , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , SueciaRESUMEN
This article summarizes the practice content and continuity for 35 senior residents in six family medicine residency model teaching units utilizing a computerized information management system. Comparisons are drawn with the content of family practices in the National Ambulatory Medical Care Survey (NAMCS), showing that family medicine third-year residents provide a large proportion of pregnancy care and general medical examinations and treat a smaller number of chronic illness patients compared with family physicians in practice. Third-year residents performed few surgical procedures in the model teaching units. Continuity of care, though espoused by family medicine residencies in principle, was deficient in the model teaching units studied. Intensive training to compensate for these deficiencies is recommended.