Use of Complementary and Alternative Medicine Among Patients With Arthritis

Introduction: Previous studies suggest that people with arthritis have high rates of using complementary and alternative medicine (CAM) approaches for managing their arthritis, in addition to conventional treatments such as prescription medications. However, little is known about the use of CAM by diagnosis, or which forms of CAM are most frequently used by people with arthritis. This study was designed to provide detailed information about use of CAM for symptoms associated with arthritis in patients followed in primary care and specialty clinics in North Carolina. Methods: Using a cross-sectional design, we drew our sample from primary care (n = 1,077) and specialist (n = 1,063) physician offices. Summary statistics were used to calculate differences within and between diagnostic groups, practice settings, and other characteristics. Logistic regression models clustered at the site level were used to determine the effect of patient characteristics on ever and current use of 9 CAM categories and an overall category of "any use." Results: Most of the participants followed by specialists (90.5%) and a slightly smaller percentage of those in the primary care sample (82.8%) had tried at least 1 complementary therapy for arthritis symptoms. Participants with fibromyalgia used complementary therapies more often than those with rheumatoid arthritis, osteoarthritis, or chronic joint symptoms. More than 50% of patients in both samples used over-the-counter topical pain relievers, more than 25% used meditation or drew on religious or spiritual beliefs, and more than 19% used a chiropractor. Women and participants with higher levels of education were more likely to report current use of alternative therapies. Conclusion: Most arthritis patients in both primary care and specialty settings have used CAM for their arthritis symptoms. Health care providers (especially musculoskeletal specialists) should discuss these therapies with all arthritis patients

Multi-Institutional Implementation and Evaluation of a Curriculum for the Medical Student Clerkship in Radiation Oncology

PURPOSE/OBJECTIVE(S): Radiation oncology curriculum development is challenging due to limited numbers of trainees at any single institution. The goal of this project is to implement and evaluate a standardized medical student clerkship curriculum following the multi-institutional cooperative group research model. METHODS AND MATERIALS: During the 2013 academic year, a standardized curriculum was implemented at 11 academic medical centers consisting of three one-hour lectures and a hands-on radiation treatment planning workshop. Post-curriculum, students completed anonymous evaluations using Likert scales (1 = "not at all" to 5 = "extremely"; reported as median [interquartile range]) and free responses. Evaluations asked students to rate their pre/post-comfort with radiation oncology as a specialty, knowledge of radiotherapy planning methods, and ability to function as a radiation oncology resident. Non-parametric statistical tests were used in analysis. RESULTS: 88 students at 11 academic medical centers completed the curriculum de-novo with 72.7% (64/88) survey response rate. 57/64 (89.1%) reported intent to pursue radiation oncology as their specialty. Median student ratings of the importance of curricular content were: Overview 4[4-5]; Radiation Biology/Physics 5[4-5]; Practical Aspects/Emergencies 5[4-5]; Planning Workshop 4[4-5]. Students reported the curriculum helped them to better understand radiation oncology as a specialty (5[4-5]), increased specialty decision comfort (4[3-5]), and would help the transition to radiation oncology residency (4[4-5]). Students rated their specialty decision comfort significantly higher after completing the curriculum (4[4-5] vs. 5[5-5], p<0.001). CONCLUSIONS: A national standardized curriculum was successfully implemented at 11 academic medical centers, providing proof-of-principle that curriculum development can follow the multi-institutional cooperative group research model

Multi-Institutional Implementation and Evaluation of a Curriculum for the Medical Student Clerkship in Radiation Oncology

PurposeRadiation oncology curriculum development is challenging because of limited numbers of trainees at any single institution. The goal of this project is to implement and evaluate a standardized medical student clerkship curriculum following the multi-institutional cooperative group research model.MethodsDuring the 2013 academic year, a standardized curriculum was implemented at 11 academic medical centers consisting of three 1-hour lectures and a hands-on radiation treatment planning workshop. After the curriculum, students completed anonymous evaluations using Likert-type scales (1&nbsp;= "not at all" to 5&nbsp;= "extremely") and free responses. Evaluations asked students to rate their comfort, before and after the curriculum, with radiation oncology as a specialty, knowledge of radiotherapy planning methods, and ability to function as a radiation oncology resident. Nonparametric statistical tests were used in the analysis.ResultsEighty-eight students at 11 academic medical centers completed the curriculum de novo, with a 72.7% (64 of 88) survey response rate. Fifty-seven students (89.1%) reported intent to pursue radiation oncology as their specialty. Median (interquartile range) student ratings of the importance of curricular content were as follows: overview, 4 (4-5); radiation biology/physics, 5 (4-5); practical aspects/emergencies, 5 (4-5); and planning workshop, 4 (4-5). Students reported that the curriculum helped them better understand radiation oncology as a specialty (5 [4-5]), increased specialty decision comfort (4 [3-5]), and would help the transition to radiation oncology residency (4 [4-5]). Students rated their specialty decision comfort significantly higher after completing the curriculum (4 [4-5] versus 5 [5-5]; P &lt; .001).ConclusionsA national standardized curriculum was successfully implemented at 11 academic medical centers, providing proof of principle that curriculum development can follow the multi-institutional cooperative group research model