11

Internationalisation of Chinese

Medicine Education: Challenges

and Solutions

Charlie Changli XueCharlie Changli XueDivision of Chinese MedicineDivision of Chinese MedicineRMIT University, AustraliaRMIT University, Australia

E-Mail: charlie.xue@rmit.edu.auE-Mail: charlie.xue@rmit.edu.au

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20%

42% 45%50% 52%

76%90%

0%

50%

100%

UK US Singapor e Canada Austr al ia J apan China

Usage of complementary medicine worldwide (Source: WHO Global Atlas of Traditional, Complementary and Alternative Medicine, Kobe, 2005

Ernst, Prevalence of complementary medicine, a systematic review)

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Usage of CAM by AustraliansUsage of CAM by Australians

MacLennan MacLennan et alet al.’s survey .’s survey in 2004:in 2004: 52.2% used 52.2% used complementary and complementary and alternative medicine alternative medicine (CAM).(CAM).

Bensoussan & Myers’ Bensoussan & Myers’ survey in 1996:survey in 1996:At least 2.8 million At least 2.8 million Chinese medicine Chinese medicine consultations per year, consultations per year, representing an annual representing an annual turnover of AUD$84 turnover of AUD$84 million.million.

Commonwealth report Commonwealth report in 1997:in 1997: Complementary medicine Complementary medicine provides health care to provides health care to 57% of Australian.57% of Australian.

2005 survey in 2005 survey in Australia (Xue et al Australia (Xue et al 2006 unpublished 2006 unpublished data):data): 68.9% Australian have 68.9% Australian have used complementary used complementary medicine and nearly medicine and nearly one one in fivein five have used Chinese have used Chinese medicine.medicine.

44

<

<

:::::::::

<

<

<

<

<

Adelaide

Brisbane

CANBERRA

Hobart

Melbourne

Perth

Sydney

Darwin

10.3%(6.0%)

17.2%(6.5%)

25.1%(13.5%)

17.1%(11.7%)

22.7%(15.4%)

% ≥ 1 CM therapy

(%) ≥ Visit 1 CM practitioner

* Data not show separately for ACT, NT and TAS, combined, 15.0% used CM, and 9.2% visited a CM practitioner)

Regional differences in CM use

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The future of Chinese The future of Chinese medicine will depend medicine will depend largely on what answers largely on what answers can be provided on can be provided on efficacy and safety efficacy and safety (harm against-benefit).(harm against-benefit).

((Scheid, V. The globalisation of Chinese medicine, Scheid, V. The globalisation of Chinese medicine, The The Lancet, 354, Supp 4, 1999, page SIV10)Lancet, 354, Supp 4, 1999, page SIV10)

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CAMCAM Education, an unmet demandEducation, an unmet demand

(Ernst E. FACT. March 2003;8(1):1-2)(Ernst E. FACT. March 2003;8(1):1-2)

Effective credentialing should meet the Effective credentialing should meet the desire to protect public from dangerous desire to protect public from dangerous practice against the wish to grant patients practice against the wish to grant patients access to reasonably safe and effective access to reasonably safe and effective

practice.practice. (Eisenberg D et al. Ann Intern Med 2002; 137:965-(Eisenberg D et al. Ann Intern Med 2002; 137:965-973) 973)

TThe future graduates of TCM course will he future graduates of TCM course will have to face the continuing development have to face the continuing development and modernisation of TCM. … change from and modernisation of TCM. … change from experience-based to evidence-based experience-based to evidence-based

practicepractice (Chan, K & Lee, H. The Way forward for Chinese (Chan, K & Lee, H. The Way forward for Chinese medicine. Taylor & Francis 2002, page 389). medicine. Taylor & Francis 2002, page 389).

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Traditional Medicine Traditional Medicine PracticePractice Range of traditional medicine practice Range of traditional medicine practice

(WHO 2002)(WHO 2002)– Systematic practice: highly developed and Systematic practice: highly developed and

well-documented such as Chinese and Indian well-documented such as Chinese and Indian Traditional Medicines Traditional Medicines

– Simpler forms: in isolated ethnic groupsSimpler forms: in isolated ethnic groups Traditional medicine as supplementary Traditional medicine as supplementary

treatments provided by other health professionals treatments provided by other health professionals Practitioner regulation: Chinese medicine Practitioner regulation: Chinese medicine

practice has been regulated in the State of practice has been regulated in the State of VictoriaVictoria ( (wwwwww.cmrb.vic.gov.cmrb.vic.gov.au.au))

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TTypes of Education ypes of Education NeededNeeded

Quality training for primary Chinese medicine Quality training for primary Chinese medicine practitioners and continuing educationpractitioners and continuing education

Medical and other healthcare professions need Medical and other healthcare professions need adequate knowledge and skills to understand adequate knowledge and skills to understand potential benefits and risks of Chinese medicinepotential benefits and risks of Chinese medicine

Public education related to benefits and risks of Public education related to benefits and risks of traditional medicines, in particular, concurrent traditional medicines, in particular, concurrent use of Chinese and western medicinesuse of Chinese and western medicines

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CM Tertiary Higher Education CM Tertiary Higher Education in Australia, UK, US and in Australia, UK, US and CanadaCanada

AustraliaAustraliaRMITRMIT University (5 years double degree program) University (5 years double degree program)

Victoria University of Technology (BHlthSc, 4 years)Victoria University of Technology (BHlthSc, 4 years)

University of Western Sydney (BApplSc, 4 years)University of Western Sydney (BApplSc, 4 years)

University of Technology, Sydney (BHlthSc, 4 years)University of Technology, Sydney (BHlthSc, 4 years)

UKUK (Fully BAAB Accredited Teaching Institutions only)(Fully BAAB Accredited Teaching Institutions only)

Middlesex University (Bsc Honours, 4 years)Middlesex University (Bsc Honours, 4 years)

University of Salford (Bsc Honours, 3 years)University of Salford (Bsc Honours, 3 years)

University of Westminster (Bsc Honours, 3 years)University of Westminster (Bsc Honours, 3 years)

University of Lincoln (Bsc Honours, 3 years)University of Lincoln (Bsc Honours, 3 years)

College affiliated to universities (6 accredited)College affiliated to universities (6 accredited)

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CM Tertiary Higher Education CM Tertiary Higher Education in Australia, UK, US and in Australia, UK, US and CanadaCanada

USUS48 colleges accredited by The Accreditation Commission for 48 colleges accredited by The Accreditation Commission for Acupuncture and Oriental Medicine (Sept. 06)—Master’s Acupuncture and Oriental Medicine (Sept. 06)—Master’s degree and Master’s level programsdegree and Master’s level programs Approx. 80% (98 of the 126) medical schools in the US Approx. 80% (98 of the 126) medical schools in the US included some CAM courses (2003)included some CAM courses (2003)

CanadaCanadaBeijing University of Chinese Medicine (Canadian Education Beijing University of Chinese Medicine (Canadian Education Centre)Centre)

Shanghai TCM College of BC, CanadaShanghai TCM College of BC, Canada

Alberta College of Acupuncture and Traditional Chinese Alberta College of Acupuncture and Traditional Chinese Medicine Medicine

Ontario College of Traditional Chinese MedicineOntario College of Traditional Chinese Medicine

……

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Less than two thirds (60.4%) for the purpose of Less than two thirds (60.4%) for the purpose of treating medical conditions, approx. 40% for treating medical conditions, approx. 40% for general health and well-being onlygeneral health and well-being only

The most common conditions being treated were The most common conditions being treated were cold and flu (11.6%) and energy (qi) related cold and flu (11.6%) and energy (qi) related problems (8.5%). CHM users mentioned at least problems (8.5%). CHM users mentioned at least 30 different conditions that being treated by CHM30 different conditions that being treated by CHM

Rationale of using Rationale of using CHMCHM

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Vast majority (92.0%) for the purpose of Vast majority (92.0%) for the purpose of treating medical conditions, 8.0% was for treating medical conditions, 8.0% was for general health and well-being only general health and well-being only

The most common conditions being The most common conditions being treated were back pain and related treated were back pain and related problems (20.7%), shoulder pain and problems (20.7%), shoulder pain and problems (15.5%), arthritis (8.5%) and problems (15.5%), arthritis (8.5%) and injury (7.0%)injury (7.0%)

Rationale of using Rationale of using acupunctureacupuncture

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Chinese Medicine Chinese Medicine EducationEducation ½ ½ century in the Chinese higher education century in the Chinese higher education

system system From one uniform system to more flexible From one uniform system to more flexible What can we learn from China’s experienceWhat can we learn from China’s experience Understanding education needs in a Understanding education needs in a

Western country such as AustraliaWestern country such as Australia Developing programs that address the local Developing programs that address the local

issues: healthcare systems, regulatory issues: healthcare systems, regulatory matters, etc.matters, etc.

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WHO Expert Meeting on Traditional WHO Expert Meeting on Traditional Medicine Education QA, Melbourne Medicine Education QA, Melbourne

20032003

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General medical education General medical education principles principles (WHO 2001)(WHO 2001)

– Combination of knowledge, skills and attitudesCombination of knowledge, skills and attitudes Difficult to define concrete list of factual knowledge,

practical skills and attitudes

– Encourages Self-Directed Learning (SDL) and Encourages Self-Directed Learning (SDL) and some in depth studiessome in depth studies

– Emphasizes sufficient clinical trainingEmphasizes sufficient clinical training– Emphasizes study in disease preventionEmphasizes study in disease prevention– Encourages students to be enquiring, Encourages students to be enquiring,

analytical, and to develop professional analytical, and to develop professional attitudesattitudes

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General objectives General objectives for for primary healthcare primary healthcare practitioner training practitioner training ((WHO WHO June June 2002004: Reporting on Working Group Meeting 4: Reporting on Working Group Meeting on Quality of Academic Education in Traditional on Quality of Academic Education in Traditional Medicine Medicine ))

To produce broadly educated traditional medicine To produce broadly educated traditional medicine practitioners with an practitioners with an appropriate foundation for general appropriate foundation for general health practicehealth practice

KKnowledge, skills and attitudesnowledge, skills and attitudes in traditional medicines in traditional medicines and and scientific principles scientific principles

Ability to Ability to practice independently, safely, ethically and practice independently, safely, ethically and effectively, with continuing educationeffectively, with continuing education

EmphasiEmphasisses sufficient clinical traininges sufficient clinical training and adapting an and adapting an evidence-based approachevidence-based approach in clinical practice in clinical practice

Encourages students to be enquiring, analytical, and to Encourages students to be enquiring, analytical, and to be responsive to changing needsbe responsive to changing needs

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Points for Consideration: Points for Consideration: Chinese Medicine Programs Chinese Medicine Programs (1)(1) CM is not in isolation:CM is not in isolation: concurrent use of concurrent use of modalitiesmodalities

Unique characteristics and integrity of Unique characteristics and integrity of CM theoretical framework should be CM theoretical framework should be preserved:preserved: a common problema common problem

Balance between western and CMBalance between western and CM:: integration is encouraged to meet public integration is encouraged to meet public expectationsexpectations

Complementarities between Western Complementarities between Western and CM in clinical practice:and CM in clinical practice: selection of selection of treatment options based on evidence, treatment options based on evidence, affordability and accessibilityaffordability and accessibility

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Chinese Medicine Programs (2)Chinese Medicine Programs (2)

Clinical training should be adequateClinical training should be adequate:: availability of facilities availability of facilities

Critical thinking and research skills should Critical thinking and research skills should be embedded:be embedded: EBM and EBCM EBM and EBCM

Adoption of recent advances of teaching Adoption of recent advances of teaching technologies and innovative curriculum technologies and innovative curriculum design to enhance learning outcomes and design to enhance learning outcomes and learning efficiency:learning efficiency: outcome measuresoutcome measures

Learning from the past forms the basis of Learning from the past forms the basis of future success:future success: literature and future research literature and future research planning planning

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Definition of ‘Curriculum’Definition of ‘Curriculum’

Curriculum’ is defined as:

“all the arrangements the institution makes for student learning and development and research. This includes the content of the course, student activities, teaching approaches, and the ways in which the teaching and learning is organised. It also includes decisions on the need for and use of facilities.”*

*Adapted from the Osteopaths Registration Board of Victoria Accreditation Policy: Procedures and Guidelines for Accreditation of Osteopathic Programs, February 2000.

2020

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Educational standards Educational standards endorsed by the registration endorsed by the registration board/associationboard/association Guidelines for the Guidelines for the

Approval of Courses of Approval of Courses of Study in Chinese Medicine Study in Chinese Medicine as a Qualification for as a Qualification for RegistrationRegistration (CMRB, VIC) (CMRB, VIC)

Australian Guidelines for Australian Guidelines for Traditional Chinese Traditional Chinese Medicine EducationMedicine Education.. AustralianAustralian

Acupuncture and Acupuncture and Chinese Medicine Chinese Medicine Association. Association.

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CMRBVic Standards for Course CMRBVic Standards for Course ApprovalApproval

1.1. Graduate knowledge, Skills and Graduate knowledge, Skills and AttributesAttributes

a)a) Theoretical knowledgeTheoretical knowledgeb)b) Clinical SkillsClinical Skillsc)c) Practice Management and Interpersonal SkillsPractice Management and Interpersonal Skillsd)d) Professional Ethics and ValuesProfessional Ethics and Values

2.2. Course Structure and OperationCourse Structure and Operationa)a) Aim of CourseAim of Courseb)b) Philosophy and ObjectivesPhilosophy and Objectivesc)c) Course DocumentationCourse Documentationd)d) Unit DocumentationUnit Documentatione)e) Teaching and Learning MethodsTeaching and Learning Methodsf)f) AssessmentAssessmentg)g) Student Selection CriteriaStudent Selection Criteria

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CMRBVic Standards for Course CMRBVic Standards for Course Approval (continued)Approval (continued)

3.3. Course ManagementCourse Managementa)a) Institutional SupportInstitutional Supportb)b) Organisation StructureOrganisation Structurec)c) Course DevelopmentCourse Developmentd)d) Support for Research Support for Research e)e) Review and EvaluationReview and Evaluation

4.4. Resources and Physical EnvironmentResources and Physical Environmenta)a) FundingFundingb)b) Work EnvironmentWork Environmentc)c) Student SupportStudent Supportd)d) Staff Qualifications and SkillsStaff Qualifications and Skillse)e) Teaching FacilitiesTeaching Facilitiesf)f) Clinical Facilities and PlacementsClinical Facilities and Placements

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CMRBVic Standards for Course CMRBVic Standards for Course Approval (continued)Approval (continued)

5.5. Curriculum Curriculum a)a) Program LengthProgram Length

i.i. Four academic years (8 semesters full time study)Four academic years (8 semesters full time study)ii.ii. 500-800 hours supervised practical clinical training 500-800 hours supervised practical clinical training

b)b) Relative Weighting Relative Weighting c)c) Modes of DeliveryModes of Delivery

i.i. A substantial proportion of face-to-face educationA substantial proportion of face-to-face educationii.ii. Encourage innovation in the delivery of coursesEncourage innovation in the delivery of courses

d)d) Theory and Clinical StudiesTheory and Clinical Studiese)e) Biomedical and other SciencesBiomedical and other Sciencesf)f) Clinical Training in Chinese MedicineClinical Training in Chinese Medicineg)g) Practice ManagementPractice Managementh)h) Professional Values and BehaviourProfessional Values and Behaviour

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Developing a capability based Developing a capability based curriculum:curriculum:

Capability enables one to respond to Capability enables one to respond to NEW & CHANGING circumstances NEW & CHANGING circumstances

(Stephenson J & Yorke M 1998)(Stephenson J & Yorke M 1998)

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What is capability?What is capability?

– Is an integration of knowledge, skills, Is an integration of knowledge, skills, personal qualities and understanding personal qualities and understanding used appropriately and effectivelyused appropriately and effectively

– More than just highly focused More than just highly focused specialist contextsspecialist contexts

– But in response to NEW & But in response to NEW & CHANGING circumstances CHANGING circumstances

(Stephenson J & Yorke M 1998)(Stephenson J & Yorke M 1998)

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Evidence of capabilityEvidence of capability

Act effectively & appropriatelyAct effectively & appropriately Explain whyExplain why Live and work effectively with Live and work effectively with

othersothers Learn as an individual or with Learn as an individual or with

others in unfamiliar situations others in unfamiliar situations (Stephenson 1992)(Stephenson 1992)

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Core Graduate Core Graduate Capabilities of Chinese Capabilities of Chinese Medicine Education: A Medicine Education: A Practitioner-Based Survey Practitioner-Based Survey in Victoriain Victoria

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Overall capabilities for CM Overall capabilities for CM PractitionersPractitioners

CM practitioners are primary health CM practitioners are primary health care professionalscare professionals

They are required to practice CM at an They are required to practice CM at an accepted level and in a professional accepted level and in a professional mannermanner

Act as an effective member in a Act as an effective member in a multidisciplinary health care system multidisciplinary health care system

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Capabilities required to ensure Capabilities required to ensure safe and effective practice of CMsafe and effective practice of CM

Technical capabilities (12)Technical capabilities (12) Communication capabilities (4)Communication capabilities (4) Responsible and sustainable Responsible and sustainable

practice (6)practice (6) Research and information Research and information

management (6)management (6)

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Technical capabilities (an Technical capabilities (an example)example)

– to apply Chinese medicine principles to apply Chinese medicine principles and diagnosis skills and diagnosis skills

– to formulate a herbal prescription or to formulate a herbal prescription or make modifications make modifications

– to develop a treatment plan including to develop a treatment plan including time-lines for treatment and review …time-lines for treatment and review …

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OverviewOverview Questionnaires were sent to Questionnaires were sent to all registered CM all registered CM

practitioners in Victoria (n=714)practitioners in Victoria (n=714) 228 valid questionnaires were received (response 228 valid questionnaires were received (response

rate=31.9%), of these, rate=31.9%), of these, 55.8% are male and 44.2% 55.8% are male and 44.2% are female.are female.

Characteristics of survey participants are Characteristics of survey participants are considered to be representative: considered to be representative: – 98.2% practice acupuncture, 98.2% practice acupuncture, – 71.0% practice Chinese herbal medicine, 71.0% practice Chinese herbal medicine, – 60.3% practice Chinese therapeutic massage and,60.3% practice Chinese therapeutic massage and,– 45.7% practice Chinese medicine dietary therapy.45.7% practice Chinese medicine dietary therapy.– Bachelor degree or above (75.0%)Bachelor degree or above (75.0%)– Nearly half (46.1%) practiced Chinese medicine >=10 Nearly half (46.1%) practiced Chinese medicine >=10

years.years.– Nearly two quarters (59%) have never practiced overseas, Nearly two quarters (59%) have never practiced overseas,

whereas15.3% have practiced overseas for 10 years or whereas15.3% have practiced overseas for 10 years or more. more.

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Results: mean score of technical Results: mean score of technical capabilitiescapabilities

MeaMeann

95%95%CICI MeanMean 95%95%CICI

T1T1 4.334.33 (4.22-4.43)(4.22-4.43) T7T7 4.014.01 (3.88-4.14)(3.88-4.14)T2T2 4.334.33 (4.21-4.45)(4.21-4.45) T8T8 4.434.43 (4.33-4.52)(4.33-4.52)T3T3 4.754.75 (4.68-4.82)(4.68-4.82) T9T9 4.284.28 (4.16-4.40)(4.16-4.40)T4T4 4.734.73 (4.67-4.79)(4.67-4.79) T10T10 4.764.76 (4.69-4.82)(4.69-4.82)T5T5 4.344.34 (4.22-4.45)(4.22-4.45) T11T11 4.254.25 (4.14-4.35)(4.14-4.35)T6T6 4.084.08 (3.96-4.19)(3.96-4.19) T12T12 4.134.13 (4.00-4.26)(4.00-4.26)

An ability to give nutrition and dietary and preventive medicine advice in terms of CM knowledge for all areas of CM

An ability to perform acupuncture treatment procedures and/or prepare and dispense a Chinese herbal prescription

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Mean score of other Mean score of other capabilitiescapabilities

MeanMean 95%95%CICI MeanMean 95%95%CICI

C1C1 3.933.93 (3.82-4.05)(3.82-4.05) R5R5 4.374.37 (4.27-4.4(4.27-4.48)8)

C2C2 4.074.07 (3.96-4.18)(3.96-4.18) R6R6 4.624.62 (4.54-4.7(4.54-4.70)0)

C3C3 4.014.01 (3.89-4.12)(3.89-4.12) Re1Re1 3.943.94 (3.82-4.0(3.82-4.06)6)

C4C4 3.993.99 (3.87-4.11)(3.87-4.11) Re2Re2 3.483.48 (3.35-3.6(3.35-3.61)1)

R1R1 4.044.04 (3.91-4.16)(3.91-4.16) Re3Re3 3.593.59 (3.46-3.7(3.46-3.71)1)

R2R2 4.624.62 (4.53-4.70)(4.53-4.70) Re4Re4 3.673.67 (3.54-3.8(3.54-3.80)0)

R3R3 4.114.11 (3.98-4.23)(3.98-4.23) Re5Re5 3.053.05 (2.90-3.1(2.90-3.19)9)

R4R4 3.753.75 (3.62-3.89)(3.62-3.89) Re6Re6 3.213.21 (3.08-3.5(3.08-3.50)0)

An ability to practice within regulatory/ ethical/safety frameworks

An ability to develop a research protocol

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Further professional Further professional developmentdevelopment

Short courses in CM to update clinical knowledge Short courses in CM to update clinical knowledge and skills: 61.9%and skills: 61.9%

Research studies to specialise in one or more areas Research studies to specialise in one or more areas to enhance practice: 44.6%to enhance practice: 44.6%

Postgraduate studies to gain further qualifications: Postgraduate studies to gain further qualifications: 37.4% 37.4%

Short courses in Western medical sciences to Short courses in Western medical sciences to ensure safe practice: 23.4%ensure safe practice: 23.4%

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Research informs educationResearch informs education

Are distal points efficacious for TTH?Are distal points efficacious for TTH? (Xue et al (Xue et al

HeadacheHeadache 2004;44:333-341) 2004;44:333-341)

– Significantly improved headache frequency, duration, Significantly improved headache frequency, duration, pain intensity, pain threshold, sickness impact scorespain intensity, pain threshold, sickness impact scores

– Conclusion: EA to distal points alone is effective for Conclusion: EA to distal points alone is effective for short-term symptomatic relief of TTH.short-term symptomatic relief of TTH.

Combining Acupuncture and CHM for SAR: Combining Acupuncture and CHM for SAR: No additional effectNo additional effect (Xue et al HKMJ 2003;9:427-434)(Xue et al HKMJ 2003;9:427-434) – Acupuncture or CHM alone was effective Acupuncture or CHM alone was effective (separate (separate

publications)publications)

– Systematic review on CHM: effective Systematic review on CHM: effective (Xue et al Current (Xue et al Current Medicinal Chemistry 2004;11:1403-1421)Medicinal Chemistry 2004;11:1403-1421)

– Combined the two, did not produce any additional benefitsCombined the two, did not produce any additional benefits

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Incorporation of research findings into Incorporation of research findings into curriculum and teaching materialscurriculum and teaching materials– Is Chinese medicine effective for SAR and PAR?Is Chinese medicine effective for SAR and PAR?– What treatment protocol should be adapted?What treatment protocol should be adapted?– Duration of treatment: acupuncture Vs CHMDuration of treatment: acupuncture Vs CHM

Promote EBCM development:Promote EBCM development: – Level of evidence: limited evidence availableLevel of evidence: limited evidence available– Searching for historical/traditional evidenceSearching for historical/traditional evidence– Evaluating low level evidence: instrument Evaluating low level evidence: instrument

development development – Disseminating evidence: database developmentDisseminating evidence: database development– See See www.chinesemdicnewww.chinesemdicne.com.com

Education reflects research

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Chinese Medicine Portal

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Challenges and solutions Challenges and solutions (1)(1)

ChallengesChallenges Solutions/ProgressSolutions/ProgressUnderstanding the community Understanding the community needs, this may vary needs, this may vary significantly significantly

Ongoing monitoring use of CM Ongoing monitoring use of CM by specific communities by specific communities

Setting basic training for safe Setting basic training for safe practicepractice

WHO initiative for developing WHO initiative for developing the guidelines, with the guidelines, with understanding of different understanding of different needs, balance between CM and needs, balance between CM and WM WM

Growing concerns about quality Growing concerns about quality of graduates’ capabilities of of graduates’ capabilities of working in complex healthcare working in complex healthcare systemssystems

WHO WPRO has developed WHO WPRO has developed Guidelines for this: QA Guidelines for this: QA processesprocesses

Limitation of teaching Limitation of teaching resources: English materials, resources: English materials, teaching staff, teaching teaching staff, teaching facilities/technology, clinical facilities/technology, clinical supervisionsupervision

Chinese PMPH Project, Chinese PMPH Project, institutional collaboration, institutional collaboration, online teaching etconline teaching etc

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Challenges and solutions Challenges and solutions (2)(2)

ChallengesChallenges Solutions/ProgressSolutions/ProgressTerminologies Terminologies WHO WPRO project, near WHO WPRO project, near

completioncompletion

Standardisation of practice with Standardisation of practice with an evidence-based approachan evidence-based approach

WHO WPRO project, excellent WHO WPRO project, excellent progress; RMIT Project of progress; RMIT Project of evaluating case series studiesevaluating case series studies

Concerning quality, efficacy and Concerning quality, efficacy and safety of productsafety of product

WHO WPRO FHH project, WHO WPRO FHH project, excellent progressexcellent progress

Adaptation of an evidence-Adaptation of an evidence-based approach in clinical based approach in clinical practicepractice

Capability building: students, Capability building: students, staff, researchers and staff, researchers and international expertise sharinginternational expertise sharing

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Acupuncture Practice in a Public Hospital

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Summary/CommentsSummary/Comments The setting of CM practice in Australia and The setting of CM practice in Australia and

other countries is substantially different from other countries is substantially different from ChinaChina

CM is not in isolation and expectation of CM CM is not in isolation and expectation of CM practitioners is significantly higher in the practitioners is significantly higher in the areas of biomedical science and clinical skillsareas of biomedical science and clinical skills

Education should reflect research findings Education should reflect research findings Research should inform educationResearch should inform education Standardization, EBM and integration are the Standardization, EBM and integration are the

major challengesmajor challenges Capabilities of graduates should be the main Capabilities of graduates should be the main

focus on program development in CMfocus on program development in CM International collaborationInternational collaboration

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CommentsComments

Leadership role of international Leadership role of international organisations in this development organisations in this development such as WHO and major professional such as WHO and major professional associationsassociations

Future directions: mutual Future directions: mutual recognitions, specialisation, effective recognitions, specialisation, effective application of teaching technologyapplication of teaching technology

The role of continuing professional The role of continuing professional developmentdevelopment

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