Nohomovich Brian, Tito Emmanuel, Baker Joanne, Gomes Theotonius
Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.
Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Osteopath Med. 2025 Jan 8;125(3):127-134. doi: 10.1515/jom-2023-0165. eCollection 2025 Mar 1.
In 2020, the allopathic and osteopathic residency programs were merged into a single residency system, with the Accreditation Council for Graduate Medical Education (ACGME) as the sole accreditor for residencies and fellowships in the United States. As a result of this merger, osteopathic recognition (OR) emerged as a unique approach to promoting osteopathic training and practice. However, there is a lack of data on the effects of OR in residency, specifically university-based residency programs.
The objective of this study is to investigate the impact of OR on retaining and applying osteopathic principles in a mixed cohort of residents in a single-center setting.
We conducted a prospective cohort study of allopathic and osteopathic-trained residents at varying years of postgraduate training in family medicine (FM), internal medicine (IM), and combined internal medicine-pediatric residencies at a single site. Participation in both the osteopathic curriculum and study was voluntary. We distributed a presurvey before the residents participated in the curriculum for that year and a follow-up 6 months later as a postsurvey. The surveys measured confidence levels based on a Likert scale and were aligned with the Osteopathic Recognition Milestones Project (ORMP). Statistical analysis with paired t tests and a Wilcoxon signed-rank test was conducted on participants who completed both surveys.
We had 38 % (18/47) of participants complete both surveys. We observed significant improvements in confidence levels related to osteopathic principles (p=0.036). Residents reported statistically significant gains in their ability to conduct a literature review on osteopathic medicine (p=0.0288). Additionally, there was a trend toward significance in confidence levels regarding the patient's perception of touch (p=0.0741) and the osteopathic treatment plan (p=0.0635). Notably, content knowledge was significantly improved (p=0.0313) for all participants. Based on the postsurvey responses, we discovered that participants who not only reported higher confidence overall but also had practiced osteopathic manipulative treatment (OMT) in the last month were more likely to state they would practice osteopathic manipulative medicine (OMM) after residency.
We conducted a prospective cohort study to assess the effects of OR utilizing surveys aligned to the ORMP. We identified knowledge- and confidence-level gains on osteopathic principles and practice (OPP) in a single-center study. Residents in OR are more likely to utilize OMT after residency.
2020年,对抗疗法和整骨疗法住院医师培训项目合并为一个单一的住院医师培训系统,美国研究生医学教育认证委员会(ACGME)成为住院医师培训和专科培训的唯一认证机构。由于这次合并,整骨疗法认可(OR)成为促进整骨疗法培训和实践的一种独特方式。然而,关于OR在住院医师培训中的效果,特别是在基于大学的住院医师培训项目中的数据却很缺乏。
本研究的目的是在单中心环境下,调查OR对混合队列住院医师保留和应用整骨疗法原则的影响。
我们对一家机构中接受过对抗疗法和整骨疗法培训、处于家庭医学(FM)、内科(IM)以及内科 - 儿科联合住院医师培训不同阶段的住院医师进行了一项前瞻性队列研究。参与整骨疗法课程和研究是自愿的。在住院医师参与当年课程之前我们进行了一次预调查,6个月后进行随访作为后调查。调查基于李克特量表测量信心水平,并与整骨疗法认可里程碑项目(ORMP)保持一致。对完成两次调查的参与者进行配对t检验和威尔科克森符号秩检验的统计分析。
我们有38%(18/47)的参与者完成了两次调查。我们观察到与整骨疗法原则相关的信心水平有显著提高(p = 0.036)。住院医师报告在进行整骨疗法文献综述的能力方面有统计学上的显著提高(p = 0.0288)。此外,在患者对触摸的感知(p = 0.0741)和整骨疗法治疗计划(p = 0.0635)方面的信心水平有趋于显著的趋势。值得注意的是,所有参与者的知识内容都有显著改善(p = 0.0313)。根据后调查的回答,我们发现不仅总体信心较高而且在过去一个月内进行过整骨手法治疗(OMT)的参与者更有可能表示他们在住院医师培训结束后会从事整骨手法医学(OMM)。
我们进行了一项前瞻性队列研究,以利用与ORMP一致的调查来评估OR的效果。我们在单中心研究中确定了整骨疗法原则和实践(OPP)在知识和信心水平方面的提高。接受OR培训的住院医师在住院医师培训结束后更有可能使用OMT。