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Medical Education

Anthroposophy is understood as a way to develop individual and autonomous competencies for recognizing the spiritual dimensions of the human being and the world. Anthroposophy aims to enhance a comprehensive and self-directed development of personality. Thus, Anthroposophic Medical Education focuses not only on innovative ways to teach and to learn Anthroposophic Medicine, but aims to contribute to a humanistic education that enables the learners to practice an integrative and patient centred health care. 

A major topic regarding education for a patient centred medicine [1] focuses on the development of physician empathy [2]. A review of the working group of the Integrated Curriculum for Anthroposophic Medicine (ICURAM) showed that empathy often declines during medical education [3], important reasons for which were found in stress and in clinical education. Further relevant determinants for the development of empathy during undergraduate medical education seem to be reflective practice, focusing on the psycho-social dimension of disease and human being, peer influence and role modelling [4,5]. A non-reductionistic understanding of the human being as in anthroposophy may also enhance empathy and patient centeredness [6]. 

As an example for an integrative medical education the ICURAM-program was developed, a six-year curriculum in Anthroposophic Medicine that is integrated throughout the medical training at Witten Herdecke University in Germany. As educational principles of the ICURAM-program, the ESPRI2T approach was developed combining Exploratory learning, Supported participation, Patient based learning, Reflective practice, Integrated Learning, an Integrative approach and Team based learning [7,8]. Preliminary evaluations showed that such an integrative medical curriculum with a student centred educational strategy is of interest to more than half of medical students [8]. First studies on ICURAM graduates indicate that such a program is not only helpful to learn Anthroposophic Medicine but also can contribute to a positive and sustainable experience of the students ́ medical training and can have a positive impact on both the development of their professional and personal identity and empathy as doctors-to-be [9]. The importance of a non-reductionistic anthropology for a whole systems approach in integrative medicine has been elaborated [6,10,11] as well as innovative didactical methods like artistic sculpturing in anatomy [12].  

Several elements of the ICURAM program as an example for integrative medical education were published, e.g. the perception practice [13] and integrative clinical clerkships [14]. For the final year rotations, clinical education wards (CEWs) have been developed in internal medicine, paediatrics and neurology. They foster supported active participation of students in health care [15]. Related research indicates that integrating students as active members of health care teams is not related to impairment of perceived health care quality but to high patient centeredness, empathy and patient enablement [16,17]. A clinical reflection training was developed on request of the first participating CEW students. This regular training under the guidance of a psychosomatic specialist allows intra- and interpersonal challenges arising from clinical practice to be reflected and appropriate individual solutions to be jointly developed [18,19]. 

According to the German regulation for undergraduate medical education, a small part of the regular curriculum (“QB12”) contains rehabilitation, physical medicine and naturopathy where different forms of complementary and alternative medicine are presented, mostly in lectures [20]. Similar surveys regarding the status of teaching of CAM (including Anthroposophic Medicine) in Switzerland have been published [21,22]. A case conference for integrative medicine has been piloted as a patient – based multidimensional method to compare and to reflect upon different methods of medicine including conventional and different forms of complementary medicine [23]. 

Educational research has also been published regarding the quality of postgraduate medical training in integrative medicine at anthroposophic hospitals in Germany and Switzerland [24] including an analysis of problems [25] and recommendations for solutions [26].

July 2017

Dr. med. Christian Scheffer, MME (Bern)
Integriertes Begleitstudium Anthroposophische Medizin - Universität Witten / Herdecke
Gemeinschaftskrankenhaus Herdecke

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