Volume 111, Issue 4

Multidisciplinary fragmentation contributes to myriad medical errors and as many as 98,000 patient deaths per year. The Institute of Medicine has proposed steps to improve healthcare delivery, including providing more opportunities for interdisciplinary training. The authors describe the interprofessional education (IPE) program at Western University of Health Sciences (WesternU) in Pomona, California. In 2007, 9 colleges at WesternU—including the College of Osteopathic Medicine of the Pacific—undertook an IPE initiative that resulted in creation of a 3-phase program. Part of the IPE development process involved identifying core competencies that were nontechnical and nonclinical and common to all healthcare professions. The IPE development and implementation process and the identified competencies were analyzed for their relationship to the tenets of osteopathic medicine and the core competencies of osteopathic medical education. Although these tenets and core competencies were not intentionally used in the development process of the WesternU IPE program, the analysis revealed that the major components of the program are congruent with the framework of osteopathic principles and practice. The osteopathic medical profession's founding principles, broad-based perspective, and health-promoting tenets put the profession in a position to emerge as one of the leading forces in IPE.

Thirty-nine volunteer students from 3 health science colleges at Touro University California participated in an exercise designed to promote interprofessional collaboration. In the event, thirteen 3-person multidisciplinary teams of students identified potential medical errors in a series of case-based scenarios. In an immediate postevent survey, 33 of 39 respondents (85%) indicated that the exercise marked the first time that they had worked on clinical problems with students from other health professions. All respondents agreed that interprofessional education was useful and necessary. A 6-month follow-up survey had 24 respondents, 9 of whom (38%) indicated that the experience helped them in interprofessional communications in their clinical rotations. Twenty-two respondents (92%) recalled that all team members were involved in the selection of answers. Respondents reported that team answer selections were made by consensus (12 [50%]), by accepting the opinion of an “expert” on the team (9 [38%]), or by majority vote (3 [13%]). Since this exercise, there has been a surge of interprofessional activities at Touro University California, including steps toward the implementation of campus-wide interprofessional education.

Context: As the osteopathic medical profession grows and enrollment in osteopathic graduate medical education falls, it is important to ensure that all osteopathic medical students receive adequate training in osteopathic manipulative medicine (OMM). Objective: To determine if incorporating mandatory exposure to OMM into third- and fourth-year clinical clerkships favorably influences osteopathic medical students' comfort with the use of OMM. Methods: All participants attended a 1-hour mandatory didactic lecture and a 3-hour practical clinic every week as part of their rotations at Wilson Memorial Medical Center. The authors distributed 2 hardcopy questionnaires to each subject: the first survey before rotations began and the second at the end of rotations. The survey comprised 7 clinical situations to which students used a visual analog scale ranging from “comfortable” to “uncomfortable” to describe their personal comfort with using OMM in each situation. Students' responses before and after rotations were compared using the paired t test. Results: Sixty-eight students had rotations at the clinic; 50 students completed both questionnaires. The study demonstrated a statistically significant increase in comfort level of 17.9% ( P <.001) after the rotations. Conclusions: Students' reported levels of comfort with OMM increased after they underwent formal OMM education. Incorporating exposure to an OMM curriculum may help instill a greater sense of identity as a future osteopathic physician and may influence participation in an osteopathic residency.

The anterior cruciate ligament (ACL) of the knee and the function of its anteromedial (AM) and posterolateral (PL) bundles are a focus of orthopedic research. Because of the probability that third-year and fourth-year osteopathic medical students will encounter ACL injuries during clinical rotations, it is of paramount importance that students fully understand the functions of the AM and PL bundles as 2 distinct functional components of the ACL. The authors assess the degree to which the AM and PL bundles are discussed within basic science curricula at colleges of osteopathic medicine (COMs). In September 2008, a 6-question survey addressing various aspects of ACL education was mailed to instructors of lower-extremity anatomy at all 28 COMs that existed at that time. Nine of the 21 responding institutions (42.9%) indicated that both the AM and PL bundles of the ACL are discussed within their basic science curricula. Four of these 9 COMs indicated that their instruction mentions that the bundles are parallel in extension and crossed in flexion. Nine of the 21 responding COMs (42.9%) indicated that they instruct students that the AM bundle is a major anterior-posterior restrictor, and 12 (57.1%) indicated that they instruct students that the PL bundle is the major rotational stabilizer of the ACL. In 7 of the 21 responding COMs (33.3%), the AM and PL bundles are identified via direct visualization during anatomic dissection of the ACL. The authors conclude that their findings suggest the need for enhanced presentation of the AM and PL bundles within the basic science curricula at COMs to provide osteopathic medical students with a more comprehensive education in anatomy.

The American Osteopathic Association Commission on Osteopathic College Accreditation (AOA COCA) is recognized by the US Secretary of Education as the only accrediting agency for predoctoral osteopathic medical education. To maintain its recognition with the US Secretary of Education, AOA COCA is required to adhere to all federal laws and regulations associated with recognition of accrediting agencies. Included in the regulations are requirements for training the evaluators of institutions and programs. The authors discuss AOA COCA's established procedures for evaluator training and site visit conduct. Also included is a review of class sizes of the accredited colleges of osteopathic medicine.

The authors report on the status of osteopathic graduate medical education training for the 2009-2010 academic year. Data are presented on approved programs and trainee positions, including distribution by state and by specialty. An update on the impact of restructuring the internship year into specialty residencies is provided, indicating no net loss of training positions related to this initiate. Summary data from the American Osteopathic Association Intern/Resident Registration Program (ie, the AOA “Match”) are provided.

Since the 1970s, the American Osteopathic Association (AOA) has provided a means for osteopathic physicians to apply for approval of their postdoctoral training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Osteopathic physicians who trained in ACGME programs need this approval to meet AOA licensure and board certification requirements. The AOA approves ACGME residency training with several different approval processes. Approval of the first year of postdoctoral training occurs through Resolution 42, specialty approval (for specialties in which the first year of training is part of the residency), or federal or military training approval. For residency training, the AOA verifies successful completion of an ACGME training program before approving the training. The AOA is using customer surveys and online applications to improve the review process for applicants.

Students in colleges of osteopathic medicine have several options when considering postdoctoral training programs. In addition to training programs approved solely by the American Osteopathic Association or accredited solely by the Accreditation Council for Graduate Medical Education (ACGME), students can pursue programs accredited by both organizations (ie, dually accredited programs ) or osteopathic programs that occur side-by-side with ACGME programs (ie, parallel programs ). In the present article, we report on the availability and growth of these 2 training options and describe their benefits and drawbacks for trainees and the osteopathic medical profession as a whole.

All postdoctoral training programs approved by the American Osteopathic Association are required to be part of an Osteopathic Postdoctoral Training Institution (OPTI) consortium. The author reviews recent activities related to OPTI operations, including the transfer the OPTI Annual Report to an electronic database, revisions to the OPTI Accreditation Handbook, training at the 2010 OPTI Workshop, and new requirements of the American Osteopathic Association Commission on Osteopathic College Accreditation. The author also reviews the OPTI accreditation process, cites common commendations and deficiencies for reviews completed from 2008 to 2010, and provides an overview of plans for future improvements.

The author provides an update on the current CME cycle, which began on January 1, 2010, and will end on December 31, 2012. The author also details minor changes to the requirements for Category 1 CME sponsors accredited by the AOA and describes new online CME opportunities. The current article also explains changes regarding the AOA's awarding and recording of specialty CME credit hours for AOA board-certified osteopathic physicians. In addition, the article includes information to assist osteopathic specialists and subspecialists in requesting AOA Category 1-A credit for courses accredited by the Accreditation Council for Continuing Medical Education.

The Bureau of Osteopathic Specialists continually assesses the skills of osteopathic physician specialists in response to the growth of specialization in the osteopathic medical profession. Most recently, the Bureau has mandated that all osteopathic specialty certifying boards fully implement Osteopathic Continuous Certification no later than January 1, 2013. The authors discuss communication efforts related to this change, including a survey to assess physician needs in light of the new requirement. Also reported are rates of osteopathic specialty board certification and recertification for 2010.