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Evaluation of Using Three-Dimensional Sacral Models in the Education of Sacral Osteopathic Manipulative Treatment: A Quality Improvement Study

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A38-A39. doi: Subito , type of study: pretest posttest design

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

Keywords:

cranio-sacral osteopathy [158]
models [37]
osteopathic medicine [1540]
pretest posttest design [108]
USA [1086]

Abstract:

Statement of Significance: Three-dimensional (3-D) printing is a method of building structures by laying down material layer by layer. Originally designed for building prototypes for business and engineering, the scope of 3-D printing has expanded into medical applications ranging from creating models for surgical planning and patient education, to creating prostheses and bioprinting tissues. Research is limited regarding applying these methods to education in osteopathic manipulative medicine (OMM). The purpose of this quality improvement study is to analyze student satisfaction, efficiency, and retention of using 3-D printed models in the osteopathic education of sacral dysfunctions and treatment. Research Methods: The study population includes first year osteopathic medical students across three sites in Michigan. As the OMM lab at this institution utilizes a flipped-classroom approach, all students reviewed a pre-recorded lecture and demonstration videos on sacrum diagnosis and treatment prior to attending their lab session. Two sites (approximately 250 students) received the traditional sacrum in-person lab experience utilizing other methods to conceptualize sacral motion and dysfunction. Previous methods used to convey concepts include paper, cardboard models, portraying the body as the sacrum, or a pillow. Another site (approximately 50 students) utilized 3-D printed sacral models. Students received a pre-test including four case-based multiple-choice questions on sacrum diagnosis and treatment. After the lab session, students received a post-test with the identical multiple-choice questions as the pre-test. Students were asked to evaluate the use of models and value of their learning session. A follow-up survey was completed approximately 6 months after the initial survey to determine the long-term effectiveness of using the sacral models. All surveys were administered through Qualtrics survey software. Data Analysis: Statistics were completed using a cumulative link mixed model. The results showed higher scores at both the post-test (OR = 2.92, p < 0.001) and follow-up (OR = 1.68, p = 0.014) compared to pre-test for participants. The groups had a similar score on the pre-test (OR = 1.00, p = 0.996). There was no significant difference in the score at the post-test time point (OR = 1.04, p = 0.944), but there was significant difference at the follow-up time point (OR = 5.21, p = 0.003). This indicates that students utilizing the 3-D models showed a larger improvement from pre-test to 6-month follow-up than students that did not use the 3-D models group. While students reported improvement in their comfort diagnosing sacral dysfunctions from pre-test to post-test (OR = 19.46, p < 0.001) and follow-up (OR = 14.34, p < 0.001), there was no significant difference between the intervention groups at the time of post-test or follow-up. Conclusion: Overall, this study indicates a possible relationship between use of 3-D printed models and long-term performance on questions related to sacral dysfunction. The limitations of this study include variable sample sizes between groups and different instructors between sites. Further areas of study would include assessment of understanding of OMT using other 3-D models, evaluation of confounding variables and review at additional time points.


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