Promoting cultural competency and osteopathic medicine awareness among premedical students through a summer premedical rural enrichment program.

CONTEXT: Premedical preparatory programs at osteopathic medical schools that recruit students from medically underserved areas (MUAs) may promote interest in practicing osteopathic medicine in underserved or rural areas. In these programs, emphasis on cultural competency may increase diversity among medical school applicants and decrease healthcare disparities in the future. OBJECTIVES: The goal of this study is to determine whether a summer premedical rural enrichment program (PREP) held at an osteopathic medical school located in a MUA will foster greater prioritization of cultural competency in medicine, enhance interest in practicing in rural or underserved areas, and increase familiarity with osteopathic medicine. METHODS: An eight-week summer PREP was hosted at the California Health Sciences University College of Osteopathic Medicine (CHSU-COM) in Clovis, California. Seventy-eight diverse participants were recruited from the Central Valley, an underserved region of California. Attendees were required to finish the formal application process and were recommended to have completed medical school prerequisite courses. The curriculum included Medical College Admission Test (MCAT) preparation through team-based learning sessions, introduction to the osteopathic medical school curriculum, osteopathic philosophy, and osteopathic manipulative medicine, as well as integrated anatomy and physiology sessions, medical school application workshops, mock interviews, simulation workshops, and sociology and cultural competency sessions. Data were collected via a voluntary and anonymous survey administered before and after the program with questions about familiarity with osteopathy, interest in practicing in underserved areas, medical school preparedness, and a post-course survey about cultural competency. The surveys had students rate statements on a Likert scale. RESULTS: Seventy-four of the 78 premedical students (95%) completed the pre-and postsurvey. There was a significant increase in agreement to statements evaluating medical school preparedness, osteopathic familiarity, and desire to practice medicine locally in the postprogram survey, compared to the preprogram survey. In the cultural competency postsurvey, 75.0% of the responses to questions that evaluated the positive effect of the course were "Agree" or "Strongly Agree." Of the reported postcourse outcomes, the average MCAT score was 504 ± 6.2 (38 students reported, 50.7%). Of the 27 participants who reported matriculation, 16 (59.2%) were admitted to osteopathic medical schools, 9 (33.3%) to allopathic medical schools, and 2 to other health programs. CONCLUSIONS: After completing the PREP program, premedical participants reported that they have better understanding of cultural competency and improvement in preparation for medical school, including familiarity with osteopathic medicine, and interest in serving MUAs. These findings indicate that similar programs may have a positive impact on MUAs. These programs may help create diverse and culturally competent osteopathic physicians.

Integration of Nutrition Topics in Osteopathic Medical School Curriculum - Shared Experiences.

This article was migrated. The article was marked as recommended. A crucial component of osteopathic medicine's philosophy is self-regulation, preventive care, and health maintenance, including a healthy lifestyle. More than half of the osteopathic medical graduates pursue a career as primary care physicians, and as such patient education on healthy lifestyle, including eating habits, is a significant part of their daily practice. However, nutrition is often overlooked in the osteopathic medical school curricula. Therefore, strategic inclusion of evidence-based nutrition approaches will equip future osteopathic medical students with an understanding and application of nutrition to the ever-growing primary care medical profession. Working towards this goal, we are implementing nutritional science topics across the pre-clinical years of our new osteopathic medical school's curriculum. Providing nutrition topics that will fit into the systems-based curriculum may encourage other medical schools to enhance nutrition instruction in osteopathic medical education. Assimilating nutrition as a part of the curriculum will enhance osteopathic medical students' confidence to counsel and treat their future patient population.

Examining Health Care Students' Attitudes toward E-Professionalism.

Objective. To compare pharmacy, osteopathic medicine, dental medicine, and physician assistant (PA) students' perceptions of e-professionalism. Methods. A 20-item questionnaire was developed and administered to four cohorts of health care professions students early in their first professional year. The questionnaire contained 16 scenarios in which a hypothetical health care student or professional shared information or content electronically and students were asked to indicate how much they agreed that the scenario represented professional behavior. Results. Ninety-four percent of students completed the questionnaire. More female students were in the pharmacy and PA cohorts. There were statistical differences in students' perceptions of e-professionalism in five of 16 scenarios. Specific differences were most often between the osteopathic medicine students and the other cohorts. Conclusions. The health care professions students surveyed had similar perceptions of e-professionalism. Of the four cohorts, osteopathic medicine students appeared less conservative in their approach to e-professionalism than the other cohorts.

Perception of noise by emergency department nurses.

INTRODUCTION: Noise in the emergency department (ED) may be perceived to be high by both patients and nurses alike. This increased noise level is hypothesized to be responsible for communication interference and subsequent disruption of complex procedures and decision-making. The objective of this study is to quantify ambient noise level in an ED while obtaining coincident subjective surveys from nurses in the assessment of actual versus perceived noise. METHODS: Data collected from surveys of ED nurses on each of 3 different dates revealed that sound levels within the selected ED were consistently at or below 70 decibels (dB) of sound as measured by a sound level meter. This level of sound is of the same decibel of normal conversation at a 3-5 foot distance. Nurses surveyed overwhelmingly rated noise as "low" or "not loud" irrespective of a variance (though predominantly within a 10 dB range) in actual sound decibel measurements. RESULTS: Years of experience of work within emergency departments proved the most consistent predictor of nurses' opinions on the frequency with which noise levels within the ED were louder than they should be, with more experienced nurses all ranking noise levels as "frequently" or "always" louder than they should be. CONCLUSION: Individual variance existed in how nurses felt that noise level affected work function. ED nurses' perception of noise is perceived to be low and generally not interfering with their cognitive function.

Etomidate for procedural sedation in the elderly: a retrospective comparison between age groups.

OBJECTIVE: The objective of the study was to compare the complication rate and length of stay (LOS) between the elderly (65 years and older) and the adult (18-64 years old) populations when etomidate is used for procedural sedation in the emergency department (ED). METHODS: A retrospective analysis was performed. Electronic medical records selected all patients who received etomidate in the ED from June 2004 to June 2008. Patients younger than 18 years and those who were intubated were excluded. To account for correlated errors, only first-time visits to the ED were used. RESULTS: There were 31 (16%) patients who experienced a complication: 9 (20%) elderly patients compared with 22 (14.8%) adult patients. No significant difference existed between the age groups and adverse effects. The adult mean LOS was 205 minutes, and the elderly LOS was 225 minutes. There was no significant difference between age groups and adverse effects when compared with LOS. Among patients who experienced a complication, mean LOS was 267 minutes: 252 minutes in the elderly age group and 273 minutes in the adult. Among patients who did not experience a complication, the mean LOS in the elderly and adult age groups was 219 and 193 minutes, respectively, with an overall LOS of 199 minutes. There was a statistical significance (P ≤ .05) between adverse effect and LOS. Patients who experienced a complication remained in the ED for 68 more minutes. CONCLUSION: Etomidate remains as safe and effective an alternative for procedural sedation in the elderly as it is in the general aged population.