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Clinic Internship and Training


PURPOSE OF THE COURSE

Clinical Training and Internship provide very essential supervised, practical experience and is constantly emphasized throughout the program. It is here that the student becomes a true practitioner of Chinese medicine. This understanding goes to the heart of the philosophy that there is an essential unity of thought and action: "Knowledge is the beginning of action, and action is the completion of knowledge. Learning to be a sage involves only one effort. Knowledge and action should not be separated.” (Wang Yang-Ming) Each student will be required to take responsibility to discover his own truths and abilities in diagnostics, needling, and treatment techniques, ethics, and practice management. Clinical Training and Internship provide valuable hands-on experience and education that complements the academic side of the Master of Acupuncture and Oriental Medicine Degree program. This practice is required by WMI to qualify for graduation and to satisfy state and national requirements. Through clinical practice, a student becomes a true practitioner of Chinese medicine. Students complete 960 hours of clinical training in Acupuncture and Oriental Medicine in order to fulfill WMI Master of Acupuncture and Oriental Medicine Degree requirements. During this time, students must also perform at least 350 supervised patient treatments.

COURSE EDUCATIONAL OBJECTIVES

The course will enable students to formulate accurately an Acupuncture and Oriental Medicine diagnosis, to determine an effective treatment strategy based upon the diagnosis formulated; to assess the effectiveness of the treatment strategy and its execution; to enable students to prescribe and formulate correctly an herbal medicine treatment, to determine an effective herbal formula based upon the diagnosis, and to assess the effectiveness of the herbal treatment strategy and its execution; to prepare students for Hawai'i State Board of Acupuncture Licensure, National Certification in Acupuncture and National Certification in Herbal Medicine and enable graduates to set up and maintain successful professional practice of Acupuncture and Oriental Medicine.


CLINICAL TRAINING & INTERNSHIP CLASSIFICATIONS

Clinical Training and Internship is composed of Clinic Observation and Clinic Intern. The successful completion of each preceding level is prerequisite to advancing to the next level of the program.

CLINIC OBSERVATION
During the first semester students come to the clinic for an introduction to clinical protocol and procedures. Through observation, students will accumulate practical experience and develop an appreciation for both the art and science of acupuncture. Students first learn clinic tasks and duties that provide for efficient and effective treatment. Students check-in patients and show them to their room, learn moxibustion and cupping techniques, learn how to properly dispose of acupuncture needles and learn sterilizing techniques, assist in the general cleaning of the clinic.

During the second semester students continue accompanying either a licensed acupuncturist or an acupuncture intern in the clinic and help in the preparation and dispensing of herbal prescriptions. Students train to take patient medical history, to do rudimentary pulse and tongue diagnosis, and to properly remove acupuncture needles from patients. Students also learn human service skills. Sometimes patients, because of their pain and illness, are difficult or ill-tempered. Students must learn to be patient, kind, and sympathetic. Students are taught to respect patient's privacy, while at the same time making them feel welcome and comfortable. While assisting the acupuncturists, supervising acupuncturists discuss a case as it presents itself, so that students can develop an appreciation for the art and science of diagnosis and treatment.

COURSE OBJECTIVES
This program is designed to train students in the following:
  • Learning of Relevant Clinical Protocol and Procedures
  • Learning About Equipment and Safety
    • Needles: Gauges, Types, Selection, Replacement, Inspection
    • Other Equipment: Cups, Moxa, Seven Star, etc.
    • Clean Needle Technique & Sterilization: Necessity and Various Methods
    • Relevant State and Federal Regulations Concerning Equipment & Safety
    • Avoiding Harm from Typical Procedures: Needling, Moxa, Cupping, etc.
    • First Aid & Fainting During Treatment
    • Personal and Office Cleanliness and Hygiene
  • Integration of TCM, Taoist Medicine, Herbal Medicine, and Biomedical semester concepts into patient care
  • Clinical application and practice of classroom learning, clinical theories and skills
  • Steadily increasing self-confidence and professional poise
  • Diagnostic Skills and Treatment Planning in Acupuncture and Oriental Medicine
    • History Taking / Charting
    • Methods of Observation, Audio-Olfaction, Inquiry, Palpation, and Differential Diagnosis
    • Measuring and Recording of Vital Signs, i.e. Pulse Rate

CLINIC OBSERVATION COMPETENCIES
Through this program students will acquire professional competency in:
  • Clinical Protocols and Procedures
  • Utilization of Skills Appropriate for Preparation of Tools and Instruments
  • Accumulation of Practical Clinic Experience Through Observation
    • Collecting Data and Formulating a Diagnosis
    • Observation -Noting the Spirit, Color, Body Structure, Tongue, Symptom Site, and Patient’s Complexion; Olfactory Examination - Odor of the Patient's Body and Patient's Secretions, Discharges and Breath
    • Audio Examination - Sound of Patient's Voice, Abdominal Sounds, Respiration and Cough Quality Palpation - Noting the Temperature, Moisture, Texture, Sensitivity, Tissue Structure, Rhythms and Qualities of the Abdomen, Chest, Ear, Channels and Points, and Radial and Regional Pulses
    • Inquiry - Asking General Questions, Questions about Medical History, Chief and Secondary Complaints, Sleep Patterns, Excretions, Thirst and Appetite, Digestion, Nutritional Levels and Patterns, Medications, Chills and/or Fever, Perspiration, Pain, Emotional State, Life Style, Exercise, Use of Alcohol, Tobacco, and Drugs, Reproductive Cycles and Menstruation, Leucorrhoea, Sensations of Heat, Cold, Dizziness, Tinnitus, Palpitations and Chest Constriction
    • Physical Examination Adjuncts - such as Akabane and Electrical Conductivity
    • Utilization of Skills Appropriate for Preparation of Tools and Instruments
    • Accumulation of Practical Clinic Experience Through Assistance
    • Complying with Practices as Established by the Profession
    • Learning how to Take Patient Medical History; Maintaining Patient Confidentiality
    • Cultivation of Compassion
CLINIC INTERN
Students in their third semester have had sufficient theory, observation and practice to begin to take responsibility for patient care during their Clinic Training. Students begin Herbal Clinic Internship and integrate their knowledge and utilize concepts presented in Traditional Chinese Medicine Theory, Taoist Medicine, Herbal Medicine, and Biomedical Clinical Sciences with the observations they are making in Clinic. Students devise treatment plans, apply relevant technique and perform treatment under supervision. Students develop correct, effective application of theories and techniques, acquiring wisdom and mastery through practical experience. Together, students learn, develop, and share in clinical knowledge and experience. Intern permits are required by each student.

Clinic Interns perform a minimum of 350 supervised treatments incorporating acupuncture, diet, and herbal therapy. Students develop sensitivity, awareness of protocol, and professional standards and ethics. The spiritual discipline of Taoism and the practice of Chi Kung have given them an extradimensional insight and intuitive awareness into the unique needs of patients. Within this healing milieu, students have learned how to creatively personalize and tailor therapies for effective case management. Knowledge and its practical application are unified, and the students are ready to become independent practitioners. During this part of our program, all the skills learned are fully utilized and students manage all aspects of running a clinical practice, from keeping patient records up to date to collecting fees, developing the skills to begin their own practices. Students gain valuable knowledge and clinical experience in a professional clinic setting including: practice management, patient protocol, handling difficult cases, completing a student's preparation for independent practice.

COURSE OBJECTIVES
This program is designed to train students in the following:
  • Developing Confidence in Treatment Planning
    • Methods and systems for planning, carrying out and evaluating a treatment
    • Recognition of Symptoms Requiring Referrals, including Infectious Disease
    • Methods and Systems for Planning, Carrying Out and Evaluating a Treatment
    • Prognosis and Contraindications of Treatment
    • Consideration of Special Factors or Symptoms Indicating Potential for Increased Risk to the Patient (Immune Compromised Patient, Diabetic Patient), the Need to Modify Standard Therapeutic Approach (Infants and Children, Pregnancy), and Apparently Benign Presentations that may have a More Serious Cause (Hypertension, Headaches)
  • Performing Treatment by Applying Appropriate Techniques Under Supervision
    • Needle insertion: depth, duration, manipulation and withdrawal
    • Moxa: application, direct and indirect, etc.
    • Other techniques (e.g. moxibustion, cupping, gua sha)
    • Safety Issues
  • Begin Preparation for Independent Practice Further, develop and refine professional skills developed in Clinical Internship
  • Serve the community by providing low cost health care
  • Develop confidence, competencies, and poise for future independent practice
  • Complete preparation and training for independent practice
  • Counseling and Communication Skills
    • Communications Skills: Listening, Counseling, Explaining, and Teaching
    • Managing Psychological Reactions That May Arise During Treatment and Making Appropriate Referrals
    • The Availability of Additional Appropriate Modalities For Patient Referral and the Ability to Communicate with Other Health Professionals Regarding Patient Care
CLINIC INTERNSHIP COMPETENCIES
Through this program students will acquire professional competency in:
  • Performing Treatment by Applying Appropriate Techniques
    • Proper Sterilization and Aseptic Procedures
    • Preparation of the Patient, including Proper Positioning for Application of Techniques
    • Effective Communication with Patients Regarding the Nature of Illness and Treatment Plan
    • Accurate Location of Acupoints, Safe and Effective Needle Insertion Techniques Based on Point Function, Recommended Needling Depths, Underlying Anatomy at the Site, Desired Effect of Needling, and Nature of the Illness
    • Protocols in Compliance with NCCAOM Guidelines on Sanitation, Asepsis, and Clean Needle Handling
    • Safe and Effective Application of Adjunctive Techniques, Moxibustion, and Manipulation
    • Effective Control of Emergency Situations
  • Assessing Effectiveness of the Treatment Strategy and its Execution
    • Re-examination of the Patient; Comparing with Previous Condition and Expectations; Modifying of the Treatment Plan, if required, based upon that statement
    • Recognizing Situations Where the Patient Requires Emergency or Additional Care, or Care by Practitioners of Other Healthcare (or Medical) Modalities, and to Refer Such Patients to Whatever Resources are Appropriate to their Care and Well-Being
  • Performing Treatment by Applying Appropriate Techniques
    • Proper Sterilization and Aseptic Procedures
    • Preparation of the Patient, including Proper Positioning for Application of Techniques
    • Effective Communication with Patients Regarding the Nature of Illness and Treatment Plan
    • Accurate Location of Acupoints, Safe and Effective Needle Insertion Techniques Based on Point Function, Recommended Needling Depths, Underlying Anatomy at the Site, Desired Effect of Needling, and Nature of the Illness
    • Protocols in Compliance with NCCAOM Guidelines on Sanitation, Asepsis, and Clean Needle Handling
    • Safe and Effective Application of Adjunctive Techniques, Moxibustion, and Manipulation
    • Effective Control of Emergency Situations
  • Determining Treatment Strategy Based on Diagnosis Formulated
    • The Availability of Additional Appropriate Modalities for Patient Referral
    • The Ability to Communicate with Other Health Professionals Regarding Patient Care, Utilizing Commonly Understood Medical Terminology
  • Complying with Practices as Established by the Profession
    • Application of a Code of Ethics
    • Maintenance of Personal Development by Continued Cultivation of Compassion
    • Recognize Situations Where the Patient Requires Emergency or Additional Care, and to Refer Such to Whatever Resources are Appropriate to Their Care and Well-Being
    • Appropriately Utilize Relevant Biomedical Clinical Science Concepts and Understandings to Enhance the Quality of Oriental Medical Care Provided
    • Protect the Health and Safety of the Patient and the Health Care Provider Related to Infectious Diseases, And Other Issues Relevant to Blood Borne and Surface Pathogens
  • Making a Diagnosis/Energetic Evaluation By:
    • Identifying Position, Nature and Cause of the Dysfunction, Disorder, Disharmony, Vitality and Constitution Based on Knowledge of Distinctive Patterns of Disharmony and Recognition of Medical Emergencies
  • Assessing the Effectiveness of Treatment Strategies and Their Execution, Effectiveness of Herbal Treatments
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