Colleges Of Osteopathic Medicine Research Articles

Canadian DOs: International Expansion of Osteopathic Medical Education North of the Border.

The growth of osteopathic medicine in the United States has led to a vibrant expansion of the profession internationally. Canadian students represent the majority of international applicants and matriculants to US colleges of osteopathic medicine (COMs); however, to our knowledge, no studies have explored this population. To gain a better understanding of Canadian students attending US colleges of osteopathic medicine by examining their residency training preference, visa preference, intent to practice in the United States or Canada, receptiveness to incorporating osteopathic manipulative medicine into practice, specialty preference, estimated debt incurred, and effect of debt on specialty choice. A 10-question electronic survey was sent to Canadian osteopathic medical students in the 17 COMs and branch campuses that accept international applicants. The initial survey pool consisted of frst-, second-, third-, and fourth-year medical students (classes of 2014-2017) compiled from a database managed by the Canadian Osteopathic Medical Student Association. Of the 102 students contacted, 66 (65%) completed the survey. Respondents had a strong desire to practice in Canada (44 [67%]) but were considering an Accreditation Council on Graduate Medical Education (ACGME) or dually accredited residency program in the United States (46 [70%] and 15 [23%], respectively) that would sponsor an H1B visa. Respondents were receptive to incorporating osteopathic manipulative medicine into practice (44 [67%]). Most respondents chose non-primary care specialties (40 [61%]) and incurred a debt of more than $200,000 (44 of 65 [68%]); however, debt had a limited infuence on respondents' choice of specialty (χ23=1.911; P=.591). Most respondents planned to complete ACGME training, to return to Canada to practice medicine, and to practice in a non-primary care specialty. As a growing population that will play a large role in the expansion and reception of the profession internationally, Canadian osteopathic medical students and US-trained Canadian DOs merit further examination.

New colleges of osteopathic medicine, branch campuses, and additional locations--what is the difference?

The American Osteopathic Association Commission on Osteopathic College Accreditation (AOA COCA) is recognized by the US Secretary of Education as the only accrediting agency for predoctoral osteopathic medical education. To maintain its recognition with the US Secretary of Education, the AOA COCA is required to adhere to all federal laws and regulations associated with recognition of accrediting agencies. In this article, the authors discuss the development of new colleges of osteopathic medicine (COMs). They also discuss the development of additional locations and branch campuses of existing COMs and compare the 2 processes. Also included is a review of the AOA COCA- approved class sizes of the accredited COMs.

Appendix 3: Colleges of Osteopathic Medicine

Appendix 3: Colleges of Osteopathic Medicine

Relationship between residency placement and clerkship site enrollment: a retrospective analysis.

Osteopathic medical students frequently engage in clinical clerkships away from their home teaching institution, which can help them decide on a residency program, gain additional experience in a new environment, and further their professional contacts. Conventional wisdom states that these audition clerkships are an important factor in residency placement, but the educational literature concerning the topic is lacking. To determine the relationship between clerkship site enrollment and residency placement so that empirical guidelines can be established for osteopathic medical students in the process of making informed decisions about their clerkships, particularly during the fourth year. A retrospective analysis was conducted. Data on clerkship and residency placement were compiled for the classes of 2008, 2009, and 2010 at the New York Institute of Technology College of Osteopathic Medicine, and χ2 goodness-of-fit analysis and χ2 tests of independence were used to explore relationships between clerkship and residency placement. Of 862 graduates, data were available for 812 (94.2%). Statistically significant relationships were noted between residency program status (osteopathic, allopathic, and military) and audition clerkship, with fewer graduates completing audition clerkships in allopathic programs and with more graduates completing audition clerkships in osteopathic and military residency programs than expected from an independent relationship. A total of 416 graduates (51.2%) did not enroll in the residency program where they completed their audition clerkship. A total of 352 graduates (43.3%) enrolled in the residency program where they completed their audition clerkship. An additional 44 graduates (5.4%) did not complete an audition clerkship in the discipline of their residency program but rotated at a hospital. A total of 364 graduates (44.8%) enrolled in osteopathic residency programs, 425 (52.3%) enrolled in allopathic programs, and 23 (2.8%) enrolled in military programs. Although the results of this study are specific to 1 medical school, they provide evidence to counter long-held beliefs that audition clerkships determine residency placement.

Five-year summary of COMLEX-USA level 2-PE examinee performance and survey data.

The authors present data on examination format and examinee demographics, performance, and survey results for the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) from the first five testing cycles (2004-2005 to 2008-2009). First-time examinees in the 2004-2005 testing cycle had a pass rate of 96.1%, compared with a pass rate of 94.7% for first-time examinees in the 2008-2009 testing cycle. Pass rates were fairly consistent across all testing cycles. Based on postexamination survey results from all testing cycles, the majority of examinees reported that the cases in COMLEX-USA Level 2-PE represented appropriate challenges for fourth-year osteopathic medical students. The majority of examinees also reported that comprehensive standardized patient-based examinations and exercises were administered through their colleges of osteopathic medicine. In addition, survey results indicated overall satisfaction among examinees with the administration of COMLEX-USA Level 2-PE.

Posterior approach to kidney dissection: An old surgical approach for integrated medical curricula

Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated curriculum, the renal system must be covered relatively quickly after the thorax in the cadaver laboratory, often without the opportunity to fully appreciate the rest of the abdominal contents. This article provides dissection instructions that follow one of the historical surgical approaches for nephrectomy, including preservation of the posterior abdominal wall neurovasclature. Dissection procedures were developed for first-year medical students, intending this posterior approach to the kidneys to be their first introduction to the renal system. It has been successfully implemented with the first-year medical students at the University of New England, College of Osteopathic Medicine. Utilizing this posterior approach to the kidney enabled the study of the anatomy of the kidneys, suprarenal glands, and renal vessels, as well as the muscles of the lumbar spine, while maintaining the integrity of the anterior abdominal wall and peritoneal cavity for future gastrointestinal and reproductive system-based dissections.

Relationship of admissions variables and college of osteopathic medicine variables to performance on COMLEX-USA level 3.

New accreditation standards require that all US colleges of osteopathic medicine (COMs) publically report the first-time pass rates of graduates on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 3. Little is known about the extent to which admissions variables or COM performance measures relate to Level 3 performance. To examine the relationship of admissions variables and COM performance to scores on Level 3 and to assess whether a relationship existed between Level 3 scores and sex, curriculum track, year of graduation, and residency specialty in the first postgraduate year. Data were analyzed from 4 graduating classes (2008-2011) of the West Virginia School of Osteopathic Medicine in Lewisburg. Relationships were examined between first-attempt scores on COMLEX-USA Level 3 and Medical College Admission Test (MCAT) scores; undergraduate grade point averages (GPAs); GPAs in COM year 1, year 2, and clinical rotation years (years 3 and 4); and first-attempt scores on COMLEX-USA Level 1, Level 2-Cognitive Evaluation, and Level 2-Performance Evaluation. Of the 556 graduates during this 4-year period, COMLEX-USA Level 3 scores were available for 552 graduates (99.3%). No statistically significant differences were found in Level 3 scores based on sex, curriculum track, graduating class, or residency specialty. The strongest relationship between Level 3 scores and any admissions variable was with total MCAT score, which accounted for 4.2% of the variation in Level 3 scores. The strongest relationship between Level 3 scores and COM year performance measures was with year 2 GPA, which accounted for 35.4% of the variation in Level 3 scores. Level 1 scores accounted for 38.5% of the variation in Level 3 scores, and Level 2-Cognitive Evaluation scores accounted for the greatest percentage of variation (45.7%). The correlation of Level 3 scores with passing the Level 2-Performance Evaluation on the first attempt was not statistically significant. A weak relationship was found between admissions variables and performance on COMLEX-USA Level 3, suggesting that graduates with lower MCAT scores and undergraduate GPAs may have overcome their early disadvantage. Strong relationships were found between Level 3 scores and year 2 GPAs, as well as scores on COMLEX-USA Level 1 and Level 2-Cognitive Evaluation.

The State of Radiologic Teaching Practice in Preclinical Medical Education: Survey of American Medical, Osteopathic, and Podiatric Schools

PurposeThis study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. MethodsAn online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. ResultsOf 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. ConclusionsThis survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught.

Hospice Home Immersion Project: Advancing Medical Education

The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were “admitted” into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or “culture” (Hospice Home) is observed and life experiences of the medical student before, during, and immediately after the immersion are reported by him/her. The purpose of the Hospice Immersion project is to provide second year medical students with firsthand experiences of living in the Hospice Home for 48 hours to answer the question: “What it is like FOR ME to live in the Hospice Home?” The results focus on the students’ common themes that include 1) Unknown Territory; 2) Support; 3) Role of Staff; 4) Role of Immersion Learning in Palliative and End of Life Care; 5) Facing Death and Dying; and 6) Clinical Pearls. This project humanizes dying and death, solidified student realization that dying is a part of life and what an honor it is to be a part of the care process that alleviates pain, increases comfort, values communication, and human connections. Students report new found skills in patient care such as the 1) importance of physical touch; 2) significance of communication at the end of life for the patient, family, and staff; 3) the value of authenticity and sincerity that comes from being comfortable with oneself, which allows silence to communicate caring; 4) connection with and awareness of the person (rather than their terminal illness) and their family; and 5) the importance of speaking with patients and their families about end of life plans in advance. Although this is a time intensive experience for the faculty member and the Hospice Home staff, the depth of learning experienced by the students and opportunities to advance medical education in death and dying are well worth the efforts.

Factors contributing to high prevalence of gastrointestinal parasites in children aged 2–15 years in the Punta Cana region of the Dominican Republic

Factors contributing to high prevalence of gastrointestinal parasites in children aged 2–15 years in the Punta Cana region of the Dominican Republic Kristin Anne Geers Childers, James R Palmieri Department of Microbiology, Infectious and Emerging Diseases, Edward Via College of Osteopathic Medicine–Virginia Campus, Blacksburg, VA, USA Abstract: The prevalence of gastrointestinal parasites and the severity of infection have a profound impact on human health and development, affecting approximately one-third of the world's population. Gastrointestinal diseases, most notably caused by a variety of gastrointestinal parasites, are endemic to the Dominican Republic. A previous study demonstrated a 99.2% prevalence rate in children between the ages of 2 years and 15 years. The purpose of this study is to note the critical factors contributing to the high rate of gastrointestinal parasitic infections in children in the Punta Cana region of the Dominican Republic. This report addresses qualitative observations and contributory factors responsible for the high rate of gastrointestinal parasite infection. These factors include the impact of malnutrition, the role of weaning foods and caretaker food preparation in parasite transmission, the effects of contaminated water sources, sewage control, and lack of health education regarding prevention, control, and treatment of diseases. Prevention programs should be directed at both the national and the local levels, particularly in schools, for education in symptom recognition, prevention, and treatment. It is imperative that health care workers be trained in the use of new tools to help in estimating the prevalence of gastrointestinal parasites in both urban and rural settings. Parasitic infections affect growth, intelligence quotient, and nutrition–health and cause diarrhea, fatigue, dyspepsia, and anemia, resulting in high morbidity and mortality in children in this region of the Dominican Republic. Keywords: clean water, Dominican Republic, gastrointestinal parasites, Haitian, nutritional, parasitic, Verón, weaning foods

Observational Study Fails to Demonstrate the Effectiveness of OMT in Decreasing Low Back Pain

Abstract The Journal of the American Osteopathic Association (JAOA) encourages osteopathic physicians, faculty members and students at colleges of osteopathic medicine, and others within the health care professions to submit comments related to articles published in the JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research. Letters must be submitted online at http://www.osteopathic.org/JAOAsubmit. Letters to the editor are considered for publication in the JAOA with the understanding that they have not been published elsewhere and are not simultaneously under consideration by any other publication. All accepted letters to the editor are subject to editing and abridgment. Although the JAOA welcomes letters to the editor, these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.

Longitudinal Assessment and Perceptions of Medical Post Baccalaureate Students

Incoming medical students arrive from diverse academic backgrounds and different levels of preparedness for the challenges of medical school. These students face major academic and lifestyle transitions in order to be successful in the fast-paced medical school curriculum. The goal of the medical post baccalaureate (PB) program at the Lake Erie College of Osteopathic Medicine (LECOM) is to prepare students (often with below-average grade point average (GPA) and Medical College Admission Test (MCAT) scores) for medical school course content and aid these students in the development of appropriate time-management and study skills. It was hypothesized that graduates of LECOM’s PB program would perform as well as their non-PB classmates. Analysis of longitudinal study data revealed that LECOM PB students matriculated medical school with undergraduate GPAs and MCAT scores significantly lower than their non-PB classmates. However, LECOM PB graduates performed statistically similar to non-PB classmates on their step 1 board examination, at the end of their second year of medical school. Additionally, survey results suggest that LECOM PB graduates perceived they were better prepared for multiple aspects of medical school compared to their peers. These findings suggest that a 1-year PB program, heavy in basic biomedical science, prepares students for academic and social challenges they will face in medical school.

Acceptance of lesbian, gay, bisexual, and transgender patients, attitudes about their treatment, and related medical knowledge among osteopathic medical students.

Limited research exists on the health issues faced by lesbian, gay, bisexual, and transgender (LGBT) patients, as viewed in the context of osteopathic medical education. A full understanding of current medical students' acceptance of, attitudes toward, and knowledge of these issues could lead to the development and incorporation of curricula focusing on the care of LGBT patients into colleges of osteopathic medicine (COMs). To determine among osteopathic medical students the levels of acceptance of LGBT patients, attitudes toward treating this population, and medically relevant knowledge about their distinct health-related issues. In August 2012, students at 6 COMs were sent an e-mail invitation that contained basic information about the study and a link providing access to an anonymous Web-based survey. Standard scales used in previous studies were compiled and individualized into 130 items for the purposes of the present study. Of the 4112 osteopathic medical students contacted, 1698 (41.3%) entered the survey and 1335 (32.5%) completed it. Two hundred respondents (15%) self-identified as having a sexual orientation on the lesbian, gay, or bisexual (LGB) spectrum. Although respondents generally had favorable levels of acceptance of LGBT patients and positive attitudes toward treatment of this population, self-identified LGB students had even greater acceptance of LGBT patients (P<.001) and more positive attitudes toward their treatment (P<.001). When medically relevant knowledge of issues related to the health of LGBT patients was assessed, 125 respondents (12.9%) obtained a passing score of 7 or higher, with LGB students scoring significantly higher than students whose self-identified sexual orientation was heterosexual only (P=.01). Differences in the levels of acceptance of (P=.008), treatment attitudes toward (P=.001), and relevant medical knowledge (P=.05) pertaining to LGBT patients were noted between respondents from the 6 COMs. The results suggest that even though osteopathic medical students had mostly positive personal attitudes and treatment attitudes toward LGBT patients, some disparities were still present. Also, students lacked adequate knowledge of the unique medical issues faced by the LGBT population. In the future, students should be given more training to effectively treat LGBT patients and their health-related issues.

Insular cortex: structural and functional neuroanatomy.

Insular cortex: structural and functional neuroanatomy.

Multitasking behaviors of osteopathic medical students.

To the authors' knowledge, few studies have investigated the relationship between electronic media multitasking by undergraduate and graduate students during lecture and their academic performance, and reports that have looked into this behavior have neglected to investigate factors that may influence students' multitasking during lecture. To determine the extent to which medical students multitask during lecture; the types of multitasking; the frequency of multitasking and factors that influence frequency; and the correlation between multitasking and knowledge acquisition as assessed by a postlecture quiz. A 1-page survey assessing students' multitasking behavior was administered to 125 second-year students at Edward Via College of Osteopathic Medicine and collected at the onset of a standard 50-minute lecture. On completion of the 50-minute lecture, an unannounced 10-question multiple-choice quiz was given to assess knowledge acquisition during those lectures. On a separate date, after a standard 50-minute lecture, a second quiz was administered. The 1-page survey revealed that 98% of students check e-mail, 81% use social media, and 74% study for another class. Students spent the most time studying for another class (23 minutes) followed by using social media (13 minutes) and checking e-mail (7 minutes). The most influential factors behind multitasking were examination schedule (91%), lecturer (90%), and the number of lectures in the day (65%). The mean score for quiz 1 (the day after an examination) was 75%, and the mean score for quiz 2 (the day before an examination) was 60%. Multitasking during lecture is prominent among medical students, and examination schedule is the most influential factor. Although a robust drop in mean score on a lecture-based, unannounced quiz was identified 1 day before a scheduled examination, the effect from multitasking on this process remains unclear.

Bilateral subtrochanteric femoral fractures in a previous alendronate-medicated patient: a case report

Bilateral subtrochanteric femoral fractures in a previous alendronate-medicated patient: a case report Jacob J Triplet,1 Timothy Hawkes,2 Sein Lwin2 1Nova Southeastern University, College of Osteopathic Medicine, Fort Lauderdale, FL, USA; 2Broward Health Medical Center, Orthopedic Surgery Residency Program, Fort Lauderdale, FL, USA Abstract: Bisphosphonate therapy is commonly employed in the management of osteoporosis. Several drug-associated adverse events are well established but are often not considered in patients who have discontinued therapy. Here, we present the case of a patient who sustained bilateral atypical subtrochanteric fractures 1 year after discontinuation of long-term bisphosphonate therapy. We discuss the prodromal clinical presentations and the importance of radiographic imaging to investigate impending fractures. The treatment of these fractures included the implementation of a drug holiday and the use of intramedullary nail stabilization. Keywords: bisphosphonate, femur, osteoporosis, prophylactic stabilization

Prevalence of gastrointestinal parasites in children from Verón, a rural city of the Dominican Republic.

Gastrointestinal infections impose a great and often silent burden of morbidity and mortality on poor populations in developing countries. The Dominican Republic (DR) is a nation on the island of Hispaniola in the Caribbean Sea. Verón is located in La Alta Grácia province in the southeastern corner of the DR. Dominican and Haitian migrant workers come to Verón to work in Punta Cana, a tourist resort area. Few definitive or comprehensive studies of the prevalence of gastrointestinal parasitic infections have been published in the DR. Historically, most of the definitive studies of water-borne or soil-transmitted parasites in the DR were published more than 30 years ago. Presently, there is a high prevalence of gastrointestinal parasitic infections throughout the poorest areas of the DR and Haiti. In this study we report the prevalence of gastrointestinal protozoan and helminth parasites from children recruited from the Clínica Rural de Verón during 2008 through 2011. Each participant was asked to provide a fecal sample which was promptly examined microscopically for protozoan and helminth parasites using the Centers for Disease Control and Prevention (CDC) fecal flotation technique to concentrate and isolate helminth ova and protozoan cysts. Of the 128 fecal samples examined, 127 were positive for one or more parasites. The age of the infected children ranged from 2–15 years; 61 were males and 66 were females. The only uninfected child was a 9 year old female. Percent infection rates were 43.8% for Ascaris lumbricoides, 8.5% for Enterobius vermicularis, 21.1% for Entamoeba histolytica, and 22.7% for Giardia duodenalis. Of the children examined, 7.8% had double infections. Any plan of action to reduce gastrointestinal parasites in children will require a determined effort between international, national, and local health authorities combined with improved education of schools, child care providers, food handlers, and agricultural workers. A special effort must be made to reach out to both documented and undocumented immigrants working or living in the area and to pre-school aged children or those who are not part of the public education system. Lastly, it is important to address the microbial water quality and food preparation, especially during the weaning transition to solid foods and throughout childhood.

Assessing Palpation Thresholds of Osteopathic Medical Students Using Static Models of the Lumbar Spine

Although spinal somatic dysfunction diagnosis is taught at all colleges of osteopathic medicine, few objective measures have been used to evaluate student accuracy. To assess the palpatory skills of osteopathic medical students in evaluating positional asymmetry in the transverse plane using static block transverse process and lumbar spine models. For this observational study, first-year osteopathic medical students completed 3 palpatory assessments using uncovered and covered block transverse process and lumbar spine models to simulate a range of positional asymmetries of the transverse processes. With use of logistic regression, 80%, 90%, and 95% thresholds were defined as the magnitude of asymmetry for which the predicted probability of students correctly determining the direction of asymmetry exceeded a specified amount (.80, .90, or .95). A total of 346 students completed the assessments. For the uncovered block transverse process model (assessment 1), students correctly identified the direction of asymmetry with .89 probability at 1 mm of asymmetry (80% threshold), .94 probability at 2 mm (90% threshold), and .95 probability at 3 mm (95% threshold). For the covered block transverse process model, students correctly identified the direction of asymmetry with .80 probability at 1 mm (80% threshold), .92 probability at 2 mm (90% threshold), and .98 probability at 3 mm (95% threshold) by the third assessment. For the uncovered lumbar spine model (assessment 2), students correctly identified the direction of asymmetry with .93 probability at 2 mm (80% and 90% thresholds) and .95 probability at 3 mm (95% threshold). For the covered lumbar spine model (assessments 2 and 3), students correctly identified the direction of asymmetry with .87 probability at 4 mm (80% threshold); 90% and 95% thresholds were not reached with the range of asymmetries tested. Most first-year osteopathic medical students were able to discern the direction of positional asymmetry of transverse processes on static models. Depending on the model type, student performance improved (block transverse process models) or declined (lumbar spine models) over time. Future studies should evaluate whether accuracy of palpating lumbar spine models translates to accuracy of palpating human lumbar spines.

Keyboard Data Entry Use Among Osteopathic Medical Students and Residents

Candidates taking the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) are currently evaluated on their ability to document clinical findings using a handwritten postencounter note. However, keyboard data entry is increasingly used for medical documentation. To determine the use and perception of keyboard data entry among osteopathic medical students and residents in educational and clinical settings. A Web-based survey regarding frequency of and preference for keyboard data entry was distributed to 9801 osteopathic medical students, 17,268 osteopathic residents, and 34 clinical deans of colleges of osteopathic medicine (COMs). In addition, 31 COMs' clinical skills center directors were contacted to participate in a telephone survey about the use of keyboard data entry in their centers. A total of 1711 students, 1198 residents, 14 clinical deans, and 17 clinical skills center directors responded to the surveys. The majority of students (872 [51%]) reported using electronic keyboard data entry at their COM's clinical skills center for postencounter notes. Among respondents, 379 students (23%), 77 residents (9%), and 1 clinical dean reported that electronic keyboard data entry is never or rarely used during clinical rotations. Most trainees (1592 students [93%], 864 residents [94%]) reported that they were either comfortable or very comfortable with typing. Given the option of recording methods for SOAP (subjective, objective, assessment, plan) note findings on the COMLEX-USA Level 2-PE, 7 clinical deans were unsure of their students' preferences, while the remaining favored keyboard data entry (5) over handwriting (2). The majority of student and resident respondents would choose keyboard data entry (1009 [60%] and 511 [55%], respectively). Osteopathic medical students and residents are comfortable with typing; they are exposed to and would prefer using an electronic form of entry for medical documentation. These results support a conversion from written postencounter notes to keyboard data entry of notes on the COMLEX-USA Level 2-PE.

Colleges of Osteopathic Medicine: Substantive Changes—An Update

The American Osteopathic Association Commission on Osteopathic College Accreditation (AOA COCA) is recognized by the US Secretary of Education as the only accrediting agency for osteopathic predoctoral education. To maintain its recognition with the US Secretary of Education, the AOA COCA is required to adhere to all federal laws and regulations associated with the recognition of accrediting agencies. The authors discuss changes in the policies and procedures applicable to review of substantive changes in existing colleges of osteopathic medicine. Also included is a review of AOA COCA-approved class sizes of the accredited colleges of osteopathic medicine.