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Gender Sensitivity in Osteopathy: The Challenge of Diagnosing Pubic Symphysis Somatic Dysfunctions

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 24-25. doi: Subito , type of study: cross sectional study

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p13.xml)

Keywords:

cross sectional study [866]
diagnosis [400]
gender [38]
medical students [666]
osteopathic medicine [2065]
pelvic girdle [23]
pubic symphysis [2]
USA [1717]

Abstract:

Introduction: Osteopathic medical students are trained in palpatory skills to diagnose somatic dysfunctions, often practicing on peers. However, mental discomfort with evaluating certain body parts, such as the pubic symphysis, may hinder their ability to fully address clinical needs, conflicting with the osteopathic principle of treating the body as a unit. Hypothesis: This study examines areas where students may feel discomfort while diagnosing pelvic somatic dysfunctions, including the pubic symphysis. Methods: Twenty student researchers were randomly assigned fellow students to study. Following consent, researchers diagnosed the participant’s pelvis, including the pubic symphysis (n=104). Pubic somatic dysfunctions were classified as either “Superior Shear,” “Inferior Shear,” or “Equal.” Researchers rated their comfort and proficiency in accurately diagnosing the pubic symphysis on a Likert scale (1.0 = Not Proficient/Uncomfortable; 7.0 = Very Proficient/Very Comfortable). A blinded analyst compared the distribution of diagnoses based on researcher-participant gender pairings (“Same” or “Opposite”). Results: “Opposite” gender pairs showed higher “Equal“ pubic symphysis diagnoses (40.00% of all diagnoses) when compared to “Same”-gender pairs (13.56%), regardless of lateralization or innominate diagnosis. The post-study survey highlighted that researchers self-reported feeling less proficient in diagnosing pubic symphysis dysfunctions than the general pelvis (5.77 vs. 6.30). The primary barrier was the region's sensitivity (69.2% of 13 respondents). Conclusion: Students feel less proficient in diagnosing pubic symphysis dysfunctions, particularly with opposite-gender participants, due to the region's sensitivity. Osteopathic educators must consider these hesitations and help students diagnose the whole body as a unit. One limitation of our study is that not all researchers completed the post-study survey (n=13). Additional research could help identify sensitive areas where students need further instruction.


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