Kramer Joanna L, Trombetti Kirby, De Asis Kathleen, Mai Vivian, Swing Edward
Phoenix Children's Hospital, Phoenix, AZ, USA.
Former Medical Student at Midwestern University - Arizona College of Osteopathic Medicine, Glendale, AZ, USA.
J Osteopath Med. 2024 Oct 7;125(3):143-151. doi: 10.1515/jom-2024-0082. eCollection 2025 Mar 1.
Osteopathic manipulative medicine (OMM) is a unique skill set consisting of physical manipulations that treat the neuromusculoskeletal system. Although OMM can improve patient outcomes such as functionality and pain, as well as increase physician reimbursement, its use is declining. Barriers to its use include a lack of proficiency, support, reimbursement, and time. Knowledge gaps remain as to how OMM training during graduate medical education (GME) affects OMM use.
This study describes relationships between OMM exposure during GME and the use of OMM in practice.
An online survey of physicians in a variety of medical fields during late 2022 assessed the impact of OMM education during postgraduate training on its use in clinical practice. Survey data were analyzed to compare training characteristics and OMM use via chi-square tests and binary logistic regression.
A total of 299 surveys were completed. Respondents who received formal OMM education during residency were more likely (59.8 %) to utilize OMM in medical practice than those who practiced OMM informally (37.8 %, p<0.001) and those who had no OMM exposure during residency (10.3 %, p<0.001). Respondents who trained with more osteopathic attendings (p<0.001) and co-residents (p=0.012) were also more likely to utilize OMM. Those who completed residencies that were accredited by the Accreditation Council for Graduate Medical Education (ACGME) with an Osteopathic recognition track, by the American Osteopathic Association (AOA), and were dually-accredited (ACGME/AOA), were all more likely to utilize OMM (60 %, 56 %, and 53 %, respectively) than those who completed residencies with ACGME accreditation alone (22 %, p<0.01).
Although OMM can improve patient outcomes, it is underutilized by Doctors of Osteopathic Medicine (DOs) in practice. Lack of training after medical school has been identified as a contributing factor to its disuse. The results of our study illustrate that there is a positive association between OMM education during postgraduate training and OMM use in clinical practice.
整骨手法医学（OMM）是一套独特的技能，包括用于治疗神经肌肉骨骼系统的物理手法。尽管OMM可以改善患者的功能和疼痛等预后，还能增加医生的报销费用，但其使用却在减少。其使用的障碍包括缺乏熟练度、支持、报销以及时间。关于研究生医学教育（GME）期间的OMM培训如何影响OMM的使用，仍存在知识空白。
本研究描述了GME期间的OMM接触与实践中OMM使用之间的关系。
2022年末对多个医学领域的医生进行了一项在线调查，评估研究生培训期间的OMM教育对其在临床实践中使用的影响。通过卡方检验和二元逻辑回归分析调查数据，以比较培训特征和OMM使用情况。
共完成299份调查问卷。在住院医师培训期间接受过正规OMM教育的受访者在医疗实践中使用OMM的可能性更大（59.8%），高于非正规使用OMM的受访者（37.8%，p<0.001）以及在住院医师培训期间未接触过OMM的受访者（10.3%，p<0.001）。接受更多整骨主治医生培训（p<0.001）和住院医师同事培训（p=0.012）的受访者也更有可能使用OMM。那些完成了由研究生医学教育认证委员会（ACGME）认可的整骨医学认证轨道、由美国整骨疗法协会（AOA）认可以及双重认证（ACGME/AOA）的住院医师培训的人，比仅完成ACGME认证的住院医师培训的人更有可能使用OMM（分别为60%、56%和53%）（22%，p<0.01）。
尽管OMM可以改善患者预后，但在整骨疗法医生（DOs）的实践中未得到充分利用。医学院校毕业后缺乏培训被认为是其未被使用的一个促成因素。我们的研究结果表明，研究生培训期间的OMM教育与临床实践中OMM的使用之间存在正相关。
