Practicing osteopathic manual medicine (OMM) requires medical students to learn a unique psychomotor skill. OMM techniques are taught during hands-on laboratory sessions in osteopathic medical schools across the country. Determining the optimal delivery of OMM training in the first and second years of medical school is instrumental in maximizing student engagement and confidence for future use in practice. In the academic year of 2020–2021, public health guidelines for COVID-19 forced Des Moines University College of Osteopathic Medicine to restructure their OMM laboratory sessions to include in-person and live-stream demonstrations of somatic dysfunction diagnoses and treatments.

Objective(s)

To determine if there was a difference in students’ perception of the learning experience and exam performance between in-person and live-streamed osteopathic manual medicine (OMM) laboratory instruction.

Methods

An online 8-question survey was sent to 225 first year medical students from Des Moines University at the end of their first year. The survey contained a combination of Likert scale, dichotomous, and open-ended questions. Statistical analysis for the Likert scale questions included paired-t test given the nature of correlated responses by the same cohort of students. A non-parametric permutation test was used to compare Fall 2020 practical exam grades due to the heavy skewness and ties of the exam score distributions. All computations were also made using the statistical computing software R. Free text was qualitatively analyzed for recurrent themes.

Results

The survey response rate was 67.1% with 151 respondents. When students were asked to rate their learning experience (engagement, comfort asking questions, understanding of material, ability to retain and recall lab material) between in-person vs. live-stream delivery of OMM lab material on a 5-point Likert Scale, there was a statistically significant mean difference for all of the responses, indicating a preference for in-person delivery method. Comparisons of the mean practical exam scores revealed no statistically significant differences. When asked to choose between in-person vs. live-stream, 83% of students reported a preference for in-person OMM laboratory demonstrations.

Conclusion

The students’ perceptions suggest that in-person delivery of OMM was superior to live-stream instruction based on higher rankings of engagement, comfort in asking questions, understanding material to practice, and recall of material in preparation of practical exams.

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Osteopathic Medical Students’ Preferred Method of Participation in Online Lectures and Learning Activities

DO,

MS,

DO,

DO, and

DOI: 10.53702/2375-5717-32.3.18

Abstract

Introduction

The demand for online education is on the rise as technology and a global community expand. In the context of COVID-19 pandemic, the Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine (NMM/OMM) Department at Western University of Health Sciences College of Osteopathic Medicine Pacific (COMP) and Pacific-Northwest (COMP-NW) was required to transition from a hands-on, in-person model to entirely virtual teaching. With the rapid transition, student feedback was paramount in determining the effectiveness of the virtual curriculum model and establishing evidence-based guidelines to inform future online delivery methods for the teaching of osteopathic manipulative medicine.

Methods

A 7-question Qualtrics survey was developed to assess the first and second-year osteopathic medical students’ perception of their online curriculum participation, the preferred method of participation, barriers to participation, and how the NMM/OMM department can improve the curriculum to increase student participation. The survey was distributed electronically to the students at Western University of Health Sciences COMP and COMP-NW.

Results

85 students participated in the survey. The most preferred method of participation was an anonymous online polling platform such as “Kahoot!” The most frequently reported barrier to participation was lack of confidence. The most popular suggestion about increasing student participation was to increase more anonymous polls or gamification, such as “Jeopardy,” for review sessions. The logistic regression analysis showed that the following 3 student characteristics were the most decisive factors for a student to report that more participation would increase their OMM knowledge: fear of public speaking (p = 0.024), difficulty staying focused during online curriculum (p=0.041), and being a first-year osteopathic medical student (p<0.01).

Conclusion

Online curriculum design and delivery pose new and unique challenges to teachers and institutions worldwide. Understanding the creativity it allows, its limitations, and how to increase student engagement and participation needs to be continuously investigated as the technology and demand of online learning grow.

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Osteopathic Medical Students’ Subjective Preparedness for LGBTQ+ Patient Care and Influencing Factors: A Multi-Institutional Survey Study

DO,

BS,

BS, BA,

DO,

BS,

DO, and

MD, MPH

DOI: 10.53702/2375-5717-32.3.26

Abstract

Objectives

This study aims to investigate what factors correlate with osteopathic medical students’ preparedness to provide care for the LGBTQ+ community through a multi-institutional survey.

Context

This is one of the few formal research projects to assess the impact of LGBTQ+ medical education on osteopathic students’ comfort level with caring for the community.

Methods

This study was approved by the IRB at Western University of Health Sciences, Pomona, CA on 11/19/2020. An 18-question survey was created regarding the exposure to the LGBTQ+ population and healthcare education before and after attending osteopathic medical schools. The anonymous survey was electronically distributed at Western University of Health Sciences College of Osteopathic Medicine Pacific and Pacific Northwest, Idaho College of Osteopathic Medicine, Touro University, Philadelphia College of Osteopathic Medicine, Rocky Vista University College of Osteopathic Medicine, and Michigan State University College of Osteopathic Medicine between 1/6/21 and 5/8/21. The survey information was statistically analyzed via SAS University edition.

Results

The survey had 441 responses: 63% were female, 34% were male, and 3% selected other gender identities. From 441 responses to the survey, 378 responses were analyzed using a logistics regression model to comprehensively model a binary-dependent variable for the students’ preparedness. Students knowing the meaning of the acronym LGBTQ+ (p =0.04) and actively engaging in extracurricular activities for the LGBTQ+ population (p =0.01) showed the strongest correlation based on the logistic regression analysis. Additionally, Chi-square results identified 6 independent variables associated with students’ preparedness to care for the LGBTQ+ population: being a second year or a third year osteopathic medical student (p <0.01), having opportunities to learn about the LGBTQ+ population in college (p <0.01), having a formal presentation about LGBTQ+ health in medical school (p <0.01), the medical school offering extracurricular activities about the LGBTQ+ population (p <0.01), knowing what the LGBTQ+ acronym stands for (p =0.01), and actively being involved in extracurricular activities concerning the LGBTQ+ community (p=0.03).

Conclusions

Our study indicates that medical students’ educational exposure through college and medical school is a more correlating influencing factor for their preparedness to care for the LGBTQ+ population in comparison with student’s gender, hometown size, or socioeconomic, geographical, and religious background. Future studies to objectively identify medical students’ preparedness and experience with LGBTQ+ patients, as well as studying effective curricula for filling in knowledge gaps, will be necessary.

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CASE REPORTS

Osteopathic Manipulative Treatment for Optic Pathway Glioma

DO and

DO, FAAO

DOI: 10.53702/2375-5717-32.3.37

Abstract

Optic gliomas are a known complication of neurofibromatosis type 1 (NF1) and can result in significant impairment. This case report centers around a 3-year-old girl with NF1 and optic glioma diagnosed by MRI, whose optic glioma has not increased in size since commencing treatment with osteopathic manipulative treatment (OMT) at regular intervals. We cover the rationale behind treating these patients with OMT with a thorough review of the relevant anatomy. We suggest a basis of treatment that could benefit patients with a number of intracranial and extracranial pathologies.

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Effectiveness of Osteopathic Manipulation Treatment in the Rehabilitation of Post-External Immobilization for a Supracondylar Fracture of the Distal Humerus: A Case Report

DO, MA, LMHC and

DO, MPH

DOI: 10.53702/2375-5717-32.3.42

Abstract

Pediatric bone fractures are a common occurrence, particularly among youth sports participants. Supracondylar humeral fractures are the most common pediatric elbow fracture, accounting for approximately 60% of all pediatric elbow fractures for children less than 10 years of age. For nondisplaced supracondylar humeral fractures, the standard of care is to immobilize the affected arm with an above the elbow-long cast for 3 weeks. Following cast removal, the recommendations for rehabilitation are conflicting, between doing some physical therapy as part of recovery or no therapy and letting the arm heal on its own for upwards of 12 weeks. The purpose of this case report was to observe if the addition of osteopathic manipulation treatment (OMT) could improve the somatic dysfunctions associated with post-immobilization elbow stiffness and reduce the amount of recovery time. Various OMT techniques were utilized over a span of 8 sessions across 4 weeks. The use of OMT provided relief of stiffness and return to full range of motion of the affected upper extremity joints. The incorporation of OMT as a part of a recovery regimen could be considered for future utilization, research, and evaluation.

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eISSN: 2375-5717

ISSN: 2375-5776

Front Matter

View from the Pyramids: Pay It Forward

Comparing In-person vs. Live-streamed Osteopathic Manual Medicine Lab Instruction

Abstract

Context

Objective(s)

Methods

Results

Conclusion

Osteopathic Medical Students’ Preferred Method of Participation in Online Lectures and Learning Activities

Abstract

Introduction

Methods

Results

Conclusion

Osteopathic Medical Students’ Subjective Preparedness for LGBTQ+ Patient Care and Influencing Factors: A Multi-Institutional Survey Study

Abstract

Objectives

Context

Methods

Results

Conclusions

Osteopathic Manipulative Treatment for Optic Pathway Glioma

Abstract

Effectiveness of Osteopathic Manipulation Treatment in the Rehabilitation of Post-External Immobilization for a Supracondylar Fracture of the Distal Humerus: A Case Report

Abstract

From the Editor: Empirical Knowledge and the Scientific Method

Front Matter

Article Review: Osteopathic manipulation and its applicability in the emergency department: A narrative review

An Innovative Osteopathic Curriculum for Allopathic and Osteopathic Family Medicine Residents

A. T. Still's “The Rule of Fluid, Nerve, Fascia, Muscle, and Bone”–An Investigation Beyond “The Rule of the Artery”