Expansion of osteopathic medicine practitioner education on substance use disorders.

CONTEXT: Medical school graduates are generally not well prepared to treat patients with substance use disorders (SUDs), even though opioid overdose deaths in the United States have increased in recent years. When it comes to training in SUDs, osteopathic medicine lags far behind allopathic medicine. It was only in 2019 that the American Osteopathic Association approved Board Certification in Addiction Medicine to help combat the opioid epidemic. Few articles have been published in the literature pertaining to substance use education for osteopathic students and trainees. OBJECTIVES: The goal of this study was to expand the education of osteopathic medical students and primary care residents in SUDs and measure the effect that education had on the attitudes and knowledge of student and residents about SUDs. METHODS: This study collected anonymous data in the form of a voluntary online survey from third- and fourth-year students at an osteopathic medical school and family medicine residents. The survey was completed by 115 students and 29 family medicine residents. Participants completed a pretest survey and then participated in the Physician Undergraduate and Resident Substance Use Education (PURSUE) curriculum developed by the researchers. This consisted of three online modules covering Screening, Brief Intervention, and Referral to Treatment (SBIRT), substance use assessments, and treatment of SUDs. Upon conclusion of the training modules, medical student participants then completed a posttest survey to assess for any changes in knowledge and attitude. Participants also answered questions related to clinical case scenarios involving patients at varying risk levels who were assessed utilizing SBIRT. RESULTS: Students and residents who participated in the training demonstrated an increase in their average scores between the pretest and posttest, indicating effectiveness in learning from the modules. The overall increase in average scores on the pretest and posttest was 6.5 %, which was determined to be statistically significant (p<0.01). Interestingly, participants who reported growing up in underprivileged circumstances performed worse than those participants who reported not growing up in underprivileged circumstances. CONCLUSIONS: The results of our project support the need and benefit of incorporating educational modules on this topic area within medical school curriculums and residency training. Expanding the number of healthcare workers proficient in providing this type of care in these types of settings will improve the quality of and access to medical care in some of our highest-need populations.

Empathy and the Medical Student House Call: The Effect of Clinical Settings on Empathy in Third Year Medical Students.

Objective: This study measured the effect the experience of house calls might have on third-year medical students. Methods: Students were surveyed via an anonymous online survey at the start of their geriatrics clerkship, again at the end of their clerkship, and once more three months later. Empathy was measured using the Jefferson Scale of Empathy - Student version (JSE) and student attitudes towards the geriatrics population was measured using the UCLA Geriatrics Attitudes Scale (GAS). Data were analyzed using SPSS version 27.0. Results: No changes in empathy were found when comparing students who completed house calls versus those who did not. However, students who trained in office settings were noted to have higher JSE scores at the three-month follow-up survey, students who worked in hospital settings had higher JSE scores at the completion of the clerkship, and student who worked in assisted living facilities had higher GAS scores at the completion of the clerkship. Conclusions: Teaching students ways to improve empathy can be challenging. The setting in which a student trains may be an area of focus for improving empathy among trainees and should be researched further.

The role of extracurricular activities and lectures in mitigating medical student burnout.

CONTEXT: Strong evidence throughout the literature highlights burnout as a significant and increasing problem among medical students, impacting students' ability to effectively care for and empathize with patients. OBJECTIVES: To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students. METHODS: An anonymous digital survey including the Maslach Burnout Inventory (MBI) was sent to all students (n=765) at Rowan University School of Osteopathic Medicine. The survey included questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents. RESULTS: Of the 765 students enrolled, 597 completed the survey. Results indicated that women participated in significantly more clubs than men (t[456]=-4.30; p<0.001). Men had higher scores on the depersonalization subscale of the MBI than women (t[463)=2.98; p<0.01]. There were no gender differences in emotional exhaustion or personal accomplishment. Linear regression analyses including gender and club participation as predictors of each of the burnout subscales indicated a significant interaction between gender and number of clubs (ß=0.34; p<0.05), in that more club participation was associated with higher depersonalization scores for women, but lower depersonalization scores for men. The number of wellness/burnout prevention lectures attended was not predictive of scores on any of the burnout subscales. CONCLUSIONS: Our results indicate the importance of understanding what drives burnout on the individual level and adapting interventions to suit the needs of individual students, rather than the student body as a whole.

Transforming a clerkship with telemedicine.

The coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on both clinical practices and learning environments. On March 17th, 2020, the American Association of Colleges of Osteopathic Medicine and Commission on Osteopathic College Accreditation issued a statement recommending a "pause" in medical student participation in-person at clinical sites. In response, the Family Medicine Department at the Rowan University School of Osteopathic Medicine recognized the need to evolve the traditional curriculum and quickly transitioned to an online format, incorporating telemedicine into the clerkship. This new model enabled 44 third-year medical students to obtain high-quality, offsite, virtual education and learn new skills.

Undergraduate Knowledge of Osteopathic Medicine: What Premedical Students Know About Osteopathic Medicine and Its Effect on Burnout.

CONTEXT: Undergraduate student interest in becoming a physician continues to rise, but so too does the difficulty of earning acceptance to medical school. In this competitive environment, little is known about premedical students' knowledge of their medical school options. Moreover, as undergraduate students' emotional health continues to decline, little is known about whether premedical students experience or are at increased risk for the burnout symptoms reported by medical students and other physicians in training. OBJECTIVE: To examine premedical undergraduate students' knowledge of osteopathic medicine, assess how they learned of osteopathic medicine, and collect information about any reported feelings of burnout. METHODS: In this institutional review board-approved study, we electronically distributed an anonymous survey to 342 premedical undergraduate students at a midsize, public research undergraduate institution. The survey included 56 questions. Students were surveyed on their preference of medical schools, knowledge of osteopathic medicine, and experience with burnout via the Maslach Burnout Inventory which measures exhaustion, cynicism, and professional efficacy. Of those who completed the survey, only those who confirmed that they currently considered themselves to be premedical students were included in our analysis. A 2×2 factorial analysis of variance (ANOVA) test was applied to assess main and interaction effects amongst respondents who preferred osteopathic or allopathic programs, whether they learned of osteopathic medicine programs by their own research, and their scores on the 3 measures of the Maslach Burnout Inventory: exhaustion, cynicism, and professional efficacy. Bivariate and factorial analyses were completed using SPSS v26 software (IBM). All tests were 2-tailed and used a .05 standard P value. RESULTS: Of 342 students to whom the survey was sent, 160 (46.8%) responded, and only 92 (26.9%) considered themselves premedical students. Of the 160 students analyzed in our study, 80 (50%) reported first learning of osteopathic medicine through their own research. A 2×2 factorial ANOVA revealed a significant interaction effect for cynicism in respondents who reported learning of osteopathic medicine programs on their own. Conversely, when respondents reported learning of osteopathic medicine programs from another source, they also reported significantly lower cynicism (F[1,1]5.23, P=.03) and exhaustion (F[1,13] 5.79, P=.02) scores. Of the 92 respondents, only 2 students (2.2%) answered all questions regarding general osteopathic medical knowledge correctly. CONCLUSION: The results of this study suggest that among premedical students, knowledge of osteopathic medicine may be incomplete and may be impeding medical school applications. Furthermore, respondents who reported interest in osteopathic medical schools and learned of this option through their own research seemed to experience greater burnout. Based on these findings, increased outreach and education have the potential to not only better inform students of the osteopathic profession, but also to reduce burnout.

Thyroid Disorders in Athletes.

When athletic performance begins to deteriorate, it is important to identify possible underlying etiologies to explain such a phenomenon. Causes include inadequate nutrition, improper training habits, infection, and hematologic or endocrine diseases. In athletes, a thorough investigation of potentially reversible underlying medical conditions may be warranted when there are noted disruptions in training, competition, and recovery. Thyroid disorders should be considered in athletes in whom such a condition is suspected. The clinical picture may not be entirely clear, as athletes may have serum laboratory values that do not accurately correlate with the presenting signs and symptoms, as one might expect. That picture is even further muddled in individuals undergoing significant physiologic stress, and in whom anabolic agents or exogenous thyroid hormone are used. Because there are currently no consensus guidelines on the matter, return to play issues must be addressed when implementing treatment strategies and monitoring serial laboratory values on a case-by-case basis.