A clinical elective on traditional, complementary and integrative medicine (TCIM) for undergraduate medical students in Germany: A pre-post survey evaluation

Traditional, Complementary and Integrative Medicine (TCIM) combines conventional treatments with evidence-based complementary therapies. Despite growing interest, TCIM is still underrepresented in medical curricula, limiting students’ exposure. This study evaluated an interactive TCIM course for medical students, aiming to enhance understanding and engagement with integrative approaches. To evaluate student acceptance of a TCIM clinical elective and to assess pre-post changes in TCIM-related attitudes and self-reported engagement, complemented by qualitative analysis of students’ expectations and reflections, we conducted a pre-post survey-based evaluation of a two-week clinical elective for undergraduate medical students in Germany using validated psychometric instruments and closed- and open-ended items. The primary evaluation endpoint was students’ overall assessment of the elective collected post-course (T1). Secondary outcomes included pre–post changes in attitudes toward complementary and integrative medicine. Online questionnaires were administered at course start (T0) and end (T1). Quantitative data were analyzed exploratorily using Wilcoxon signed-rank tests with effect sizes, and open-text responses were analyzed using qualitative content analysis. Ninety-seven students (75 women, 22 men; mean age 26.1 ± 6.1 years) were included. The elective was rated 1.8 ± 0.9. Both CHBQ and TCIMQ scores showed moderate changes (CHBQ: 2.0 ± 5.48, p<0.001, d=0.29; TCIMQ: -2.0 ± 4.64, p<0.001, d=0.49), indicating a shift toward greater acceptance of TCIM. Qualitative pre-course data revealed diverse prior experiences and motivations, ranging from curiosity to professional aspirations. Post-course evaluations highlighted increased openness, a greater willingness to integrate TCIM into daily and professional life, and improved recognition of scientific evidence. The course was well received and led to measurable changes in students’ attitudes. Combining clinical exposure with structured reflection fostered greater openness toward integrative approaches and a nuanced understanding of scientific evidence. These findings suggest that incorporating TCIM into medical education may strengthen students’ competencies in evidence-informed, patient-centered care. • Pre–post survey evaluation of a clinical elective in Traditional, Complementary and Integrative Medicine (TCIM). • The elective was well accepted and associated with greater openness toward TCIM among participating medical students. • Quantitative outcomes (CHBQ, TCIMQ) captured changes in attitudes and self-reported engagement with TCIM. • Qualitative findings highlighted the value of hands-on, discussion-based, and evidence-informed teaching formats. • Structured TCIM electives may support evidence-informed communication, reflection, and referral-related competencies in medical education.