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Background Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by primary care professionals. Intervention Based on IH competencies developed by an interprofessional team and a needs assessment, a 32-h online interprofessional IH course, Foundations in Integrative Health, was developed. Trainees learn to conduct an IH assessment and how patients are assessed and treated from the diverse professions in integrative primary care. Methods The course was pilot-tested with educational program trainees, faculty and clinical staff at graduate level primary care training programs (primary care residencies, nursing, pharmacy, public health, behavioral health, and licensed complementary and IH programs). Outcome measures Prior to and following the course, participants completed an IH knowledge test, an IH efficacy self-assessment, and validated measures of IH attitudes, interprofessional learning, provider empathy, patient involvement, resiliency, self-care, wellness behaviors, and wellbeing. Evaluation surveys were administered following each unit and the course. Results Almost one-half (n = 461/982, 47%) completed the course. Pre/post course improvements in IH knowledge, IH self-efficacy, IH attitudes, interprofessional learning, provider empathy, resiliency, self-care, several wellness behaviors, and wellbeing were observed. The course was positively evaluated with most (93%) indicating interest in applying IH principles and that the course enhanced their educational experience (92%). Conclusion This study demonstrates the feasibility and effectiveness of a multi-site, online curriculum for introducing IH to a diverse group of primary care professionals. Primary care training programs have the ability to offer an interprofessional, IH curriculum with limited on-site faculty expertise.

The National Center for Integrative Primary Healthcare was established to support the incorporation of competency- and evidence-based Integrative Health (IH) curricula into educational programs in a movement toward interprofessional IH patient care. IH is healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle, emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies, conventional and complementary. A primary goal of the Center was to design an IH online course appropriate for interprofessional education. A study assessing the potential of and need for incorporating IH into interprofesional education was conducted. A survey was sent to educational programs to identify core IH competencies, curriculum priorities, and implementation barriers. Respondents (N = 422) were from complementary and integrative health (40%), primary care medical residencies (27%), nursing (9%), and pharmacy (9%). Patient-centered care and working interprofessionally were highest rated competencies. Highest rated content included nutrition/diet, patient-provider communication, behavior change, patient-centered care, physical activity and lifestyle counseling. Most (90%) felt it was important to offer IH content during their professional training. Time constraints, budget, and faculty expertise were the top barriers. The results demonstrated substantial interest and need for an interprofessional IH course. Common content areas and core IH competencies were identified.

Background Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by health professionals. Intervention Foundations in Integrative Health (FIH), a 32-h online competency-based interprofessional course to address this knowledge gap. Methods The course was pilot-tested by an interprofessional sample of providers in various clinical settings as professional and staff development. Outcome Measures Prior to and following the course, participants completed an IH knowledge test, an IH self-efficacy self-assessment, and validated measures of burnout, wellness behaviors, and attitudes toward IH, interprofessional teams, and patient involvement. Evaluation surveys were administered following each unit and the course. Results Thirty-one percent of the participants (n = 214/690) completed the course. Pre/post course improvements were found in IH knowledge, IH self-efficacy, attitudes towards IH and interprofessional teams, and several wellness behaviors. The course was positively evaluated with 81% of the participants indicating interest in applying IH principles in their practice and 92% reported that the course enhanced their clinical experience. Conclusion This study demonstrates the outcomes of a multi-site, online IH curriculum offered to a diverse group of health professionals in various clinical settings. This course may allow clinical settings to offer an interprofessional, IH curriculum even with limited on-site faculty expertise.

In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 "meta-competencies" through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year.2014 年 10 月，国家综合初级卫生 保健中心 (NCIPH) 启动，该中心是 亚利桑那大学结合医学中心以及结 合医学与健康学术联盟的合作产 物，并得到了健康资源和服务管理 局拨款支持。NCIPH 的主要目标是 开发一组跨专业基层医疗培训的核 心综合健康 (IH) 技能和教育方 案，以及实践论坛，并最终成为基 层医疗培训的一个必要部分。本文 报告了 NCIPH 工作的第一个阶段， 此阶段集中开发一组可以共享的综 合医疗护理技能，用于基层医疗学 科。本文描述了 10 种“元胜能 力”的开发、改进和应用流程，此 流程由一个多元化跨专业合作团队 完成。团队成员包括护理、初级医 疗保健专业、药学、公共卫生、针 灸、物理疗法、脊椎按摩疗法、营 养学和行为医学专业人员。本文提 供了所涉及的每个专业学科的专属 子技能示例，并提供了对每个学科 的潜在障碍和应用协调者评估的结 果。本文显示的技能将形成 NCIPH 45 小时网络课程的基础，用于基 层医疗培训计划，2016 年初，此课 程将面向不同领域的受众试开放， 修改后将继续面向更多受众开放。.En octubre de 2014, se inauguró el Centro nacional de atención primaria integral de salud (National Center for Integrative Primary Healthcare, NCIPH) como una colaboración entre el Centro de medicina integral de la Universidad de Arizona y el Consorcio académico de salud y medicina integral, y fue subvencionado con fondos de la Administración de Recursos y Servicios de Salud. El objetivo principal del NCIPH es desarrollar un conjunto básico de competencias de asistencia sanitaria integral (SI) y programas educativos que abarquen los espectros de formación y práctica en atención primaria interprofesional y se integren en última instancia en la educación en atención primaria. Este artículo detalla la primera fase de la iniciativa del NCIPH, que se centra en el desarrollo de un conjunto de competencias compartidas en asistencia sanitaria integral para las disciplinas de atención primaria. Se describe un proceso de desarrollo, perfeccionamiento y adopción de 10 “metacompetencias” a través de un proceso de colaboración en el que participa un equipo interprofesional heterogéneo. Los miembros del equipo representan al personal de enfermería, las profesiones médicas de atención primaria, farmacia, salud pública, acupuntura, naturopatía, quiropráctica, nutrición y medicina de la conducta. Se ofrecen ejemplos de las subcompetencias específicas de cada disciplina en fase de desarrollo en cada una de las profesiones participantes, junto con los resultados iniciales de la evaluación de los posibles obstáculos y los facilitadores de la adopción dentro de cada disciplina. Las competencias que se presentan aquí constituirán la base de un plan de estudios en línea de 45 horas elaborado por el NCIPH para su uso en programas de formación en atención primaria que se pondrán a prueba a principios de 2016 y serán posteriormente revisados para la generalización de su uso el año siguiente.

We have all thrown a pebble into a pond and watched the ripples spread out across the water. One small stone entering the water can affect the entire pond. Leaders in Integrative Healthcare who have the opportunity and responsibility to bring about transformative change within their organization are, in effect, being given the opportunity to be that pebble. For Integrative Leadership, the essence of that pebble is “informed mindfulness.” Informed mindfulness is a concept that connects mindful self-awareness and self-regulation with educated decisionmaking. The mindful person is aware, non-judgmentally, of what is occurring in the present moment and understands that his or her response is a choice. With informed mindfulness, as situations arise and decision points are faced, that same person is able to place what is happening in its larger context and, having clear values and being sufficiently educated, make an informed choice within that moment. This concept—self-awareness and self-regulation coupled with knowledge, skills, values, and wisdom—forms the foundation of Integrative Leadership. Leaders who have developed informed mindfulness are aware of how they operate in the world with and in relationship to the qualities of integrity, authenticity, compassion, courage, empathy, humility, and passion. They are committed to increasing their own capacities for these qualities, not just for selfimprovement but also as a means to bring about cultural transformation and social change. When mindfully informed leaders enter the pond, they make waves that ripple out from themselves to others. The Integrative Leader understands that every success is dependent upon nurturing insightful, functional relationships with others

Introduction The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) is committed to advancing human health through the advancement and integration of the complementary and alternative medicine (CAM) professions within the American healthcare system. This will involve the maturation and integration of the licensed CAM professions into conventional healthcare delivery, and in turn, it will involve the development of competency in integrative healthcare and interprofessional education within the CAM professions. Method and Results In 2010, ACCAHC resolved to identify the competencies necessary for this transformation, and in the process, discovered a parallel process of competency development within conventional healthcare, the Interprofessional Education Collaborative (IPEC), representing the six major conventional healthcare professions. Discussion The ACCAHC competency document, its development, and its similarity to the IPEC document are discussed. The ACCAHC competency document identified two domains of competence that were not present in the IPEC document: evidence-informed practice and institutional healthcare practices. These two domains of competency are discussed with respect to their significance in both CAM and conventional healthcare practices. Conclusion ACCAHC's goal is to foster collaboration among its member professions and with conventional healthcare professions, and to use these competency documents to improve and optimize healthcare delivery, practices, and outcomes in America. It is hoped that ACCAHC's competency document will catalyze interaction with IPEC leading to the adoption of a single shared competency document that will meet the needs of all healthcare providers and educators.