Innovative Approach to Teaching Osteopathic Manipulative Medicine: The Integration of Ultrasonography

Abstract

Noninvasive diagnostic methods and palpatory physical examination skills are especially important for osteopathic medical students intending to work in rural, underresourced, or underserved areas. The A.T. Still University-Kirksville College of Osteopathic Medicine integrates ultrasonography into the osteopathic manipulative medicine (OMM) courses required during the first 2 years of medical school, allowing students to learn the technology and to visualize anatomical structures and regions. To assess the feasibility of integrating ultrasonography into the first-year and second-year OMM curriculum through the evaluation of students' success in demonstrating the technology and visualizing the anatomy. As part of their OMM requirements at the A.T. Still University-Kirksville College of Osteopathic Medicine, all first- and second-year students in OMM courses were given ultrasonography assignments that required them to obtain images of musculoskeletal structures in different regions of the body. First-year students studied craniocervical structures and the thoracic, lumbar, and sacral regions. Second-year students studied the glenohumeral joint and the suprapatellar recess. The assignments focused on identifying structures of interest, making annotations, and measuring the structures of interest. Handouts with detailed instructions and a demonstration were provided before each assignment. A total of 183 first-year students and 165 second-year students participated. Of the first-year students, on average, 177 of 181 were able to successfully complete the assignments, with an average completion rate of 98%. The costotransverse joint assignment yielded the lowest completion rate (97%), and the craniocervical landmarks assignment had the highest completion rate (99%). Of the second-year students, 162 of 165 participants were able to successfully complete the assignments, with an average completion rate of 98%. Mean scores were the same for both second-year assignments. First-year and second-year osteopathic medical students successfully demonstrated their use and understanding of ultrasonography and found their assigned structures using live ultrasound imaging. The skills gained through these assignments added another dimension to students' understanding of normal and pathologic musculoskeletal anatomy and vasculature. The integration of ultrasonography into OMM courses may have created a foundation for learning ultrasound-guided injection techniques.