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Development of Osteopathic Neuromusculoskeletal Medicine (ONMM) Residency Curriculum Guidelines to meet ACGME Milestones

Journal: Journal of Osteopathic Medicine Date: 2021/12, 121(12):Pages: A47-A48. doi: Subito , type of study: mixed methods study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2021-2000/html)

Keywords:

curriculum [291]
mixed method study [100]
OMT [3752]
osteopathic manipulative treatment [3772]
osteopathic medicine [2025]
residency [326]
USA [1656]

Abstract:

Context: Residencies accredited through the American Osteopathic Association (AOA) completed merging with programs accredited through the Accreditation Council for Graduate Medical Education (ACGME) in 2020.1,2 This included the transition of Osteopathic Neuromusculoskeletal Medicine (ONMM) residencies. Progress through ONMM residency is evaluated based on fifteen ACGME milestones.3 However, there are no guidelines to help guide the achievement of these milestones as there are in other specialties.4-6 Objective: The primary purpose of this study was to develop a proposed structure and content for an ONMM residency curriculum (1) based on the alignment of residency curriculum with ACGME milestones in one ACGME accredited ONMM residency program, and (2) the perceived needs of residents and faculty for an ONMM residency curriculum. Methods: A mixed methods exploratory sequential approach with embedded design was used.7 Qualitative analysis of didactics curriculum content for the past two years was hand coded according to themes identified in the residency curriculum content which were further coded according to ACGME milestones.3 Curriculum topics identified in qualitative analysis were used to create a questionnaire which was administered to residents and faculty (n=24) in the ONMM residency program to examine perceived importance of each curriculum topic based on a five-point Likert scale. Open-ended questions were embedded in the questionnaire that asked how faculty and residents define ONMM and what they believe should be the purpose of an ONMM residency curriculum. Results: Five themes were identified in qualitative analysis of curriculum, namely, (1) OMM laboratory topics, defined as didactics topics that involve the hands-on application of psychomotor skills, (2) faculty-led activities and lecture topics, (3) resident-led activities and lecture topics, (4) research, and (5) training courses and volunteer activities. The most important perceived curriculum topics for faculty and residents were Osteopathic structural examination, orthopedic exam, direct and indirect methods, Osteopathic Cranial Manipulative Medicine, pediatric OMT, common upper and lower extremity injuries, and low back pain. Each of these topics aligned well with ACGME milestones. Residents reported that integrative medicine topics such as acupuncture were a significantly more important ONMM residency laboratory topic (mean=3.58, SD=0.996) compared to faculty (mean=2.33, SD=0.985), t (22)=-3.091, p=0.005. Study participants most commonly described ONMM in terms of the specialized knowledge required for the discipline (n=19, 79.2%) and the Tenets of Osteopathy (n=17, 70.8%), and felt that the purpose of an ONMM residency curriculum should be to gain knowledge (n=20, 83.3%) and become a competent physician (n=19, 79.2%). Conclusion: Present findings were employed in the development of proposed ONMM residency curriculum guidelines and submitted to the American Academy of Osteopathy for consideration. They are presented here as a resource for application to ONMM residency curriculum. Where possible, it may be beneficial to adopt components of ONMM curriculum from existing evidence-based medical and post-graduate educational programs, and implement evaluation methodologies that ensure the appropriate application of curriculum to individual program needs.


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