Core Curriculum Requirements
MEMO

From: Sylla Sheppard-Hanger and Michael Kirk-Smith
To: The education committees of the major international aromatherapy organizations

We suggest here that the aromatherapy organizations' recommended syllabi need to have some required training in Evaluation/Research Methods (tailored, of course, to be at an appropriate level and form for aromatherapy).

THE SITUATION

1. All the formal clinical/therapeutic disciplines have such requirements as part of their training (all areas of medicine, nursing, physiotherapy, occupational therapy, etc). It is simply understood that it is an ethical obligation or duty of anyone offering a therapy to "remove what doesn't work and improve what does work". Since this means evaluation of treatments, appropriate training has to be given to those who give the treatments.
2. Such training would show that aromatherapy is ethically based in the same way - without it there remains a query over aromatherapists seriousness as a professionally constituted discipline. If the methods weren't there aromatherapy would have an excuse to ignore this issue, but the methods are there - so we are obliged to offer them, like any other therapeutic discipline.
3. If aromatherapists don't do evaluation of their treatments, who will?
4. If you don't make a show of training aromatherapists in evaluation, then the regulatory bodies will wonder why not. This strikes of negligence. "Evidence-based medicine" is now what is expected of any clinical discipline/therapy (i.e., proper published research studies). Aromatherapy will be seriously questioned if it doesn't show moves towards this.

The two reasons that others (e.g., regulatory and academic bodies, medical, paramedical professions and government) will infer if you don't show that you are attempting to "remove and improve" in Aromatherapy practice are either:

1. deliberate prevention of evaluation for financial reasons, or,
2. simple negligence, through ignorance of the ethical obligations of a therapeutic discipline.

Either way, it looks very bad.

5. By training all aromatherapists in evaluation, we will soon have a "critical mass" of people who can both understand and work together on agreed protocols, e.g., each treats one or two clients - so that effort can be spread and good and sufficient publishable data rapidly acquired.

THE PROBLEM

Aromatherapists have very little idea of evaluation and scientific method. It is an embarrassment that the only aromatherapy article (on lavender and insomnia) in a major medical journal was by a nurse who had no research training, no resources or funding and wasn't even an aromatherapist (Hardy et al., The Lancet, 1995).

It is critically important for Aromatherapy, as a discipline, to evaluate its work, so Aromatherapists need to understand a bit about what is involved in evaluation. The basics of doing evaluative research are really not complicated (i.e., being essentially about how to cover the question "What would have happened anyway?"). The main problem is that many people teaching research to nurses, etc., are not researchers and they make it more complicated than it really is - thus alienating students.

THE SOLUTION

Evaluation and scientific method is not so difficult. It's just based on some simple rules. At the moment Aromatherapy just needs to demonstrate that what they do works and this is a simpler question than why (which can come later). Mark Hardy has demonstrated that the studies do not need resources or to be complicated to get published in reputable journals (and thence onto the worldwide databases).

The specifications need to be drawn up: i.e. how many hours will be required in such a module. Also, whether some practical work will be required, e.g., drawing up a proposal, and maybe doing a project (say a single case experimental design but working with others). We can advise on these specs if necessary. We see evaluation and research methods being taught by the creation of modules, e.g.:

1. A teaching module for teachers to use in a live class - (approx. 6 hours,or whatever is decided). We already have series published in the IJA and Nursing Times (see below) which can be used as a basis for a module comprising overheads/Powerpoint with accompanying notes, articles, examples and work materials.
2. A student/researcher module for students (via home study courses) or individuals to use on their own (interested parties, individual researchers, therapists wishing to document their work and publish results, etc.). Anyone will be able then to use these modules to ensure proper research and evaluation in doing studies on aromatherapy. This will not be limited to students or educators. These modules could be provided/published by the AIA, and offered through individual organizations, by drop shipment to teacher/student.

THE BENEFITS TO ORGANIZATIONS

This will then protect Aromatherapy from criticism and would actually get clinical evaluation projects going at last, with associated papers then published in the refereed journals. Demonstration of evidence in this way will inevitably create uptake and acceptance from authorities; indeed, it is the only way it can happen.

Through simple agreements, these projects and papers could then be compiled by individual organizations, and stored as a data bank for future use. Therefore, it is in our best interest to require that Aromatherapy trainees do a module about how to evaluate what they do and to understand basic notions of how research works as part of the syllabus for Aromatherapy. Hopefully this is understood as critical for the future of aromatherapy and more importantly, as essential to improving what we offer patients.

Articles

IJA Series

1. Kirk-Smith, M. and Stretch, D. (1994) Clinical Trials in Aromatherapy I: Writing research proposals and papers. The International Journal of Aromatherapy, 5(4), 28-32.
   
   Covers the structure and standard sections that need to be in a proposal or paper
   
   
2. Kirk-Smith, M. and Stretch, D. (1994) Clinical Trials in Aromatherapy II: Developing research questions. The International Journal of Aromatherapy, 6(1), 32-35.
   
   How to frame your aims and questions sensibly. If these aren’t right then the rest of the study may be pointless. A key aspect.
   
   
3. Stretch, D. and Kirk-Smith, M.(1995) Clinical Trials in Aromatherapy III: Reading and documenting the literature. International Journal of Aromatherapy, 6(3), 30-33.
   
   Explains what counts as "authoritative" literature and how to find and use it.
   
   
4. Kirk-Smith, M.(1996) Clinical Trials in Aromatherapy IV: Planning the Study. The International Journal of Aromatherapy, 7(3), 33-39.
   
   The central article - the first part covers patient samples, intervention, measures, procedure. The second part covers how to overcome the difficulties of case studies by designing the study carefully. The essence of scientific method.
   
   
5. Kirk-Smith, M.(1996) Clinical Trials in Aromatherapy V: Presenting, analysing and discussing the results. The International Journal of Aromatherapy, 8(2), 36-39.
   
   A brief explanation of presentation of data and basic statistics (personally, I "design out" the need for complicated statistics - I think they just confuse things - better to have well posed Aims and thence minimal statistics).
   
   

NURSING TIMES SERIES
(Based on IJA series but sub-edited by NT to be more formally written and concise than the IJA series with IJA paper 5 sensibly split into two)

1. Kirk-Smith, M. (1996) Clinical Evaluation I: Winning ways with research proposals and reports. Nursing Times, 92(11), 36-38. (13-19/3/96)
   
   Covers the structure and standard sections that need to be in a proposal or paper.
   
   
2. Kirk-Smith, M. (1996) Clinical Evaluation II: Finding, reading and documenting literature. Nursing Times, 92(15), 34-35. (10-16/4/96)
   
   Explains what counts as "authoritative" literature and how to find and use it.
   
   
3. Kirk-Smith, M. (1996) Clinical Evaluation III: Deciding what questions to ask. Nursing Times, 92(19), 34-35. (8-14/5/96)
   
   How to frame your aims and questions sensibly. If these aren’t right then the rest of the study will be pointless. A key aspect.
   
   
4. Kirk-Smith, M. (1996) Clinical Evaluation IV: Planning and carrying out a clinical study. Nursing Times, 92(24), 36-38. (12-18/6/96)
   
   Covers patient samples, intervention, measures, procedure.
   
   
5. Kirk-Smith, M. (1996) Clinical Evaluation V: How to design an effective research study. Nursing Times, 92(28), 40-41. (10-16/8/96)
   
   The central article - covers how to overcome the difficulties of case studies by designing the study carefully. The essence of scientific method (with IV.)
   
   
6. Kirk-Smith, M. (1996) Clinical Evaluation VI: Analysing the data. Nursing Times, 92(36), 46-47. (4-10/9/96)
   
   A brief explanation of presentation of data and basic statistics (personally, I "design out" the need for complicated statistics - I think they just confuse things - better to have well posed Aims and thence minimal statistics).
   
   

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