Attitudes toward osteopathic medicine scale: development and psychometrics.

Mohammadreza Hojat,Leonard H Calabrese,Lynn Bragan,Mark R Speicher,Jennifer Desantis,Robert A Cain

doi:10.5116/ijme.615c.2cfa

Abstract

To develop a valid and reliable instrument for measuring attitudes toward osteopathic medicine. Participants included 5,669 first-year students from 33 U.S. colleges of osteopathic medicine, who completed an online survey at the beginning of the 2019-2020 academic year. Using data from the nationwide Project in Osteopathic Medical Education and Empathy, we developed a 13-item instrument: Attitudes Toward Osteopathic Medicine Scale (ATOMS) and demonstrated the validity and reliability of its scores. The social desirability response bias was controlled in statistical analyses. The corrected item-total score correlations were all positive and statistically significant, and the effect sizes of item discrimination indices were large. Cronbach's coefficient alpha reliability was 0.83. Construct validity, corroborating face and content validity of the ATOMS, was supported by three components, emerged from factor analysis: "Perspectives on Osteopathic Medicine," "Osteopathic Diagnosis and Treatment," and "Holistic-Integrative Care." Correlations between ATOMS scores and scores of cognitive empathy, emotional empathy; orientation toward interprofessional collaboration; lifelong learning; and burnout were statistically significant in the expected direction, providing validity evidence for the ATOMS. Using the method of contrasted groups, significant differences in the ATOMS scores were found by gender, ethnicity, academic background, and career interest in the expected direction, supporting the validity of the ATOMS scores. National norms were developed to assess individual scores alongside national percentile ranks. The ATOMS, developed in a nationwide study, supported by strong psychometric evidence for measuring orientation toward osteopathic medicine, has implications for the assessment of osteopathic medical education, patient outcomes, and admission decisions.

Highlights

Diagnosis and treatment of illness in the context of holistic care was recognized in 1874 by Andrew Taylor Still, MD, who called his view of medical care “osteopathy” and founded the first osteopathic medical school in 1892 in Kirksville, Missouri
The core tenets of osteopathic medicine specify that a human is a unit of the physical, mental, and social/spiritual; that the body is capable of self-regulation; and that holistic treatment should be based upon an understanding of body unity, self-regulation, and interrelationships of structure and function.[1,2]
Attitudes toward specific features and tenets of osteopathic medicine contribute to the career decisions of applicants and to the practice of medicine by graduates of osteopathic medical schools

Summary

Introduction

Diagnosis and treatment of illness in the context of holistic care was recognized in 1874 by Andrew Taylor Still, MD, who called his view of medical care “osteopathy” and founded the first osteopathic medical school in 1892 in Kirksville, Missouri (currently A.T. Still University-Kirksville College of Osteopathic Medicine). Fundamental osteopathic medical competencies include the application of osteopathic manual diagnosis and treatment; the ability to work effectively with other health care professionals as members or leaders of an interprofessional collaborative team; and demonstration of humanistic behavior such as empathy, altruism, compassion, respect, integrity, honesty, and trustworthiness.[3] While osteopathic and allopathic medical education systems currently share most of the aforementioned features in educating physicians-intraining, osteopathic medicine emphasizes manipulative diagnosis and treatment and holistic care. Study participants were often accessible samples from a single institution and insufficient in size

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Discussion

Conclusion