Volume 118, Issue 4

Context Medical students from rural and medically underserved areas (MUAs) are more likely than their peers to practice medicine in rural areas and MUAs. However, students from MUAs are also more likely to face socioeconomic barriers to a career in medicine. Objective To determine whether a week-long summer enrichment experience (SEE) at Edward Via College of Osteopathic Medicine-Carolinas could successfully teach high school students from MUAs basic biomedical concepts and foster an interest in medicine and the health sciences. Methods The SEE program is open to high school students in the Spartanburg, South Carolina, area. The program includes interactive lectures, laboratories, demonstrations on gross anatomy prosections, demonstrations on medical simulation models, tours of emergency vehicles, an introduction to osteopathic manipulative medicine, and student-led research projects. Participants were asked to complete a 15-question quiz that assessed their knowledge of basic biomedical concepts and a 10-question survey that assessed their attitudes toward careers in medicine and health sciences. Both the quiz and the survey were completed on both the first and final days of the program. The data were analyzed using paired t tests. Results Participant knowledge of basic biomedical concepts, as determined by the quiz scores, increased after completion of the program (9.1 average correct answers vs 12.6 average correct answers) ( P <.001). Participant attitude toward medicine and the health sciences improved in 9 of the 10 items surveyed after completion of the program ( P <.05). Conclusions Participant knowledge of basic biomedical concepts and their knowledge of and interest in careers in the health sciences improved after completing the SEE program. These findings suggest that educational interventions for high school students could help to develop primary care physicians for rural areas and MUAs and that there is a role for osteopathic medical schools to nurture these students as early as possible.

Context The osteopathic medical profession traditionally emphasized the education of primary care physicians. A common thread for both osteopathic and allopathic residency matches, however, has been an increase in the interest in specialties outside of primary care. Objective To determine whether there are critical points in medical school associated with residency selection decision-making, what factors affect residency selection decisions, and whether any identifiable shifts or trends exist. Methods This mixed-methods study sequentially used qualitative and quantitative research approaches. The study population was a convenience sample of osteopathic medical students, interns and residents, and practicing physicians from partner medical schools, associated hospitals, and a regional association of osteopathic physicians. In the first phase, interviews and focus group discussions were analyzed for codes, categories, and themes relating to factors that influence residency selection. In the second phase, a survey was created from the results of the first phase and administered to study participants. Results Of the 3450 potential participants, 282 completed the survey. Ninety-one of 209 participants (43.5%) indicated that the third year of medical school was the time they will or did decide what type of residency program to pursue. There were no significant differences in the mean scores between the respondent groups (ie, students, residents, and physicians) when ranking the importance of the 10 influential factors associated with residency selection decision-making ( P >.05 for all). Conclusion The highest percentage of participants indicated the third year of medical school was the time that they made residency selection decisions regarding what specialty they were interested in entering. No shifts regarding the importance of specific primary care residency choice factors were found between training status of respondents.

Context Mastering the art of assessing interprofessional outcomes has been a topic of interest in academic research. Specifically, the Interprofessional Education Collaborative has been publishing thorough bodies of work that aim to strengthen teamwork among health professionals and reinforce competencies that will lead to better patient care. Objective To determine osteopathic medical students’ perceived effectiveness of simulated clinical experiences in cultivating interprofessional competencies with nursing students. Methods Second-year osteopathic medical students (classes of 2016 and 2017) and nursing students participated in a simulated clinical experience using a simulated patient mannequin. Students were assessed on clinical and humanistic skills using graded evaluations performed by faculty and actors portraying family members and given feedback on their performance. Evaluation grades were not analyzed. Students were asked to complete an anonymous survey that assessed their attitudes toward the collaborative experience. Results A total of 743 medical students participated in the study—371 from the class of 2016 and 372 from the class of 2017. Incomplete surveys (1 from the class of 2016 and 3 from the class of 2017) were included in the analysis. Statistically significant differences were found between the 2 classes of medical students in their responses to 2 items. With regard to appropriate patient data collection, the ranked distribution of scores was significantly greater for the class of 2014-2015 than for the class of 2013-2014 (mean rank, 389.3 vs 354.64, respectively; U =75,445.50; P =.017). For the item on effective communication with family members, the ranked distribution of scores was significantly greater for the class of 2014-2015 than for the class of 2013-2014 (mean rank, 390.61 vs 353.34, respectively; U =75,928.50; P =.006). Overall, medical students reported feeling better prepared to care for real patients after the simulation. Conclusion Simulated interprofessional experiences during the second year of medical school may help prepare students to collaborate with other health care professionals in a clinical setting, take care of patients, and communicate with patients’ family members.

Context In the process of analyzing entrustable professional activities (EPAs) for use in medical education, ten Cate and others identified challenges, including the need for valid and reliable EPA assessment strategies. Objective To provide osteopathic medical schools with a database of assessment tools compiled from the literature to assist them with the development and implementation of robust, evidence-based assessment methods. Methods MEDLINE, ERIC, PubMed, and other relevant databases were searched using MeSH keywords for articles outlining robust, evidence-based assessment tools that could be used in designing assessments for EPAs 1 through 6. Results A total of 55 publications were included in content analysis and reporting. All but 2 of the assessment articles were conducted in an undergraduate or graduate medical education setting. The majority of the 55 articles related to assessment of competencies affiliated with EPA 2 (16 articles) and EPA 4 (15 articles). Four articles focused on EPA 3. Conclusion Osteopathic medical schools can use this database of assessment tools to support the development of EPA-specific assessment plans that match the unique context and needs of their institution.

Context The transition period for the single accreditation system for graduate medical education under the Accreditation Council for Graduate Medical Education (ACGME) began on July 1, 2015, and will end June 30, 2020. As of February 5, 2018, 82.6% of residency programs accredited by the American Osteopathic Association (AOA) have applied for or achieved ACGME accreditation and 160 programs have applied for or achieved osteopathic recognition. Objective To assess baseline attitudes of osteopathic and allopathic faculty and residents in AOA-accredited and dually accredited residency programs regarding the value of osteopathic-focused educational curricula and mentors. Methods A survey was emailed to 60 program directors of AOA-accredited programs and dually accredited residency programs, some of which had obtained ACGME osteopathic recognition. The survey was to be completed by residents and faculty. Items were formulated to obtain baseline measurements regarding the level of awareness of osteopathic principles and practice (OPP), attitudes regarding osteopathic culture, and the weighted importance of aspects of the osteopathic curriculum. Principal components analysis with Varimax rotation was used. Comparison analysis was accomplished by either independent t tests for subscale scores or Mann-Whitney U tests for item-level scores. Results A total of 327 people responded to the survey (115 faculty members, 211 residents, and 1 no response). Of the 60 program directors contacted, 53 replied with at least 1 program representative. One hundred twenty-nine of all 211 residents (61.7%), including 107 of 134 osteopathic family medicine residents (79.9%), agreed that they intended to use OMT when in practice. The curricular component item with the lowest total survey score, indicating the highest-ranked level of importance, was the ability to work with osteopathic faculty (mean [SD], 1.98 [0.98]). Of the items measuring osteopathic awareness, statements with the strongest level of agreement from all respondents were “I have seen OMT performed on a patient or a peer” and “I am familiar with the basic tenets of OPP.” Conclusion Residents in AOA-accredited programs value osteopathic mentors and OMT, and they generally intend to use OMT when in practice. Respondents from programs with osteopathic recognition had more favorable attitudes toward osteopathic culture and curriculum than did respondents from programs without osteopathic recognition.

In 2014, the American Osteopathic Association (AOA), the American Association of Colleges of Osteopathic Medicine, and the Accreditation Council for Graduate Medical Education (ACGME) agreed to establish a new, single accreditation system for graduate medical education in the United States. The 5-year transition period, from July 1, 2015, through June 30, 2020, gives AOA training programs time to apply for and receive ACGME accreditation before the AOA ceases its postdoctoral accreditation functions. This article discusses policies to protect osteopathic residents during training, addresses program size, reviews progress at the midpoint of the 5-year transition, and looks at next steps in the establishment of the single accreditation system.