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Perceptions and Awareness of Osteopathic Medicine Among Students in Other Health Professions
Dyches, R. P. [2]
Ruck, L. D. [1]
Stein, A. B. [2]
Gailius, G. C. [1]
Worden, K. [5]

Journal: Journal of Osteopathic Medicine Date: 2019/12, 119(12):Pages: e95-e97. doi: Subito , type of study: pretest posttest design

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2019.128/html)

Keywords:

medical students [402]
osteopathic medicine [1540]
perception [89]
pretest posttest design [108]
USA [1086]

Abstract:

Statement of Significance: Interprofessional models have better health outcomes for patients but training in the health professions often occurs in isolation, which causes health care professionals in training to remain uncertain about their responsibilities and value of their related peers. Patient centered care requires that we be at the forefront of a collaborative model, and that misconceptions about DO's scope of practice be addressed. An ideal place to approach other health professionals is during their training, as many student DOs share their campuses with other health professionals. This collaboration may facilitate communication and allow for better patient care in the future. Methods: Participants were recruited from the dental, podiatry, optometry, nurse anesthesia, speech/language pathology, physician assistant, occupational therapy, physical therapy, biomedical sciences, cardiovascular science, pharmacy, clinical psychology, and veterinary medical programs at Midwestern University in Glendale, AZ. Participants were required to be OMM naïve (defined as never having received or directly observed any osteopathic manipulative treatments). Students were recruited via a campus-wide email. The intervention was conducted on October 31st 2018 over 4 1 hour blocks. The intervention consisted of the following: Participants were administered an initial survey to evaluate their baseline understanding and perception of osteopathic medicine. Participants were then given a brief presentation regarding the background, history, training, and scope of practice of osteopathic physicians. Participants received an OMT demonstration consisting of 5 different techniques performed by an OMM scholar/fellow or a member of the OMM department at the Arizona College of Osteopathic Medicine. The techniques were suboccipital release, muscle energy of an anterior innominate rotation, high-velocity low-amplitude of a posterior radial head, strain-counterstrain of the trapezius, and myofascial release of the thoracic inlet. Following the demonstration, participants were re-administered the same survey to assess for a change in their understanding and perception of osteopathic medicine. Data Analysis: 43 participants (53% female, 47% male) met the inclusion criteria, attended the session and completed the surveys. Participants included students from Biomedical Sciences (28%), Dental (21%), Physician's Assistant (PA) (19%), Speech/Language Pathology (12%), Pharmacy (7%), Optometry (7%), and Clinical Psychology (2%) programs. 2 students did not identify which program they attended. A paired t test was performed on each survey question to determine changes in participants’ knowledge and perceptions of osteopathic medicine before and after the educational intervention. An independent-samples t test was also used to compare responses between male and female participants before and after the intervention. Subgroup analysis was performed, using ANOVA, on 3 subgroups to assess differences between professions. The 3 subgroups were: Biomedical Sciences students (many of whom will apply to osteopathic medical school); the Physician Assistant and Pharmacy students (both of whom frequently work with osteopathic physicians in hospitals and other practice settings); and all other health professions students. The 2 survey responses which did not identify programs were not included. Tukey all pairwise comparisons test was conducted on the groups post hoc. Results: When applied to all of the survey questions, the paired t test yielded P<.0001. There was no statistically significant difference between the before and after change in mean scores for the responses from male and female participants. The ANOVA yielded significant differences for 5 of the 11 survey questions. These questions were “I understand the difference between a DO and an M.D.” (P=.0473), “I understand the difference between an osteopathic physician and a chiropractor” (P=.0121), “I understand the difference between osteopathic manipulative treatment and chiropractic treatments” (P=.0214), “I feel comfortable explaining osteopathic medicine to another person” (P=.0297), and “OMT can reduce pain due to trauma” (P=.0136). The results of the Tukey all-pairwise comparisons post hoc test was as follows: For 1 of the statements in the survey, “I feel comfortable explaining osteopathic medicine to another person,” Biomedical Sciences students had statistically significantly more agreement than the Pharmacy/PA group (adjusted P=.0231). For the other 4 statements tested above, Biomedical Sciences students were statistically significantly higher in agreement with the statement compared with the all-other-professions group. Finally, for the statement, “I understand the difference between a DO and a Chiropractor,” Pharmacy/PA students had statistically significantly greater agreement than the all-other-professions group. Conclusion: Our study demonstrates that an intervention in interprofessional education during health professions training can lead to increased understanding of osteopathic medicine among health profession trainees. Compared with pre-intervention, postintervention scores were statistically significantly higher for each statement of understanding. Highest scores were achieved by professions that were more likely to work with osteopathic physicians; however though they did not have the highest mean scores, the all-other professions group had the largest average mean increase in scores. Limitations included the single-site setting of the study, the relatively small group size (especially for subgroup analyses) and the brevity of the intervention. The lack of a comparison group, and the absence of randomization into the intervention, are also methodological weaknesses. More research is needed to determine if the impact of this type of intervention is generalizable to other settings. Additionally, further study may determine the reason for the subgroup differences described in our study. This study demonstrates a brief, low-cost intervention is associated with meaningful improvements in the understanding of osteopathic medicine by an interprofessional team. However, the limitations of this study preclude making causal inferences from the results. This training may help clarify the role of osteopathic physicians as members of the health care team, and ultimately benefit their patients.

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