Kauffman Zachary S, Harper Tony, Augustyniak Robert A, Ruff Chloe
Medical Student, DeBusk College of Osteopathic Medicine, Harrogate, TN, USA.
Assistant Professor of Anatomy, DeBusk College of Osteopathic Medicine, Knoxville, TN, USA.
J Osteopath Med. 2025 Sep 10. doi: 10.1515/jom-2024-0197.
Across eight classes at Lincoln Memorial University - DeBusk College of Osteopathic Medicine (DCOM), survey data reveal a decrease in students' identification with osteopathy, which is what distinguishes an osteopathic physician's values, attitudes, and commitment to the tenets of osteopathy. Without intervention, this trend of decreasing osteopathic identification may produce future generations of osteopaths who devalue the specific tenets of osteopathy.
This study aims to determine factors that influence a student's identification with osteopathy, as quantified by Likert-style survey response data, and to precisely quantify these factors' predictive effect on osteopathic identification while simultaneously controlling for other possibly confounding factors. We hypothesize that preparedness and osteopathic manipulative medicine (OMM) skills will be the strongest predictors of osteopathic identification.
We utilized retrospective survey data from 1991 past DCOM students. Identifying data were redacted and replaced with research IDs. The survey contained an item that gauged respondents' identification with osteopathy. To explore our primary objective, we utilized paired samples tests to determine changes in osteopathic identification from matriculation to graduation within each class, as well as Pearson's correlation coefficient to determine each item's correlation with osteopathic identification. To explore objective 2, we utilized multiple regressions and structural equation modeling (SEM) path analyses to quantify these factors' ability to predict osteopathic identification.
Osteopathic identification decreased between matriculation and graduation for each class (10-21 % decrease, p<0.001). Feeling highly motivated to serve the community correlated best with osteopathic identification upon matriculation (r=0.2; p<0.001). One's perception of one's OMM skills - both in explaining OMM philosophy (r=0.5; p<0.001) and utilizing OMM (r=0.5; p<0.001) - as well as feeling happy to be an osteopath (r=0.6; p<0.001), best correlated with osteopathic identification upon graduation. OMM Skills have the greatest direct predictive effect on osteopathic identification, with an effect size of 0.4 (p<0.001). Commitment to Organization, mediated by both OMM Skills and Preparedness, has the greatest overall predictive effect on osteopathic identification, with an effect size of 0.6 (p<0.001).
The current study builds on past research by utilizing SEM path analysis to elucidate the predictive value of multiple factors on osteopathic identification. Application of the current study should consider looking at interventions geared toward increasing students' OMM skills as well as their commitment to their institution, field, and career overall.
林肯纪念大学德布斯克整骨医学院（DCOM）的八个班级的调查数据显示，学生对整骨疗法的认同感有所下降，而整骨疗法正是区分整骨医生的价值观、态度以及对整骨疗法原则的承诺的关键所在。若不进行干预，这种整骨疗法认同感下降的趋势可能会导致未来几代整骨医生贬低整骨疗法的具体原则。
本研究旨在确定影响学生对整骨疗法认同感的因素（通过李克特式调查回复数据进行量化），并精确量化这些因素对整骨疗法认同感的预测作用，同时控制其他可能的混杂因素。我们假设准备情况和整骨手法医学（OMM）技能将是整骨疗法认同感最强的预测因素。
我们利用了1991名过去DCOM学生的回顾性调查数据。识别数据被编辑并替换为研究ID。该调查包含一个衡量受访者对整骨疗法认同感的项目。为探究我们的主要目标，我们使用配对样本检验来确定每个班级从入学到毕业期间整骨疗法认同感的变化，以及皮尔逊相关系数来确定每个项目与整骨疗法认同感的相关性。为探究第二个目标，我们使用多元回归和结构方程模型（SEM）路径分析来量化这些因素预测整骨疗法认同感的能力。
每个班级从入学到毕业期间整骨疗法认同感均有所下降（下降10 - 21%，p<0.001）。入学时，服务社区的强烈动机与整骨疗法认同感的相关性最强（r = 0.2；p<0.001）。一个人对自己OMM技能的认知——无论是在解释OMM理念（r = 0.5；p<0.001）还是在运用OMM方面（r = 0.5；p<0.001）——以及作为一名整骨医生的幸福感（r = 0.6；p<0.001），在毕业时与整骨疗法认同感的相关性最强。OMM技能对整骨疗法认同感具有最大的直接预测作用，效应大小为0.4（p<0.001）。由OMM技能和准备情况介导的对组织的承诺，对整骨疗法认同感具有最大的总体预测作用，效应大小为0.6（p<0.001）。
本研究在以往研究的基础上，利用SEM路径分析阐明了多个因素对整骨疗法认同感的预测价值。本研究的应用应考虑着眼于旨在提高学生OMM技能以及他们对机构、领域和整体职业的承诺的干预措施。
