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Differences in Learning Approach and Resource Utilization Between First- and Second-Year Osteopathic Medical Students
Jose, R. M. [2]
Goldstein, L. [7]

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A20-A22. 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]
learning [61]
medical students [402]
osteopathic medicine [1540]
USA [1086]

Abstract:

Statement of Significance: There is a lack of research on Osteopathic Medical Students’ (OMS) learning behavior and resource utilization. This study builds on a previously validated survey, the “Approaches to Learning and Studying Inventory” (ALSI), which splits students into different learning approaches [1]. Differences in medical student self-confidence in correlation with learning approach and resource utilization can reveal the strategies and resources that are most effective among successful medical students. To identify the differences in learning approach and resource utilization between first-year (OMS-I) and second-year (OMS-II) Osteopathic medical students, in correlation to their self-confidence on class exams and board exams. Research Methods: A modified version of ALSI was used to analyze medical student learning behavior. ALSI splits students into four different learning approaches: Deep Approach (DA), Monitoring Studying (MS), Effort Management/ Organized Studying (EMOS), and Surface Approach (SA). DA entails thoroughly understanding concepts; MS is related to DA, but students use self-reflection to guide their studying; EMOS entails proper time management to complete needed tasks, and SA focuses on memorizing information without seeking understanding [1]. DA is associated with higher performance on exams, and SA is associated with lower performance on exams [2,3]. A resource utilization assay (RUA) with a comprehensive list of resources assessed the frequency of use of different medical resources. Additional questions on medical school exam scores and self-confidence on board exams were also included in the survey. The survey was sent to all (851 students) OMS-I (442 students) and OMS-II (414 students) from the New York Institute of Technology College of Osteopathic Medicine at Old Westbury (NYITCOM-OW) (629 students) and NYITCOM at Arkansas State (NYIT@AState) (222 students) campuses. The survey was sent out every two weeks for two months, between April – June 2023, to all 851 students. The inclusion criteria included being an OMS-I or OMS-II during the 2022-2023 academic year. The only exclusion criterion was not fully completing the whole survey. The Mann-Whitney U test analyzed the differences between OMS-I and OMS-II. The frequency scores from the RUA were extrapolated and Mann-Whitney U test analyzed any differences between OMS-I and OMS-II. Spearman’s rho was used to analyze for correlation of the learning approach against board-exam confidence and class-exam scores. Students were also asked open-ended questions on how they prepare for Osteopathic Manipulative Medicine practical exams (OMMPE), thus providing an understanding of how students are studying for their Osteopathic practical exams. Data Analysis: 115 out of 851 students participated in the study; however, 14 only completed part of the survey, so they were omitted. 101 participants were included in the final data analysis, thus a response rate of 11.86%. 73.7% of students were from the NYITCOM-OW campus, and 26.3% were from the NYIT@AState campus. 51.8% of students were OMS-I, and 48.3% were OMS-II. There was a statistically significant difference in SA (p = 0.006), MS (p = 0.015), and DA (p = 0.042) between OMS-I and OMS-II as more OMS-I had a SA to learning, and more OMS-II had an MS or DA to learning. The RUA showed statistically significant more OMS-II used question banks such as USMLE-World (p < 0.001), COMQUEST (p < 0.001), and Amboss practice questions (p = 0.042). No statistically significant difference was found in the use of TrueLearn (p = 0.673) between OMS-I and OMS-II. More OMS-II also used review books and rapid review videos such as Boards and Beyond (p < 0.001), Pathoma (p < 0.001), First Aid Review Book (p < 0.001), Amboss online articles (p = 0.013), and Dirty Medicine (p < 0.001). There was no statistically significant difference between OMS-I and OMS-II in the use of USMLE RX Bricks (p = 0.231) and Sketchy medical videos (p = 0.139). A statistically significant positive correlation existed between DA and board exam confidence (rho = 0.206; p = 0.039). There was a slight positive correlation between DA and self-reported class exams; however, it was not statistically significant (rho = 0.138; p = 0.168). A statistically significant negative correlation existed between SA and board exam confidence (rho = -208; p = 0.037). A statistically significant negative correlation existed between SA and self-reported class exam scores (rho = -0.381; p < 0.001). In practicing for OMMPE, 51% of student responses had a DA, involving hands-on practice with a partner, and 49% of student responses had a SA, involving reading or skimming lab notes. Conclusion: The ALSI and RUA can provide relevant information for medical educators and students. More OMS-I employed a SA to learn, whereas more OMS-II used a DA. Understanding the reason for this difference can help medical educators curate their lectures to meet the needs of students. Regarding resources, more OMS-II used question banks; however, OMS-I and OMS-II had a similar frequency in using TrueLearn. This could be explained by NYITCOM providing all OMS-I and OMS-II with a free TrueLearn account and assigning questions for each block. More OMS-II also used rapid-review resources; however, the use of USMLE RX Bricks and Sketchy Medical was similar between OMS-I and OMS-II. NYITCOM also provides all OMS-I and OMS-II with USMLE RX accounts; however, NYITCOM does not provide students with a Sketchy Medical subscription. This could indicate that students seek out and use Sketchy Medical videos as OMS-I and OMS-II due to the quality of the videos in helping students understand the material. The correlation between DA and better confidence on board exams could indicate that students who employ a DA prepare better for board exams, thus feeling more confident. Likewise, the negative correlation between SA and board exam confidence and class exam scores could indicate a maladaptive learning approach, hindering students from understanding information thoroughly. Finally, the near-even split of DA and SA in OMMPE prep could be explained by the fact that practice exams are are not give a number grade, unlike class exams. The OMMPE is also held during the same week as class exams, which could sway students to focus more on class exams over OMMPE. One limitation of this study is the low response rate, so these results may only partially indicate the learning approach and resource utilization of all OMS-I and OMS-II; however, this study fills a much needed gap in Osteopathic medical education, and can be improved by sending the survey to different Osteopathic medical schools.

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