EDUCATION

ON HARNESSING THE POWER OF MEDICAL

STUDENTS TO REACH THEIR PEERS

| Aaron Winkler, MD, Victor S. Sierpina, MD, and

Mary Jo Kreitzer, RN, PhD|

European and American culture histor-ically ebbs and flows in relation tomind–body medicine.1 As we reach thelimit of western medicine to treatepidemics like obesity and attentiondeficit, the tide is flowing in favor ofmind–body approaches. A google-newssearch for “mindfulness” on January12th, 2014 showed articles published inthe prior week in several major newsoutlets including The Times, The Guard-ian, The Telegraph, Harvard Health Pub-lications, and Medscape, all with positiveheadlines such as, “Mindfulness Medi-tation May Ease Anxiety and Stress,”2

and “How Mindfulness can Help YourChildren.”3 Companies have begunoffering lunch-time mindfulness medi-tation.4 The effect of mindfulness onelite athletic performance has beenstudied5 and reached popularawareness. During the Sochi WinterOlympics, an article on athletes usingimagery to prepare for events was one of

Content on integrative healthcare and com-plementary and alternative medicine is beingtaught in hundreds of educational programsacross the country. Nursing, medical, osteo-pathic, chiropractic, acupuncture, naturo-pathic, and other programs are findingcreative and innovative ways to include theseapproaches in new models of education andpractice. This column spotlights such innova-tions in integrative healthcare and CAMeducation and presents readers with specificeducational interventions they can adapt intonew or ongoing educational efforts at theirinstitution or programs. We invite readers tosubmit brief descriptions of efforts in theirinstitutions that reflect the creativity, diver-sity, and interdisciplinary nature of the field.Please submit to Dr. Sierpina at vssier-pi@utmb.edu or Dr. Kreitzer at krei-t003@umn.edu. Submissions should be nomore than 500–1500 words. Please includeany website or other resource that is relevantas well as contact information.

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top 10 most-emailed articles on The NewYork Times' website.6

Similar positivity may be starting totake hold at medical institutions, butmore progress remains to be made. Arecent study from the Mayo Clinic inMinnesota asserts that between 2004and 2012, “the attitudes of physiciansin our department of medicine towardcomplementary and alternative therapies(CAM) became much more positive,and physicians showed an increased will-ingness to use CAM to address patientcare needs. However, knowledge of andexperience with many specific CAMtreatments did not change.”7

One way to increase future physicianknowledge of and experience with integrat-ing CAM and conventional approaches[integrative medicine (IM)] is to harnessthe energy of IM-minded medical studentsto inform and engage their classmates.Precisely this is currently taking place atWake Forest University School of Medi-cine, even though no formal IM curricu-lum is available. A vital studentorganization has grown over just a fewyears. This success is the result of factorsthat should be reproducible at otherschools. First, there has been strong facultymentorship locally at Wake Forest andnationally at AMSA's annual leadershiptraining program (LEAPS into IM). Sec-ond, there is financial support locallythrough Wake's Center for IntegrativeMedicine (CIM) and Student WellnessCenter (SWC) and also nationally fromorganizations such as the Weil Founda-tion. Last, perhaps most important andleast discussed, there has been stronglongitudinal mentorship between students.The story is simple: In 2011, a single

Wake Forest student reconstituted adefunct IM interest group and, in paral-lel, worked with the counseling depart-ment to find funding for studentwellness programming. She attended

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“LEAPS into IM” the following summerand used the very modest grant funds toorganize a simple “introduction to IM”lunch talk for her fellow students. Amember of the following class attendedat the lunch talk. She had never heard ofIM but was intrigued and attendedLEAPS the following summer. Thesetwo students were working against thegrain. Their peers were unaware of oruninterested in IM modalities.But their work began to bear fruit

with the following class. One studentarrived already certified as a yoga instruc-tor. She used some of the funds recentlyearmarked for student wellness to start afree-for-students weekly yoga class. Gar-nering impressive attendance, the classhad to be moved to a bigger room tohold the regular crowd of 30–40 MDand PA student attendees. A secondstudent well-versed in IM dietaryapproaches brought organizationalprowess and utilized student activitiesfunding to bring in diverse speakersthroughout the year to teach IM as itrelates to cardiovascular health, chiro-practic care, and nutrition. A thirdstudent (the author of this piece) appliedto LEAPS and, with an interest groupalready in place, was able to direct thegrant funds toward clinical research. Aswith all strong teams, the whole becamemuch greater than the sum of its parts.Strong support for each other's ideasbred the following successful initiatives:

�

r/

A yoga hike during new studentorientation

�

Participation in a community garden � Pre-exam meditation � Post-exam detox with fruit juiced toorder and a loving kindnessmeditation-centered yoga class

The results of these efforts have begunto seep into the fabric of student life.

December 2014, Vol. 10, No. 6 411

There are now plans to invite largenumbers of students to do communityservice at the community garden. Theweekly yoga class is so well attended thatplans have been laid to continue to offerit as the current teacher moves on in hermedical training. Students who hadalready noticed the similarity betweenthe unhealthy diets mentioned in athero-sclerosis lectures and the unhealthy foodserved at school events saw an alternativein the healthy lunches provide at IMlunch talks. At the request of peers, theinterest group wrote and distributed aone-page document on how to providehealthy lunches at a reasonable cost.The next class of IM student leader-

ship is already running and planningevents. It is not far-fetched to think thatwithin three to four years students willsimply expect there to be a yoga class,expect to meditate before exams, andexpect that student groups who servepizza will find their events less wellattended than those with pita sand-wiches and fresh vegetables.This past summer I attended LEAPS.

The LEAPS experience was far morethan I hoped for; life-changing in allthe ways other students describe. I findmyself seeking out quiet corners duringlunch hours to engage in the walkingmeditation practice I learned there. I relymore on journaling to emotionally proc-ess medical training. I am more open toand accepting of the leadership ofothers. By connecting with like-mindedstudents, I was able to bring the idea ofpre-test meditation sessions from a col-league at another institution to my ownschool. Thanks to past LEAPS awardsand the IM student organization thathas grown at Wake Forest, I was able toapply with a very different kind ofproject than my predecessors: novelclinical research. I proposed and am

412 EXPLORE November/December 20

now currently enrolling subjects in astudy of the effects of living ornamentalplants placed in the hospital rooms ofcardiothoracic surgery patients, trackingtheir recovery for both objective andsubjective benefits. The concept andmethod were honed with mentorshipprovided at LEAPS. Funding for theproject was provided by the CIM hereat Wake Forest thanks to the currentdirector Dr. Jeffery Feldman's advocacyin support of student research.Here at Wake Forest, the opportuni-

ties available for students interested inintegrative modalities has blossomed:from no events to a single awarenessevent each year to weekly yoga, medi-tation opportunities, hikes, multipletalks from diverse IM practitioners, astudent plot in a community garden,and student-led clinical research. Therehas been synergy between a strong teamof diversely talented students, a suppor-tive faculty, external leadership trainingopportunities, and a fertile fundingenvironment.The national mood toward IM modal-

ities is positive, and medical students areaware. Some medical schools such asGeorgetown do offer formal teaching inIM concepts and treatments. But this isthe exception rather than the rule. Manymedical students may progress throughtheir training without any meaningfulexperience of IM at all. In this setting,helping interested students reach theirpeers offers a way to break the logjam.Wake Forest's IM student organization isevidence that with institutional support,faculty mentorship, and national leader-ship training programs like LEAPS,today's medical students are ready tobring IM modalities into their own lives,the lives of their peers, and most impor-tantly into the lives of their futurepatients.

14, Vol. 10, No. 6

REFERENCES1. Harrington A. The Cure Within: A History

of Mind-Body Medicine. New York: W.W.Norton; 2008.

2. Harvard Health Publications; 2014.3. The Times; 2014.4. Gelles D. The mind business. FT Maga-

zine. ⟨http://www.ft.com/cms/s/2/d9cb7940-ebea-11e1-985a-00144feab49a.html#axzz2sqm5v1al.⟩; 2012.

5. Bernier M, Thienot E, Codron R, FournierJF. Mindfulness and acceptanceapproaches in sport performance. J ClinSports Psychol. 2009;4:320–333.

6. Clarey C. Olympians use Imagery as Men-tal Training. The New York Times. ⟨http://www.nytimes.com/2014/02/23/sports/olympics/olympians-use-imagery-as-mental-training.html?hpw&rref=sports.⟩; 2014.

7. Dietlind L, et al. Physicians' attitudestoward complementary and alternativemedicine and their knowledge of specifictherapies: 8-Year follow-up at an academicmedical center. Complement Ther Clin Pract.2014;20(1):54–60. http://dx.doi.org/10.1016/j.ctcp.2013.09.003).

Aaron Winkler, is an MD Candidate atWake Forest University School of Medicinein Winston-Salem, North Carolina.

Victor S. Sierpina, MD, is the W.D. andLaura Nell Nicholson Professor ofIntegrative Medicine, Professor FamilyMedicine, Director of Medical StudentEducation, at the University of TexasMedical Branch in Galveston, Texas. Heis an associate editor for EXPLORE.

Mary Jo Kreitzer, PhD, RN, is thefounder and director the Center forSpirituality and Healing and a professorin the School of Nursing at the Universityof Minnesota, Minneapolis, Minnesota.

Education