Osteopathic Medical Students Entering Family Medicine and Attitudes Regarding Osteopathic Manipulative Treatment: Preliminary Findings of Differences by Sex.

CONTEXT: Factors distinguishing osteopathic physicians from their allopathic counterparts include the use of osteopathic manipulative treatment (OMT), application of osteopathic principles and practice (OPP), and a greater likelihood of entering primary care, specifically family medicine (FM). In the United States, the percentage of entering osteopathic medical students who were female rose from 14.3% in fall 1977 to 44.3% in fall 2015. OBJECTIVES: To investigate the perspectives of female osteopathic medical students as they relate to osteopathic distinctiveness. METHODS: Students at the West Virginia School of Osteopathic Medicine who were eligible to participate in graduation exercises in 2014 or 2015 were asked to complete the school's standard Exit Survey. The research team chose 5 items from the survey to include in the current analysis. Sex had been self-identified at admission, and residency in first postgraduate year was categorized as FM or other specialty. Graduates entering a transitional year or traditional internship were removed from analysis. RESULTS: Analysis was conducted for 308 of the 375 students (82%) expected to graduate in 2014 or 2015. χ2 analysis found no difference by sex in the number of graduates entering FM residencies vs other specialties (P=.727). Statistically significant differences were found in 2 survey items: "Use of OMT will enhance my practice" (P=.005) and "What emphasis do you believe OMT will have in your practice?" (P<.001). Graduating female students responded more favorably to OMT on both items. For the latter item, 91.4% of female and 80.3% of male students indicated OMT would have at least some role in their practices. Sex differences remained after statistically controlling for entry into FM. CONCLUSION: Female graduating osteopathic medical students were more likely to report that OMT will have at least some role in their practices. Future studies of the attitudes and practice patterns of osteopathic physicians should analyze for differences by sex.

Relationships between clinical rotation subscores, COMLEX-USA examination results, and school-based performance measures.

At the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, an electronic rating form was created to assist preceptors in evaluating student performance for third- and fourth-year clinical rotations. Multiple preceptors, often in rural locations, rated the clinical performance of 70 students in the WVSOM graduating class of 2005. The current study analyzes these ratings. Using Cronbach alpha, subscore reliability coefficients were obtained for all rotations: clinical knowledge, 0.80; data collection, 0.59; application of knowledge, 0.65; and professionalism, 0.78. For the three required family medicine rotations, which were almost always supervised by osteopathic physicians, reliability of the rating for osteopathic principles and practice (OPP) was 0.44. Intercorrelations among these five subscores ranged from 0.46 to 0.94, all statistically significant at the .01 level. Ratings for the five subscores were compared with 19 measures of student performance in other parts of the WVSOM curriculum, many correlations were significant at the .01 level. Clinical knowledge correlated 0.59 with year 2 grade point average (GPA), 0.51 with years 1 and 2 OPP GPA, 0.50 with Comprehensive Osteopathic Medical Licensing Examination USA Level 2 Cognitive Evaluation, and 0.45 with years 1 and 2 physical diagnosis GPA. Application of knowledge correlated 0.55 with year 2 GPA and 0.50 with the organization score on the college's year 3 objective structured clinical evaluation. Professionalism correlated 0.51 with year 2 GPA and 0.49 with OPP years 1 and 2 written examination score. The average preceptor rating using the new electronic form was 92.6, compared with 96.8 when the previous paper-based form was used for the WVSOM class of 1998 (change significant at .05 level). These moderate correlations provide some support for the validity of the Clinical Education Grade Form.

Relationships between scores on the COMLEX-USA Level 2-Performance Evaluation and selected school-based performance measures.

The Comprehensive Osteopathic Medical Licensing Examination USA Level 2 Performance Evaluation (COMLEX-USA Level 2-PE) is a national multistation performance examination designed to examine students' osteopathic clinical skills. The current study examines the relationship between achievement levels on the COMLEX-USA Level 2-PE and selected school-related variables for the class of 2005 at the West Virginia School of Osteopathic Medicine in Lewisburg, WVa (N=70). Significant (P<.01) correlations between the COMLEX-USA Level 2-PE summary performance and selected academic achievement measures include: weighted Physical Diagnosis grade, 0.41; weighted year 1 and year 2 Osteopathic Principles and Practice grade, 0.37: overall year 2 grade point average, 0.42; the objective structured clinical evaluation (OSCE) Physical Examination score, 0.40; and the OSCE Total Station score, 0.33. While further research is needed, the current study found modest but notable relationships between school-generated academic variables and performance on the COMLEX-USA Level 2-PE, and therefore supports the validity of the COMLEX-USA Level 2-PE examination for assessing the clinical skills of future osteopathic physicians.