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Factors contributing to or impeding the development of OPP knowledge and skills among COM students – A Cross-Sectional Survey
Roberts, T. [2]
Wardle, M. [1]
Pryor, J. [1]

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A36-A38. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2023-2000/html)

Keywords:

cross sectional study [597]
medical students [402]
osteopathic medicine [1540]
osteopathic principles [62]
USA [1086]

Abstract:

Statement of Significance: Students at colleges of osteopathic medicine (COMs) have varying knowledge, attitudes and practices (KAP) regarding the use of osteopathic principles and practice (OPP). There seems a growing portion of students chose not to cultivate this knowledge and skill beyond the minimum needed to pass exam requirements.1,2 This differential interest in OPP is a challenge to the relevance and continued existence of the osteopathic profession as being something distinct from conventional medicine. Utilizing annual cross-sectional surveys of OPP-related KAP among Rocky Vista University College of Osteopathic Medicine (RVUCOM) students, this study intends to illuminate various factors that may contribute or impede the development of OPP knowledge and skills. It is to identify ways in which COMs might develop more effective learning and teaching interventions to augment the capacity of their graduates to incorporate OPP during their externships, residency training, and clinical practice. Research Methods: RVUCOM Institutional Review Board approved this 4-phase study beginning with a cross-sectional study. The 20-item survey was designed from several validated surveys found in osteopathic motivational survey literature,3,4 the Reduced Instructional Materials Motivation Survey (RIMMS),5 and RVUCOM OPP course evaluations. Questions pulled from the mentioned surveys were modified by the investigators to gauge the students’ opinions about osteopathic philosophy and osteopathic manipulative medicine (OMM) curriculum. Students were provided with a consent form and asked to enter their student ID at the beginning of the survey with the agreement that all identifiable information will be de-identified before analysis, including their grades. Incentive was given via 10 gift cards valued at $50 each to be raffled to participants. The survey platform was Qualtrics and distributed to randomly selected students via email stating the survey will take approximately 10 minutes to complete. The survey was initially sent in October 2022 to 633 of 1329 students across both Utah and Colorado campuses for a total of 8 cohorts with a goal of 445 final respondents, 33.5% of total student population. A reminder email was sent two weeks after for final responses. Students that did not respond were removed from the participant list and new students were randomly selected in their place. Data analysis was conducted using Epi Info 7 for Windows. Study variables were analyzed using appropriate statistical methods including frequency counts for categorical variables, cross-tabulations between exposure and outcome variables with calculations of appropriate measures of association, and chi-square and p values using a two-tailed p value < 0.05 to determine statistical significance. Data Analysis: Across all four years and both campuses, 447 of 633 invited students completed the survey for an overall response rate of 70.6%. There was, however, a higher response rate at the Utah campus (77.4% of 257 invited) as compared to the Colorado campus (66.0% of 376 invited): p value = 0.0019. Response rates were highest among OMS I students on both campuses (74.3% in Colorado, and 94.9% in Utah) and lowest among OMS III students on both campuses (61.9% in Colorado, and 67.1% in Utah).Across all RVUCOM respondents, the teaching modalities thought to be most useful for learning OMM were noted in descending order as the OMM lab (93.2%), one-on-one clinical encounters (49.7%), lectures (26.8%), punch cards in OMM lab (25.1%), group grand rounds presentations (2.0%), with other experiences being noted as useful including work with the predoctoral OPP Fellows, competency or practical exams, and work with the OPP tutors.Across all RVUCOM respondents, future interventions that respondents thought might be useful in the OMM curriculum in descending order included small group learning (67.3%), animated videos (49.0%), OMM question banks (40.7%), student-run OMM activities (36.5%), related imaging (28.9%), a lab manual computer application (28.0%), and virtual reality applications (14.8%).Various other KAP relationships are under ongoing analysis and will be reported on later. Conclusion: According to the survey, OMM lab was perceived as the most valuable learning modality for OMM, while grand rounds ranked the least useful. Mixed responses were received regarding one-on-ones, lectures, and punch cards, all of which were considered less valuable than OMM lab. The interventions presented in the survey also had mixed reviews, with small group learning receiving the most positive feedback and virtual reality applications receiving the least favorable response. Based on these results, it would likely be beneficial for RVUCOM to continue to prioritize OMM lab and consider implementing small group learning. Conversely, discontinuing grand rounds in the OMM curriculum would likely be met with approval by students. Additionally, including virtual reality in the curriculum is unlikely to be perceived as useful by students. These insights could be leveraged by RVUCOM to enhance the perceived usefulness of the OMM curriculum.Limitations must be acknowledged. First, the survey was conducted at a single school with two campuses, thereby limiting generalizability of the findings. Second, some currently employed teaching modalities were not included in the survey causing their impact on student perception to remain unknown. These aspects should be incorporated into future surveys. Further data analysis of other survey questions is needed to correlate students’ perception of the usefulness of the OMM curriculum and the likely application of OPP and OMM in practice.

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