Background:Case reports and clinical registry data are underused sources of real-world evidence in acupuncture and herbal medicine (AHM). This study explored researchers' reflections on conducting secondary analyses of acupuncture case reports and clinical registry data relating to pain.Methods:An anonymous qualitative survey was conducted with members of an international pragmatic research team (n=8) engaged in secondary analyses of AHM case reports and clinical registry data. Eight open-ended questions explored respondents’ experiences of collaboration, data complexity, evidence synthesis, and professional learning. Survey responses were analysed using descriptive thematic analysis, following established phases. Perplexity Pro was used in a limited, supportive role to assist with initial topic clustering and clarity checks, exploring the use of artificial intelligence (AI)-powered tools in qualitative data analysis. All coding, interpretation, and theme development were researcher-led.Results:Five interrelated themes were identified: (1) ambitious and integrative aims; (2) working with messy, real-world data under time pressure; (3) the value and strain of international, multidisciplinary collaboration; (4) re-thinking evidence synthesis and the role of case reports; and (5) learning, growth, and future priorities for AHM. Respondents described the challenges of heterogeneous clinical data and the benefits of collaborative mixed-methods inquiry.Conclusion:This study highlights how reflective collaboration and iterative learning can support the collective analysis of complex, real-world data. Secondary analysis of case reports and clinical registry data, conducted through international and multidisciplinary collaboration, has the potential to contribute to evidence development in AHM. Continued attention to collaborative research frameworks, transparent reporting practices, and practitioner education will be important for strengthening the quality and impact of future practice-based AHM research.

Introduction Traditional East Asian Medicine (TEAM) relies heavily on case reports for clinical decision-making. However, methods for analyzing data from multiple case reports are currently underdeveloped. This protocol will outline novel methods for secondary analyses of TEAM case reports and clinical registry data focused on pain to inform practice-based research. Methods We will use a concurrent triangulation mixed methods design to analyze data from 12 case reports and 130 clinical registry records, meeting the requirements of the CARE guidelines and focusing on TEAM treatments for pain. Quantitative analysis will include descriptive statistics, pairwise t-tests, and responder analysis. Qualitative analysis will employ thematic analysis with both deductive and inductive approaches. Data will be standardized using ICPC-2 and ICD-11 Traditional Medicine codes. Key focus areas include practitioner diagnosis, clinical reasoning, patient outcomes, and self-care behaviors. Discussion Anticipated outcomes include refined methodologies for case report and clinical registry data analysis, insights into TEAM clinical practice patterns, and identification of complex system phenomena within TEAM frameworks. Conclusion This project aims to address research gaps in modelling case data analysis methodologies for TEAM, potentially enhancing the rigor, validity, and applicability of practice-based research, informing clinical trial design, and contributing to better patient-centered care.

Background:While acupuncture use and research publications are growing in the United States, we know little about acupuncture and chinese herbal medicine (ACHM) students' beliefs and behaviors regarding acupuncture research. Purpose:This project aims to identify barriers to teaching acupuncture research and opportunities to engage and excite students to study acupuncture research. To our knowledge, a national survey of acupuncture students' research interests has not been completed previously. Methods:A cross-sectional survey of 32 closed and 6 open-ended questions was administered once through SurveyMonkey© to ACHM students in the United States. Analysis techniques include simple tabulations with confidence intervals for central tendency, along with selected correlations between variables. Results:We received responses from students at 36 different schools, with 16 schools not represented. The total number of student respondents recorded was 467. We found heterogeneity in many of the attitude and behavior response sets, highlighting the diversity of students' viewpoints. Many students were comfortable with their level of research skills. Attitudes toward the importance of research for the ACHM profession were often correlated with each other, with demographics suggesting that the background and demographics of the students may be related to their attitudes towards research education. These relationships can help tailor ways to address specific subpopulations of acupuncture students and students interested in studying acupuncture research. Discussion:The authors are ACHM educators and researchers who offer data-based suggestions to potentially improve students' appreciation of the importance of research to ACHM.

Introduction Clinical trials of acupuncture are difficult to meaningfully aggregate due to small sample sizes, and reductionist, heterogenous outcome measures. To improve the quality of evidence, standardized reporting of minimum data that reflects whole-person health, essential to East Asian Medicine (EAM), is needed. The Core Outcome Measures in Effectiveness Trials (COMET) initiative offers a methodology for developing core outcome sets (COS) through collaborative group consensus, including consumers. This study presents the 'Acupuncture Sets of Trial Reported Outcomes' (ASTRO) for women's health. Using domains of pain, sleep, mood/cognition, and safety, the ASTRO framework captures EAM complexity as well as standardizing reporting outcomes. Purpose To develop a COS for acupuncture trials in women's health, reflecting whole-person health outcomes across the lifespan. Methods Following COMET guidelines, we used a three-stage consensus process involving practitioners, researchers, patients, and policymakers to develop a COS for reporting minimum data for acupuncture trials in women's health. This process involved a systematic review, roundtable discussion, two-round Delphi survey, and a consensus meeting. We examined the conditions of menstrual health, PCOS, fertility, pregnancy, and menopause to develop an outcome set for safety, feasibility and EAM specific outcomes. Results From 320 studies, 579 outcomes were identified. A final COS of 12 outcomes was agreed upon: Safety (n=2): Serious adverse events (SAEs) and minor adverse events (AEs); EAM (n=8): Changes to primary and secondary patient reported outcome measures (PROMs), change in EAM diagnostic indices, patient experience/satisfaction, demographics, mood/cognition, sleep, and pain; Feasibility (n=2): Acceptability and cost. Definitions for S/AEs follow Witt et al., and Baumler et al., and outcomes are to be used in conjunction with those specified in the STRICTA guidelines. Conclusion The ASTRO Women's Health COS enables consistent, whole-person outcome reporting, to improve the quality and comparability of acupuncture research. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Institutional ethics approval was obtained from the University of Notre Dame Australia's Human Research Ethics Committee (024-078). Consent was obtained from all study participants by a click button entry to the survey. The COS development protocol and study have been registered in the COMET database: (https://www.comet-initiative.org/Studies/Details/3476). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript

Objective: Collaboration between complementary and integrative health (CIH) institutions and research-intensive (R1) institutions has been successfully undertaken in the United States, resulting in federally funded research projects, educational programs, and faculty development. The aim of this cross-sectional survey study was to explore the barriers and facilitators to establishing and maintaining such collaborative partnerships. Methods: A 32-question survey was sent to participants recruited through author contacts and resources, literature review, and database searches. Participants were required to be researchers and affiliates who attempted, completed, or had current collaborative endeavors involving CIH and R1 institutions. Data were collected in the research electronic data capture (REDCap) system and descriptive quantitative and qualitative data analysis was undertaken. Results: A total of 26 unique entries were included in the final data analysis; four of which were paired entries (one from an R1 institution and one from a CIH institution) to make up two dyad data collections. Eighty-one percent of the participants had senior leadership roles at CIH institutions representing five CIH disciplines-East Asian medicine (acupuncture and Traditional Chinese Medicine), chiropractic medicine, massage therapy, naturopathy, and yoga. Collaborative research projects were often (>38%) in response to specific project funding mechanisms. Over 60% of the collaborations also included educational activities and faculty development. Collaborations resulted in multiple different types of benefits to both institutions but were not without associated challenges. Conclusion: Collaborations between R1 and CIH institutions can be cooperative, productive, and mutually beneficial. Funding mechanisms supporting R1 and CIH collaboration increase CIH research productivity as well as the development of innovative research methodology to study the real-world practice of CIH therapies, whole systems, and whole person health. CIH researchers would greatly benefit from such funding, allowing access to research infrastructure, professional development, and the provision of protected time to conduct research.

Aim: The aim of our study is to describe Chinese herbal medicine (CHM) therapy, outcomes, and safety with patients experiencing symptoms possibly related to the novel 2019 Coronavirus (COVID-19). Method: In this ongoing prospective, longitudinal, descriptive cohort study at an East Asian medicine school clinical faculty practice, we are observing participants with symptoms related to COVID-19 who consent to participate in telehealth visits and receive individualized CHM. Following screening according to inclusion and exclusion criteria, all participants are asked to obtain a COVID-19 test at the time of enrollment. Licensed practitioners with at least 15 years of CHM practice experience are determining the number of telehealth consultations necessary for each participant. All participants are recommended individualized CHM dispensed either as loose herbs to be decocted at home or granules. Follow-up at 24 and 48 h after each telehealth consult will provide clinicians with information to determine if an additional telehealth consultation is necessary. Additional scheduled follow-up is at 3, 6, and 12 months. We began this study observing telehealth interactions as the clinic was closed to in-person visits. The clinic opened again to in-person visits in late 2020, and we have continued data collection. Ethics and Dissemination: The study has received Institutional Review Board ethics approval and is currently enrolling. Data from this cohort study will be presented online for real-time dissemination to clinicians and scientists, at scientific conferences, and published in peer-review journals. Describing individualized CHM treatment as a potential COVID-19 therapy will provide vital preliminary data on methods, feasibility, acceptability, tolerability, effectiveness, and safety. Findings from our study will inform future controlled trials of individualized CHM therapy for symptoms related to COVID-19. Trial Registration: ClinicalTrials.gov registration number: NCT04380870.

The main objective of this qualitative analysis is to increase the quality of Traditional Chinese Medicine (TCM) research education. Subject matter experts and stakeholders were sent a list of possible topics to include in a research course and were asked to comment on it, add or subtract topics, and suggest appropriate research papers to use, lessons learned in their topic areas and possible stand-alone topics for inclusion in other courses. Their feedback was used to revise the topic list, create a list of foundational research papers to include in a research course and devise a list of stand-alone topics that could be included in the general TCM research curriculum. The result is a TCM research course curriculum that will improve the teaching of evidence-based medicine (EBM) practices to TCM students. This will help TCM faculty and program directors improve existing courses, develop new courses and strengthen EBM education.

Objective: The objective of this study was to examine the prescribing of Chinese herbal medicine (CHM) by licensed acupuncturists in the United States during the COVID-19 pandemic.Methods: A 28-question survey with nine branching questions was disseminated through collegial networks, paid advertisements, and a study website in April-July 2021. Participants indicated that they were licensed acupuncturists who treated more than five patients for symptoms likely related to COVID-19 to gain entry to the full survey. Surveys were undertaken electronically through the Research Electronic Data Capture (REDCap) system.Results: The survey was undertaken by 103 participants representing all US geographic regions and had an average of 17 years in practice. Sixty-five percent received or intended to receive the COVID-19 vaccine. Phone and videoconference were the predominant methods of patient contact; granules and pill forms of CHM were the most prescribed. A wide variety of information sources were used in devising patient treatments inclusive of anecdotal, observational, and scientific sources. Most patients were not receiving biomedical treatment. Ninety-seven percent of participants reported that they had no patients die of COVID-19, and the majority reported that <25% of their patients developed long hauler syndrome (post-acute sequelae SARS-CoV-2 infection).Conclusions: This study demonstrates that licensed acupuncturists were treating COVID-19 infected individuals in the United States during the early stages of the pandemic, and for many such patients this was the only therapeutic intervention they had access to from a licensed health care provider. Information disseminated from China through collegial networks, along with published sources including scientific studies, informed the approach to treatment. This study provides insight into an unusual circumstance in which clinicians needed to establish evidence-based approaches to the treatment of a new disease during a public health emergency.

Objective: The objective of this qualitative study was to understand how licensed acupuncturists determined treatment strategies for patients with symptoms likely related to COVID-19 using Chinese herbal medicine (CHM) and the impact of the pandemic upon their clinical practice.Methods: A qualitative instrument was developed with questions aligned with when participants started treating patients with symptoms likely related to COVID-19 and the availability of information related to the use of CHM for COVID-19. Interviews took place between March 8 and May 28, 2021, and were transcribed verbatim by a professional transcription service. Inductive theme analysis and ATLAS.ti Web software were used to determine themes.Results: Theme saturation was achieved after 14 interviews lasting 11-42 min. Treatment predominantly started before mid-March 2020. Four themes emerged (1) information sources; (2) diagnostic and treatment decision-making; (3) practitioner experience; (4) resources and supplies.Conclusion: Primary sources of information informing treatment strategies came from China through professional networks and were widely disseminated throughout the United States. Scientific studies evaluating the effectiveness of CHM for COVID-19 were generally not deemed useful for informing patient care because treatment had been initiated before they were published and because of limitations associated with the research and the ability to apply it to real world practice.

Introduction East Asian Medicine (EAM) is a Whole System medicine that includes Chinese herbal medicine (CHM). Chinese herbal medicine has been utilized to reduce symptom burden in infectious disease, with notable theoretical reformulations during pandemics of the 3rd, 13th, and 17th centuries. Today, Licensed Acupuncturists trained in CHM have utilized it to treat symptoms and sequelae of COVID-19. However, little is known about its use or efficacy by the public and health practitioners. Understanding and evaluating whole medicine systems of healthcare is inherently complex; there is international consensus for a descriptive, pragmatic approach. We are conducting a feasibility pilot study using a prospective, pragmatic, observational design using Whole Health and Whole Person perspectives. The complexity of COVID-19 reflects the impact on multiple homeoregulatory systems and provides a unique opportunity to assess the impact of interventions such as EAM on whole health. Observation of these EAM encounters will provide valuable qualitative and quantitative data on the interface of an extant Whole System medicine with a novel complex illness as a precursor to a randomized clinical trial. Methods This ongoing study observes a CHM clinic offering telehealth consultations to a diverse patient population since April, 2020. Patients who report symptoms potentially related to COVID-19 disease are consented for standardized collection and analysis of demographic and clinical data from each clinical encounter. Results To date, 61 patients engaged in 195 consultations (mean 3.3) with 49 reporting symptom resolution sufficient to complete treatment, and 4 withdrawals. Just over half (62%) were female, with an average age of 45.7 years. A wide variety of CHM formulas and EAM dietary and lifestyle modifications were provided. Discussion Adequate recruitment and retention suggest feasibility of the intervention and data collection. The rich dataset may facilitate the construction of Whole Health models of CHM’s clinical impact, as well as integrative inquiry into CHM’s effects on symptoms.

Objective The objective of this study was to examine the prescribing of Chinese herbal medicine (CHM) by licensed acupuncturists in the United States during the COVID-19 pandemic. Methods A 28-question survey with nine branching questions was disseminated through collegial networks, paid advertisements, and a study website in April-July 2021. Participants indicated they were licensed acupuncturists that treated more than five patients for symptoms likely related to COVID-19 to gain entry to the full survey. Surveys were undertaken electronically through the Research Electronic Data Capture (REDCap) system. Results The survey was undertaken by 103 participants representing all US geographic regions, and had an average of 17 years in practice. Sixty-five percent received or intended to receive the COVID-19 vaccine. Phone and videoconference were the predominant methods of patient contact; granules and pill forms of CHM were the most commonly prescribed. A wide variety of information sources were used in devising patient treatments inclusive of anecdotal, observational, and scientific sources. Most patients were not receiving biomedical treatment. Ninety-seven percent of participants reported that they had no patients die of COVID-19, and the majority reported less than 25% of their patients developed long hauler syndrome (post-acute sequelae SARS-CoV-2 infection). Conclusions This study demonstrates that licensed acupuncturists were treating COVID-19 infected individuals in the US during the early stages of the pandemic, and for many such patients this was the only therapeutic intervention they had access to from a licensed healthcare provider. Information disseminated from China through collegial networks, along with published sources including scientific studies, informed the approach to treatment for the vast majority of the acupuncturists surveyed. This study provides insight into an unusual circumstance in which clinicians needed to establish evidence-based approaches to the treatment of a new disease in the midst of a public health emergency. Strengths and Limitations of the Study ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board of Albert Einstein College of Medicine gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.

Importance: Given that many midlife women use evidence-based non-pharmacologic interventions for symptom management during the menopausal transition and early postmenopause and that many women experience two or more symptoms (symptom cluster), it is important to review recent evidence on said interventions for symptom clusters. This review focuses on randomized clinical trials (RCTs) of traditional East Asian Medicine (TEAM), including acupuncture, acupressure, moxibustion, and Chinese herbal medicine, for hot flashes and one or more co-occurring symptoms experienced during peri- or post-menopause. Objective: The primary objective of the study was to review RCTs (published 2011-2021) of TEAM interventions for hot flashes and at least one other co-occurring symptom, including sleep problems, cognitive function, mood, and pain. Evidence Review: We searched Medline, CINAHL Plus, and PsychINFO for RCTs reported in English from July 7, 2011, to December 31, 2021. We included RCTs that assessed women in the menopausal transition or early postmenopause with masking as appropriate; TEAM interventions were studied as the treatment with one or more comparison groups; hot flushes and at least one additional symptom from at least one of the symptom clusters were reported as an outcome (from sleep, mood, cognition, pain symptom groups). Bias was assessed. Findings: Of 409 abstracts identified, 9 RCTs examined the effectiveness of therapies for hot flashes and at least one additional co-occurring symptom. One study reported separately on two TEAM interventions. The maximum trial duration was 6 months (range: 5 weeks to 6 months). Statistically significant improvement was reported in 2 or more symptoms: 5 of 6 studies of acupuncture, one acupressure study, one moxibustion study, 1 of 2 studies of Chinese herbal medicine. Conclusions and Relevance: Our systematic review summarizes the recent literature on TEAM interventions for symptom clusters during the MT and EPM. A majority of studies reported symptom reduction. Overall, our findings highlight the need for further investigation with studies that include whole systems TEAM as each intervention was studied separately in the reviewed trials. Clinical practice often includes concurrent use of acupuncture, moxibustion, CHM, and advice to patients to use self-acupressure. Studying each modality separately is a scientific abstraction that does not reflect clinical practice.

Objective: To identify factors associated with implementing bundled group acupuncture and yoga therapy (YT) to treat underserved patients with chronic pain in community health center (CHC) settings. This is not an implementation science study, but rather an organized approach for identification of barriers and facilitators to implementing these therapies as a precursor to a future implementation science study. Design: This study was part of a single-arm feasibility trial, which aimed to test the feasibility of bundling GA and YT for chronic pain in CHCs. Treatment outcomes were measured before and after the 10-week intervention period. Implementation feasibility was assessed through weekly research team meetings, weekly yoga provider meetings, monthly acupuncture provider meetings, and weekly provider surveys. Settings: The study was conducted in New York City at two Montefiore Medical Group (MMG) sites in the Bronx, and one Institute for Family Health (IFH) site in Harlem. Subjects: Participants in the feasibility trial were recruited from IFH and MMG sites, and needed to have had lower back, neck, or osteoarthritis pain for >3 months. Implementation stakeholders included the research team, providers of acupuncture and YT, referring providers, and CHC staff. Results: Implementation of these therapies was assessed using the Consolidated Framework for Implementation Research. We identified issues associated with scheduling, treatment fidelity, communication, the three-way disciplinary interaction of acupuncture, yoga, and biomedicine, space adaptation, site-specific logistical and operational requirements, and patient-provider language barriers. Issues varied as to their frequency and resolution difficulty. Conclusions: This feasibility trial identified implementation issues and resolution strategies that could be further explored in future implementation studies. Clinical Trial Registration No.: NCT04296344.

Background Integrative medicine has become a new healthcare model due to the growing evidence base for complementary and integrative therapies. However, some question whether complementary and integrative therapies can truly be integrated with biomedicine due to differences in underlying paradigms and theoretical bases. This study aimed to explore differences in scientific worldviews between students studying East Asian medicine and those completing an allopathic medical degree using the validated Thinking about Science Survey Instrument (TSSI). Methods 122 medical students from Albert Einstein College of Medicine (Einstein) and 48 East Asian medicine students from the Pacific College of Health and Science (Pacific College) participated in this study. Participants completed the TSSI, a 60-item Likert-scale instrument that quantitatively measures the sociocultural resistance to, and support for science. Item and category means were compared for each group using the two-sample t-test. Results Einstein students were generally supportive of science and Pacific College students were generally supportive of/positively neutral to science. Einstein students more strongly affirmed the relationship of science in relation to the categories of Epistemology, Public Health, Emotion and Aesthetics, the Economy, and Public Policy. Pacific College students more strongly affirmed the relationship between science and the category Race and Gender. There were no differences in the categories of Environment and Resource, Science for All, and Religion and Morality. Conclusion This study suggests that there are differences underlying the scientific worldviews of Einstein and Pacific College students, particularly with regard to Epistemology and Public Health. Such differences may be related to the different theoretical knowledge bases and ways of viewing health within the two disciplines. Our study also suggests that both groups may be receptive to the value of other paradigms. Providing courses that focus on different therapeutic approaches and paradigms during medical training may foster interprofessional understanding and collaboration between providers of different medical disciplines.

Acupuncture has been shown to be effective for the treatment of chronic musculoskeletal back, neck, and osteoarthritis pain. However, access to acupuncture treatment has been limited in medically underserved and low-income populations. Acupuncture therapy delivered in groups could reduce cost and expand access. We compared the effectiveness of group versus individual acupuncture for pain and function among ethnically diverse, low-income primary care patients with chronic musculoskeletal pain. This was a randomized comparative effectiveness non-inferiority trial in 6 Bronx primary care community health centers. Participants with chronic (> 3 months) back, neck, or osteoarthritis pain were randomly assigned to individual or group acupuncture therapy for 12 weeks. Seven hundred seventy-nine participants were randomized. Mean age was 54.8 years. 35.3% of participants identified as black and 56.9% identified as Latino. Seventy-six percent were Medicaid insured, 60% reported poor/fair health, and 37% were unable to work due to disability. Participants received weekly acupuncture treatment in either group or individual setting for 12 weeks. Primary outcome was pain interference on the Brief Pain Inventory at 12 weeks; secondary outcomes were pain severity (BPI), physical and mental well-being (PROMIS-10), and opiate use. Outcome measures were collected at baseline, 12 and 24 weeks. 37.5% of individual arm and 30.3% in group had > 30% improvement in pain interference (d = 7.2%, 95% CI − 0.6%, 15.1%). Non-inferiority of group acupuncture was not demonstrated for the primary outcome assuming a margin of 10%. In the responder analysis of physical well-being, 63.1% of individual participants and 59.5% of group had clinically important improvement at 12 weeks (d = 3.6%, 95% CI − 4.2%, 11.4%). Both individual and group acupuncture therapy delivered in primary care settings reduced chronic pain and improved physical function at 12 weeks; non-inferiority of group was not shown. Clinicaltrials.gov # NCT02456727

Objectives: To train faculty and develop curricula in evidence-informed practice (EIP) within a Chinese medicine degree program. Setting: Pacific College of Oriental Medicine (New York). Design: Faculty EIP training was undertaken through utilization of online EIP modules, and development and completion of a 3-credit (45 h) online Foundations of EIP course. This was supplemented by faculty meetings and one-on-one support from department chairs. Curriculum development was undertaken by an EIP Curriculum Committee. The committee followed a modified Delphi process to develop EIP course learning outcomes (CLOs), and to make changes to the College's clinic policies and procedures. EIP assignments were developed for each course in accordance with the CLO. Results: Ninety-one percent of the faculty and 97% of clinical supervisors received formal EIP training. Thirty-five percent of all didactic faculty, 38% of faculty teaching courses with EIP incorporated, and 30% of clinical supervisors completed 10 or more h of EIP training during this project. Faculty also received informal EIP training through participation in department and general faculty meetings. Seventy-three percent of the Master's degree curriculum, inclusive of 40 didactic courses and fifteen 60-h clinic shifts, were modified to incorporate EIP. EIP CLOs and corresponding assignments were developed. Clinic intake forms were modified to facilitate undertaking EIP in the College clinic. Issues related to how EIP is defined in conjunction with the nature of available scientific research in Chinese medicine required discussion and resolution. Conclusions: Training faculty and developing curricula in EIP within Chinese medicine colleges has unique challenges that must be factored into the strategies and processes. Factors that contributed to the success of this project were having faculty drive the process, integrating EIP content within existing curricula, gradual exposure, identifying champions, relating EIP to practice building, and openly discussing opposing perspectives.