Volume 103, Issue 11

Mastery of osteopathic palpatory skills and the skilled delivery of osteopathic manipulative treatment is a life-long venture that demands from practitioners increasingly sophisticated manual skills. Specific receptors and neural networks within the brain allow for the gradual development of refined manual skills that parallel responsive alterations and refinements that develop with repeated experience. During clinical training, most graduates of colleges of osteopathic medicine are not given opportunities to hone their palpatory skills. This is unfortunate because there is an increasing public demand for the nonpharmacologic treatment modalities osteopathic physicians could supply. At Berkshire Medical Center in Pittsfield, Mass, a major teaching affiliate of the University of Massachusetts Medical School in Worcester, the authors assembled a team of osteopathic and allopathic physicians to found an osteopathic manipulative medicine clinic. In this article, the authors share their experience in the creation of this research-based osteopathic medical clinic.

The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) is a national medical licensing examination for physicians earning the doctor of osteopathic medicine (DO) degree. Little has been published regarding the validity of this relatively new, high-stakes examination. The purpose of this study was to examine the validity of COMLEX-USA Level 2, which is given to fourth-year osteopathic medical students and focuses on clinically relevant content. Nineteen osteopathic medical schools were asked to submit Level 2 scores and associated academic information, including predictions by deans or deans' representatives regarding whether each student would pass the examination. Twelve of the 17 schools that had students eligible to take the Level 2 examination provided data for 1254 (80%) of 1577 first-time test takers in March 2000. The overall mean score of study participants was 533.35, with a pass rate of 91.98%. The highest average correlation with COMLEX-USA Level 2 performance was with COMLEX-USA Level 1 scores (r = 0.76), followed by basic science grade point average (GPA) (r = .66), total GPA as a fourth-year student (r = .65), and clinical GPA (r = .36). Students identified as being at highest risk received the lowest mean score (427.54) and were most likely to fail Level 2. COMLEX-USA Level 2 scores are moderately to highly related to academic achievement in osteopathic medical schools.

The authors investigated the extent to which colleges of osteopathic medicine include evidence-based medicine education in their curricula. Information was obtained through a questionnaire survey, including a Likert scale. The survey was sent to 19 colleges of osteopathic medicine for completion. Twelve responses were received within the time limits of this cross-sectional study, yielding a 63% response rate. Four colleges of osteopathic medicine report that they currently teach evidence-based medicine within their education programs. Variations among the programs included the type of faculty delivering the evidence-based medicine course, the years in which instruction occurs, the number of hours of instruction, and assessment methods used. Seven additional schools have plans to implement evidence-based medicine into their educational programs. Suggestions for the design of an evidence-based medicine course and an evidence-based medicine-based curriculum are discussed in relation to the survey results.