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Student Utilization of Osteopathic Manipulative Treatments on Clinical Rotations
Nelson, C. [5]
Dean, G. [1]
Dean, D. [2]
Martinez, E. [6]
Goering, E. [6]

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A74-A75. doi: Subito , type of study: cross sectional study

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

Keywords:

clinical rotation [3]
cross sectional study [597]
medical students [402]
OMT [2951]
osteopathic manipulative treatment [2973]
osteopathic medicine [1540]
USA [1086]
utilization [6]

Abstract:

Statement of Significance: WesternU provides approximately 220 hours of hands-on training in osteopathic manipulative treatments (OMT) to first and second-year osteopathic medical students. One way to quantify student success is through assessment scores during these pre-clinical years, but the ultimate goal is for students to take the concepts and principles learned and apply them during their clinical years. To determine whether osteopathic medical students are utilizing OMT while on clinical rotations, and which modalities they are using most commonly. Research Methods: An investigative survey was distributed via WesternU email addresses to the osteopathic medical students in the classes of 2023 and 2024 (DO2023 and DO2024, respectively) on both the Pomona, CA, and Lebanon, OR, campuses. These classes were included as they were the only two classes on clinical rotations at the time of survey disbursement. The survey results were analyzed using IBM SPSS Statistics 28.0.1.1 (14). Frequency tables were created examining student responses to whether they utilized OMT on clinical rotations outside of the required osteopathic manipulative medicine (OMM) rotation, which rotations students chose to utilize OMT, and which modalities they utilized the most and the least. The frequencies were then stratified by class (DO2023 versus DO2024) and campus (Lebanon versus Pomona), with each of these groupings being compared via a chi-squared analysis. Graphical representations were made to illustrate the findings more clearly. Gaining a clear understanding of the use of OMT outside of OMM rotations and what specific modalities are being utilized the most will better inform pre-clinical instructors of what needs to be emphasized more in pre-clinical curriculum and what modalities are actually being utilized outside of the classroom. Data Analysis: Approximately 600 students were sent the investigative survey and 50 responses were received for a final survey response rate of 8.3% (n=50). Of the 50 respondents, 42% were in the DO2023 class, 58% were in the DO2024 class, 76% were enrolled at the Lebanon campus, and 24% were enrolled at the Pomona campus. Of the total 50 respondents, 72% indicated they utilized OMT outside of the required OMM rotation with the most common rotations being family medicine (71.4%), internal medicine (48.6%), and pediatrics (31.4%). When analyzing student utilization of OMT on clinical rotations outside of the required OMM rotation, there was no significant association to be found between the classes (Pearson Chi-Square = 0.315) or between the campuses (Pearson Chi-Square = 0.070). During the pre-clinical OMM curriculum, students are taught soft tissue, articulatory, muscle energy, high velocity-low amplitude (HVLA), counterstrain, lymphatics, myofascial release, balanced ligamentous tension, Still’s, cranial, and visceral techniques. Of these various modalities, counterstrain and soft tissue techniques were used the most (48.8% and 43.9%, respectively), and HVLA and cranial techniques were used the least (58.5% and 53.7%, respectively). Conclusion: The fact that 72% of respondents are utilizing OMT outside of the required OMM rotation is indicative that students are finding ways to incorporate OMT when embarking on clinical rotations. However, given the poor response rate it is possible that these numbers are skewed and the results inherently biased. Interestingly, there was no significant association between classes or campuses. This could be an indication that the pre-clinical curriculum is maintained well across years and campuses, however more research is needed to further investigate this. Regarding the OMT modalities that were used the most and the least by the respondents, HVLA and cranial techniques are the least used. This poses the question of whether the pre-clinical curriculum could be improved to better educate on appropriate and efficacious clinical applications of these modalities. More investigation is needed into why certain modalities are utilized while others are not as it could help to better inform instructors on how to design future pre-clinical curriculum. WesternU provides approximately 220 hours of hands-on training in osteopathic manipulative treatments (OMT) to first and second-year osteopathic medical students. One way to quantify student success is through assessment scores during these pre-clinical years, but the ultimate goal is for students to take the concepts and principles learned and apply them during their clinical years. Previous studies have evaluated student use of OMT on specific rotations, with Internal Medicine, Pediatrics, and Surgical rotations citing the lowest utilization of OMT(1). Other studies have investigated how often students were likely to suggest using OMT based on their physical examination and documentation(2), and Vazzana et al.(3), investigated whether early clinical exposure to OMT in first and second-year students led to student perceptions and attitudes towards the utilization of OMT on clinical rotations. While these studies have investigated the use of OMT in various settings and the perceptions towards the use of OMT in practice, they have failed to identify what specific OMT modalities were used most and within which particular rotation.

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