Introducing APRN Students in the Armed Forces to the Power of Transdisciplinary Integrative Methodologies

Purpose: Complementary and alternative medicine (CAM) is an expansive domain encompassing an extensive repertoire of healing techniques and resources which complement Western medicine with a unique focus on individuals as holistic beings (Cochrane Collaboration). CAM is rapidly gaining popularity in the United States as a growing body of evidence emerges in support of the synergy between integrative techniques and conventional therapies to treat disease and illness. In 2017, nearly one-third of Americans reported routine use of alternative approaches to wellness-healing and 83% of Military Treatment Facilities (MTF) offered at least one type of CAM to patients (RAND, 2017). To align with this emerging paradigm in medicine along with trends toward collaborative transdisciplinary care team models, faculty of a graduate nursing school partnered with physician, social work, and physical therapy colleagues to design an innovative a one-credit course exploring CAM methodologies along with certification of all APRN students in battlefield auricular acupuncture (BFA).

Methods: Linking three adult learning theories: andragogy, experiential and transformational; course delivery included a series of asynchronous online modules (recorded lectures, knowledge assessment quizzes, scholarly annotated bibliographies) and a comprehensive, transdisciplinary, one-day, face-to face intensive clinical practicum delivered by subject matter experts from multiple disciplines. CAM modality selection was based upon popularity and accessibility within Military Treatment Facilities: acupuncture, nutrition, progressive muscle relaxation, physical movement (yoga), and guided imagery/meditation. This novel approach additionally highlighted lifestyle changes consistent with optimal wellness for patients and demonstration on the utility of CAM techniques on leveraging therapeutic relationships and patient empowerment.

Results: 190 advanced practice nursing students have achieved battlefield auricular acupuncture certification in 3 years. 100% of the 190 students report "Good to Excellent" course satisfactions on a scale of 1-5 with 66% (n=125) reporting “Excellent”. Qualitative comments include: “Thanks for this great course, it is a great way to provide comprehensive care and learn about all the methods patients are using besides pharmaceuticals," "a tremendously beneficial experience especially as we learn to navigate the challenges that await us with the opioid epidemic," and "thank you for helping us build resiliency from within."

Conclusion: Basic concepts of CAM were interwoven with hands on application of techniques including acupuncture, guided imagery and progressive relaxation. Scholarly assignments reinforced application of evidenced-based principles to enhance understanding of how alternative approaches to healthcare can be effectively integrated into Western Medicine clinical practice. Content delivery by a dynamic transdisciplinary faculty to graduate nursing students proved to be a cornerstone of a robust program which intrigued and excited burgeoning practitioners’ interest in critical appraisal, appreciation, and invitation of CAM into future patient prescription. Suggestions for subsequent iterations of CAM education include expansion to an transdisciplinary learning curriculum committed to deeper concepts of maintenance, restoration, and resiliency of the mind, body, and soul for both students and experienced healthcare providers.