First-year Osteopathic Medical Students Research Articles

Case-based EBM instruction for Osteopathic Medical Students: A Case Report

Background: Evidence-based medicine (EBM) is an important part of graduate medical education and a learning outcome necessary for preparing students to become effective residents. However, many medical educators and librarians struggle to offer EBM instruction that is contextualized, relevant, and engaging. Case-based learning (CBL) can establish the relevance of EBM instruction sessions by using clinical scenarios that link theory to practice. Experience: This case report describes how a college of osteopathic medicine (COM) liaison librarian redesigned a large cohort, lecture-based learning approach to EBM instruction into interactive, relevant, and contextualized CBL labs. CBL labs with smaller student groups were designed to provide an active learning environment and encourage peer-to-peer learning. The CBL format has been previously applied to EBM instruction but not quantifiably evaluated. A modified rubric was created to provide a quantifiable measurement of student performance in future evaluations. Discussion: First-year osteopathic medical students participated in CBL sessions, integrating EBM into their curriculum. The small groups facilitated personalized guidance, peer-to-peer learning, and critical thinking. Clinical scenarios that were mapped to the students’ curriculum provided relevance to the learning experience. The CBL format allowed the librarian to support students individually and increased engagement compared to lecture-based learning. Challenges included assessing the students’ prior EBM knowledge and the time commitment for a solo librarian. However, group assignments and a grading rubric helped to minimize the challenge. Conclusion: The initial pilot testing of this instructional design format and rubric has shown promise in reaching the objectives of providing a relevant and active learning platform with quantifiable results. A future randomized controlled trial is planned to provide quantifiable evidence supporting CBL labs for EBM instruction when compared to lecture-based learning

Effects of a focused training on first-year osteopathic medical students' ability to incorporate point-of-care ultrasound in assessment of the anterior knee.

Patients frequently present to the outpatient clinic, urgent care, or emergency department with a painful, swollen knee. Differentiating the underlying etiology can be a challenge for both medical students and seasoned clinicians alike. Because this scenario can represent a time-sensitive emergency, developing skills to diagnose the underlying cause quickly and accurately is essential for proper management, whether the patient would benefit from osteopathic manipulation, prompt administration of antibiotics, or a more invasive procedure like joint aspiration or surgery. The objectives are to determine the effects of a focused ultrasound training on first-year osteopathic medical students' ability to identify normal sonographic anatomy of the anterior knee and to differentiate between three common pathologies: joint effusion, prepatellar bursitis, and cellulitis. First-year osteopathic medical students voluntarily participated in this cross-sectional study. The study protocol included a focused ultrasound training (online materials, brief didactic and single hands-on sessions) followed by a hands-on assessment. A written test and 5-point Likert scale questionnaire were administered before and after the focused training. Nine weeks later, students completed a follow-up written test. The proportion of students who correctly identified common pathologies on written tests before (pretest) and after (posttest) training and on the follow-up written test were compared utilizing the Fisher's exact test. A t test was utilized to compare data from the pretraining and posttraining questionnaires. Of 101 students completing the written pretest andpretraining questionnaire, 95 (94.1 %) completed the written posttest and posttraining questionnaire, and 84 (83.2 %) completed the follow-up written test. Students had limited previous experience with ultrasound; 90 (89.1 %) students had performed six or fewer ultrasound examinations before the focused ultrasound training. On written tests, students accurately identified joint effusion (22.8 % [23/101] pretest, 65.3 % [62/95] posttest, 33.3 % [28/84] follow-up test), prepatellar bursitis (14.9 % [15/101] pretest, 46.3 % [44/95] posttest, 36.9 % [31/84] follow-up test), and cellulitis (38.6 % [39/101] pretest, 90.5 % [86/95] posttest, 73.8 % [62/84] follow-up test). Differences were found between pretest andposttest for identification of all three pathologies (allp<0.001) and between the pretest and 9-week follow-up test for identification of prepatellar bursitis andcellulitis (both p≤0.001). For questionnaires, (where 1=strongly agree, 5=strongly disagree), the mean (standard deviation [SD]) confidence for correctly identifying normal sonographic anatomy of the anterior knee was 3.50 (1.01) at pretraining and 1.59 (0.72) at posttraining. Student confidence in the ability to differentiate joint effusion, prepatellar bursitis, and cellulitis utilizing ultrasound increased from 4.33 (0.78) at pretraining to 1.99 (0.78) at posttraining. For the hands-on assessment, 78.3 % (595 correct/760 aggregated responses) of the time students correctly identified specific sonographic landmarks of the anterior knee. When the evaluation combined real-time scanning with a prerecorded sonographic video clip of the anterior knee, 71.4 % (20/28) accurately identified joint effusion, 60.9 % (14/23) correctly diagnosed prepatellar bursitis, 93.3 % (28/30) recognized cellulitis, and 47.1 % (8/17) diagnosed the normal knee. Our focused training was effective at immediately increasing basic knowledge, as well as confidence of first-year osteopathic medical students when assessing the anterior knee with point-of-care ultrasound. However, spaced repetition and deliberate practice may be useful for learning retention.

Student Engagement Using HoloLens Mixed-Reality Technology in Human Anatomy Laboratories for Osteopathic Medical Students: an Instructional Model.

Mixed-reality technology is a powerful tool used in healthcare and medical education to engage students in life-like scenarios. This blend of virtual and augmented reality images incorporates virtual projections with the real environment to allow real-time observation and interaction [1]. While this immersive technology offers advantages over cadaver dissections, it creates new challenges to keeping students engaged [2, 3]. Student engagement improves students' commitment to learning, critical thinking, and motivation and results in successful course outcomes [4, 5]. This paper provides an activity model using the HoloLens mixed-reality technology to deliver human gross anatomy laboratory sessions to first-year osteopathic medical students. The activity was designed using Gagne's model for instructional design and team-based learning to create an active learning model, which targets the behavioral, emotional, and cognitive dimensions of student engagement [6, 7]: behavioral engagement through autonomy and time on task, emotional engagement through providing the guiding exploration and narrative flow to accompany students' visual experience, and cognitive engagement by incorporating team-based learning (TBL) and case-based learning (CBL). The instructional model also answers the call for a new type of virtual reality instructor and pedagogical strategy that addresses the unique challenges and increases student engagement with this new technology. The effectiveness of this classroom activity was assessed by observing students for indicators or behaviors of student engagement, which are discussed. Further studies are required to measure the extent to which these indicators were exhibited and compare student engagement with this mixed-reality to didactic cadaver-based laboratory sessions.

A Longitudinal Pilot Study of Stress and Sleep in First-Year Osteopathic Medical Students.

Poor sleep quality is thought to be a contributor to medical student stress. The authors evaluated the effect of high and low periods of academic stress on sleep quality and quantity in first-year medical students. A group of 25 students in their first year of medical school were provided Fitbit Charge 3 activity trackers for continual use and were surveyed at 4 intervals to assess stress level, sleep quantity, and sleep quality. Fitbit data were collected through the Fitbit mobile app and uploaded to the Fitabase (Small Steps Labs, LLC) server. Data collection times were scheduled around the academic exam schedule. Weeks in which testing occurred were identified as high-stress periods. Results from assessments were compared to nontesting periods of low stress. During stressful periods, students slept an average of one hour less per 24-h period, took more naps, and reported poorer sleep quality than during the low-stress periods. No significant change was seen in the 4 surveyed intervals in sleep efficiency or sleep stages. Students slept less and had poorer quality sleep in their main sleep event during stressful periods but attempted to compensate with increased napping and weekend catchup sleep. The objective Fitbit activity tracker data were consistent with and validated the self-reported survey data. Activity trackers could potentially be used to optimize the efficiency and quality of both student napping and main sleep events as one component of a stress reduction program for medical students.

Perceived Stress, Grit, and Self-Care Behaviors in First-Year Medical Students.

Medical students experience more stress than the general population, which over time can cause mental and physical disease, including burnout. Identifying factors impacting stress during early medical training could inform strategies to minimize its impacts throughout training and in clinical practice. This study surveyed 238 first-year osteopathic medical students to assess stress (Perceived Stress Scale; PSS), grit, sleep quality (Pittsburgh Sleep Quality Index; PSQI), physical activity (Godin-Shephard Leisure-Time Physical Activity Score; LTPA), and nutrition habits (Rapid Eating Assessment for Participants; REAP) within the first 2weeks of starting medical school and again 10weeks later. Incomplete responses were removed, leaving 204 study participants. We observed statistically significant decreases in grittiness (∆grit = -2.230%, P = .002) and physical activity (∆LTPA = -22.147%, P < .0001), while perceived stress (∆PSS = 34.548%, P < .0001) and poor sleep quality (∆PSQI% = 19.853, P < .0001) increased. Correlation analyses identified the strongest relationships were between ∆PSS vs ∆PSQI (r = .47, P < .0001) and ∆PSS vs ∆LTPA (r = -.20, P < .01). Multivariable linear regression analysis isolated ∆PSQI (P < .0001) and ∆LTPA (P = .012) as statistically significant predictors of ∆PSS. These results suggest early, repeated curricular interventions focused on physical activity and sleep hygiene may help students better manage stress during medical education.

Addressing Motivations and Barriers to Research Involvement during Medical School among Osteopathic Medical Students in the United States

Involvement in research is regarded as a high-impact educational practice, which, for medical professionals, is associated with sharpened critical thinking and life-long learning skills, greater appreciation for evidence-based medicine, and better clinical competence scores. However, there are limited data regarding the research experience and/or interest among osteopathic medical students in the United States despite a rapidly increasing enrollment and expansion of the number of osteopathic medical schools. Thus, we administered an electronic survey examining prior research experience, interests, and perceptions about research participation during medical school to four successive classes of incoming first-year osteopathic medical students. We also performed focus groups with rising third-year osteopathic medical students around the topic of perceived barriers to and potential enablers of promoting research participation. This yielded a survey addendum where first-year osteopathic medical students provided feedback on the likelihood of specific incentives/enablers to encourage participation in research during medical school. Overall, osteopathic medical students are interested in research, view research experience as valuable, and perceive research experience as beneficial to future career development. Students perceive that the primary barrier to involvement in research is a potential negative impact upon performance in coursework. Feedback on the likelihood of specific enablers/incentives was also garnered. Our findings from a single institution may have important implications in defining the prior experiences and perceptions held by first-year osteopathic medical students. Specifically, our study indicates that research experiences intentionally designed with (1) a strong likelihood of gaining a publication, (2) financial compensation, and (3) the opportunity for short-term involvement, a flexible time commitment, and/or a dedicated time period are most likely to encourage research participation by osteopathic medical students.

Harry Potter and the Osteopathic Medical School Part 2: Creating a Virtual Harry Potter-Themed Day as a High-Yield Review for Final Examinations.

The role of gamification and active learning has been common topics of conversation in higher education for many years. These learning tools have been correlated with a multitude of positive effects, including increased student engagement, collaboration, and motivation to learn. This article explores the role of gamification and active learning in a virtual setting using a gamified Harry Potter-themed final examination review session for first-year osteopathic medical students. We also discuss how gamification can be used to improve the connectivity and wellness of students as they attend classes almost entirely online during the COVID-19 global pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40670-022-01501-4.

The effectiveness of the metabolic map in promoting meaningful learning.

Many medical students and practicing physicians view biochemistry, especially its metabolic pathways, as a challenging topic given the depth of material. Medical biochemistry educators aim to help prepare future physicians to apply knowledge of metabolism to disease processes. Research confirms that study tools promote critical thinking and help to connect biochemistry concepts to health and disease processes. To explore whether the Pathways of Human Metabolism Map as a study tool helps to connect basic metabolic pathways to clinical applications. We provided the Pathways of Human Metabolism Map to our first-year osteopathic medical students and conducted a survey to assess their perceptions. Our survey questions aimed to explore the effectiveness of utilizing the metabolic map for connecting the basic metabolic pathways to clinical applications on their studies. Students were surveyed at the end of the course utilizing a Qualtrics survey encompassing Likert scale questions as well as open-ended responses. The results of our comprehensive survey questions revealed the unique perceptions of students. Analysis of our data implicates that study tools like the metabolic map inspire meaningful learning. Our data show that students who utilized the metabolic map in their studies reported that utilizing the map improved their understanding of medical biochemistry. Our research results suggest that providing study aids like the metabolic map encourages students to minimize rote memorization and promotes integration with clinical context. Our results provide a support for study strategies that implement meaningful learning in medical education.

The flipped classroom: a novel approach to physical examination skills for osteopathic medical students.

Medical students are faced with the challenge of synthesizing large volumes of information quickly. With the increasing accessibility of technology, a "flipped classroom" allows students to learn foundational material independently. Class time is instead devoted to in-depth skill building with instructors, promoting an active learning environment. This method of content delivery is also relevant given the current COVID-19 pandemic. To comprehensively evaluate the benefit of adopting a flipped classroom approach in teaching physical exam skills (PES) to first-year osteopathic medical students. A cohort study was conducted comparing first-year osteopathic students in the class of 2022 (n=201), who had taken the PES course traditionally, with the class of 2023 (n=203), who experienced the flipped classroom approach. Objective metrics such as cumulative grades, objective structural clinical examination performance (OSCE), and practical exam performance were compared using nonparametric Mann-Whitney U rank sum tests. Subjective measures such as student course evaluations were used to analyze course perceptions using independent sample t-tests assuming unequal variances. A faculty survey was administered to faculty who taught both cohorts to assess instructor attitudes toward the flipped classroom approach. Due to the COVID-19 pandemic, Spring 2020 quarter data was not included, given the transition of all classes to an online learning environment. The flipped classroom approach significantly improved objective student performance for the Fall (p=0.009) and Winter (p<0.001) student cumulative grades and the History-Taking OSCE (p=0.010). Performance on Fall and Winter practical exam scores had no significant association with the flipped classroom. General student perceptions of the course remained unchanged between both cohorts. Faculty survey results from 10 faculty members showed that six (60%) faculty members preferred the traditional classroom, while four (40%) preferred the flipped classroom. The flipped classroom approach showed some statistically significant improvement in student PES. Further studies are needed to evaluate the benefits of a flipped classroom approach using skills-based assessments styles to measure student performance, with a focus on standardization of in-classroom groupwork.

Effect of occipitoatlantal decompression on cerebral blood flow dynamics as evaluated by Doppler ultrasonography.

Osteopathic manipulative treatment reduces symptoms in patients with headache disorders, but the underlying mechanisms are unclear. To evaluate blood flow in the intracranial and extracranial vasculature before and after occipitoatlantal decompression (OAD) using Doppler ultrasonography. Healthy, first-year osteopathic medical students from A.T. Still University's Kirksville College of Osteopathic Medicine participated in a randomized, single-blinded, two-period, two-treatment crossover study. The participants were randomly assigned to 1 of 2 treatment interventions: OAD or sham touch. After one week, participants returned to have the other intervention performed. Blood flow parameters-peak systolic velocity (PSV) and end-diastolic velocity (EDV)-in the middle cerebral artery (MCA), internal carotid artery (ICA), and vertebral artery (VA) were evaluated before, immediately after, 5minutes after, and 10minutes after treatment. Differences in PSV, EDV, heart rate (HR), and blood pressure (BP) for both interventions were analyzed for the four time points using mixed-effects models. Thirty healthy medical students (11 men, 19 women; mean age, 24years) participated in this study. EDV increased after OAD in the MCA, ICA, and VA (all p<0.001); no change occurred after sham touch (all p>0.05). EDV was greater for all post-treatment timepoints after OAD in the MCA, ICA, and VA than after sham touch (all p<0.001). Although baseline PSV in the MCA measured before treatment was different between treatment interventions (p=0.01), no difference was found between interventions at any post-treatment time point (all p>0.59). Changes in PSV in the ICA and VA and for HR and BP did not depend on treatment intervention (p>0.06). Increases in EDV occurred in major cranial arteries after OAD but not after sham touch, indicating that OAD improves blood flow to the brain. The exact mechanism of this increase is unknown; however, it can be explained by either parasympathetic stimulation through the secretion of vasodilating neurotransmitters or by a decrease in external tissue pressure on ICA and VA, with the resulting flow causing further dilation in the MCA.

Predictors of research self efficacy in first-year osteopathic medical students

BackgroundThere has been a decline in the number of physician-scientists which has promoted interest in developing research initiatives for students in medical school. While it is unclear what might promote student success in research endeavors, it has been postulated that research self-efficacy (RSE) may be contribute to student engagement in research. It is thus important to consider what factors contribute to student engagement in research in the early years of medical training. ObjectiveThe purpose of this study was to assess first-year osteopathic medical students’ (OMS) attitudes towards research and identify factors contributing to RSE. MethodsData were collected from 357 first-year OMS via an online questionnaire on attitudes of and opinions towards research. Multiple regression modeling was used to determine if certain attitudinal factors would be associated with RSE. Hypothesis testing was conducted using Pearson correlation coefficients (r) and multiple regression analysis. ResultsRegression modeling successfully explained 33% of the variance in predicting RSE: F(4,350) = 44.475, p < 0.001 with an R2 of 0.337 (adj. R2 = 0.329). Greater security in understanding research, greater belief in ability to conduct research, feeling research was important in their future career, and wanting more research education and opportunities while in medical school contributed to greater RSE. ConclusionsEvidence-based medicine and the importance of research continue to influence osteopathic education and medical practice. Cultivating RSE should be a goal for medical educators as they design curricular initiatives to facilitate critical thinking and improve chances to apply research skills in residency and beyond.

Assessment of the Research Interests and Perceptions of First-Year Medical Students at 4 Colleges of Osteopathic Medicine.

There are limited data regarding the experiences of and attitudes toward research participation among osteopathic medical students despite rapidly increasing enrollment and expansion of the number of osteopathic medical schools. To assess first-year osteopathic medical students' experience with research, their interest in it, their perceptions of its value, and barriers to participation. An anonymous, online survey was sent to 868 medical students in the class of 2021 at 4 colleges of osteopathic medicine. The survey consisted of 14 multiple-choice items (7 of which offered the option of a written response) and 1 open-ended item that asked them to report their age. The survey remained open for 2 weeks, with 1 reminder email sent on the last day of the survey. Incomplete responses were excluded from the analysis. A total of 328 participants were included, for a response rate of 38%. A majority of respondents reported previous research experience (261 [79.6%]), consistent with a strong perception that research participation is important (315 [96.0%]). Fewer students (177 [54.0%]) were either currently participating in research or affirmed interest in performing research during medical school, with the highest level of interest in clinical research (259 [79.0%]) followed by basic science (166 [50.6%]). Regarding incentives that might encourage participation in research, students preferred monetary compensation (213 [64.9%]) or extra credit in courses (195 [59.5%]). A commonly reported barrier to performing research during medical school was the possibility of a negative impact on performance in coursework (289 [88.1%]). First-year osteopathic medical students are interested in research, view research experience as valuable, and consider research experience as beneficial to future career development. This study's findings highlight opportunities for increasing student participation in research through incentives or removal of perceived barriers.

Interprofessional Education on Medication Adherence: Peer-to-Peer Teaching of Osteopathic Medical Students.

Medication nonadherence is an important barrier to achieving optimal clinical outcomes. Currently, there are limited data on methods used to train medical students about medication adherence. To evaluate the knowledge, confidence, and attitudes of first-year osteopathic medical students before and after a 30-minute peer-to-peer medication adherence education program led by a third-year pharmacy student. All first-year medical students from Touro University California College of Osteopathic Medicine were invited to participate in 1 of 3 medication adherence educational sessions held in May 2019. A third-year pharmacy student who received training from Touro University California College of Pharmacy faculty served as the peer educator. Each session took approximately 1 hour to complete. The session included a preprogram survey, a 30-minute program, and a postprogram survey. Survey items included demographics; medication adherence knowledge, confidence, and attitudes; and attitudes toward the peer-to-peer educational format. Statistical comparisons of preprogram and postprogram knowledge, confidence, and attitudes were made using a paired t test, the McNemar test, and the Wilcoxon signed-rank test. P<.05 was considered statistically significant. A sample size calculation was performed using mean knowledge scores to determine whether the study achieved 80% power. Twenty-three students participated in the study. Medication adherence knowledge scores improved after the program (17.4 [77.4%] vs 9.98 [92.2%]; P<.001). Confidence scores also improved for all 7 survey items (P<.001). Medical students had more positive attitudes toward medication adherence after the program, with 8 of 10 survey items in this domain showing improvement. Most students had a positive attitude toward the peer-to-peer educational format. All participants reported that they would implement the medication adherence skills learned at the program with future patients. A 30-minute peer-to-peer program led by a pharmacy student improved first-year medical students' knowledge, confidence, and attitudes with regard to medication adherence and provided an effective format to enhance interprofessional learning and collaboration.

The Effectiveness of Anatomy Laboratory Videos on Osteopathic Medical Students’ Performance

This article was migrated. The article was not marked as recommended. Introduction: The usage of audio-visual aids in medical education has always been rewarding. This study aimed at evaluating the efficacy of supplementing traditional dissection based laboratories with the video demonstration of specimens. Methods: The study was conducted among first-year osteopathic medical students of two consecutive years. The laboratory demonstration videos were recorded and provided to the experimental group and the previous class served as the historical controls. Two Likert scale based questionnaires were completed by the experimental group before and after their final examination. The students' performance in the Anatomy practical examinations were compared between the two groups. Results: The students' response showed that the videos added value to their knowledge. The videos helped them in understanding the structures in the dissection lab with ease they felt more confident about the examinations. The experimental group scored significantly higher grades in the practical examinations than the control group. The results confirm that the video demonstration has a positive impact on the traditional dissection method. Conclusion: The effect on the student's perception is impressive and the positive outcome in the examination grades adds on to the significance of this teaching methodology. Integration of multimedia with dissection is suggested as a helpful model to improve Anatomy learning process.

Just Say Know to Drugs! A High School Pharmacology Enrichment Program for a Rural Population.

Just Say Know to Drugs! is a summer pharmacology enrichment program for high school students. First-year osteopathic medical students serve as teachers, introducing students to pharmacology while acquiring teaching skills. To assess the effects of a pharmacology program on high school students and to understand the effects of teaching this program on first-year osteopathic medical students. The influence of a pharmacology STEM (science, technology, engineering, and mathematics) enrichment program on high school students' career interests and student teacher preparedness was determined by a pre- and posttest, as well as a postprogram survey. Data from all 37 participating high school students and 10 of 16 student teachers (medical students and undergraduate assistants) were evaluated in the study. Survey findings suggested that this STEM program increased student awareness and knowledge of pharmacology, osteopathic medicine, and scientific research. Furthermore, student teachers thought that they developed the necessary skills to communicate and educate populations with diverse science backgrounds and comprehension levels. The immersion of high school students in the scientific content significantly increased student awareness of pharmacology (paired t test, P<.0001). The Just Say Know to Drugs! program delivered benefits for both high school students and student teachers.

An Exploration of Zink’s Common Compensatory Pattern: Comparing Myofascial Restrictions to Segmental Spinal Somatic Dysfunctions: A Retrospective Study

Abstract Background Zink’s Common Compensatory Pattern (CCP) is a pattern of somatic dysfunction that can be observed in the spinal transitional zones. The CCP can be described as left/right/left/right rotation in the regions of C0/C1/C2, C7/T1, T12/L1, and L5/S1, respectively. It has been proposed that Zink’s pattern can be identified by both myofascial and segmental assessments. This retrospective study investigates myofascial restrictions and spinal somatic dysfunctions to determine whether an agreement exists between myofascial rotation restrictions and osteopathic structural exam findings. Methods Osteopathic manipulative medicine (OMM) screening exams were completed for incoming first-year osteopathic medical students at the Western University of Health Sciences College of Osteopathic Medicine of the Pacific in August 2012. In this retrospective study, there were 208 participants, of which 15 had documented significant previous medical history. For the structural exam, rotational restrictions were assessed at OA, C7, T12, and L5. Myofascial restrictions were assessed at the craniocervical, cervicothoracic, thoracolumbar, and lumbosacral transitional zones. This method of assessment creates 8 separate variables. These variables were recorded using a simple binomial system with 3 options: R for right rotation, L for left rotation, and O for lack of rotational restriction. The authors then evaluated these variables using kappa statistical analysis and the Fisher’s exact test to determine if there was any statistically or clinically significant correlation present between the structural findings and the myofascial restrictions. Results Of the 208 participants, 14 individuals (6.731%) matched all 4 of the structural exam restrictions with the myofascial restrictions, 24 (11.538%) matched 3 of the 4 transition zones, 62 (29.808%) matched 2 zones, 73 (35.096%) matched 1, and 35 (16.827%) exhibited 0 matches. Of the 15 individuals with documented significant previous medical history, 2 individuals (13.333%) had all 4 matches, 1 (6.667%) had 3 matches, 6 (40%) had 2 matches, and 6 (40%) had 1 match. Of the 198 individuals without significant limitations, 12 individuals (6.218%) had all 4 matches, 23 (11.917%) had 3 matches, 56 (29.016%) had 2 matches, 67 (34.715%) had 1 match, and 35 (18.135%) lacked any agreement between structural and myofascial findings. On initial kappa analysis with all 208 participants, the authors found a total of 325 matches within the data, yielding a kappa value of 0.0527 with a 95% confidence interval of 0.0025 to 0.1028. For the 15 participants with medical limitations, the authors found the kappa value to be 0.2450 with a 95% confidence interval of 0.0615 to 0.4284 (P=0.0063). For the 198 individuals without limitations, the authors found the kappa value to be 0.0373 with a 95% confidence interval of -0.0147 to 0.0893 (P=0.1488). Conclusion Regarding the group of 208 participants, there is a weak, but statistically significant correlation between all data points. For the 15 individuals with significant medical limitations, there is a statistically significant correlation between structural and myofascial exam findings, excluding the lumbosacral transition zone. For the remaining 198 individuals, there is no statistically significant correlation between structural and myofascial findings. Ambiguity of significant medical limitations and lack of interrater reliability should be addressed in future research. With the limitations of this retrospective pilot study, the authors hope to further investigate the correlation between myofascial restrictions and structural exam findings.

Exodus From the Classroom: Student Perceptions, Lecture Capture Technology, and the Inception of On-Demand Preclinical Medical Education.

Some medical educators have noted a decline in classroom attendance. Understanding student preferences for content delivery and the relationship between student attendance and learning outcomes may enhance curricular design and best practices for technology-supported learning. To measure the attendance of first-year osteopathic medical students, evaluate the relationship between classroom attendance and aggregate mean course grades, and characterize factors that influence attendance decisions when recorded lectures are available. In nonmandatory class sessions during the 2015-2016 academic year, student attendance data were collected using audience response technology and were linked to course grades. Pearson product moment and partial correlations, controlling for Medical College Admissions Test scores, were calculated to quantify the relationship between classroom attendance and aggregate mean course grades. Students were surveyed to characterize factors influencing attendance decisions and compare the perceived convenience, efficiency, and effectiveness of classroom attendance vs lecture capture technology. The preferred modality for receiving didactic content was assessed, and open-ended questions were included about the advantages or disadvantages of lecture capture, classroom attendance, and podcasts. Responses were analyzed using open and axial coding. A 78% reduction in first-year student classroom attendance was measured from the beginning to the end of the academic year (P<.001). The correlation between classroom attendance and aggregate mean course grades (r=0.17; P=.29) and the partial correlation between them after controlling for admission test scores (r=0.18; P=.08) were not significant, except in the Neuromusculoskeletal A course (r=0.22; P=.027). Students regarded lecture capture recordings as more convenient, efficient, and effective than classroom attendance, and podcasting was the preferred method of content delivery. Major themes associated with the open-ended questions were effective or ineffective time management, enhanced interaction, learning advantages or challenges, and positive or negative content characteristics. First-year classroom attendance decreased significantly during the academic year, but the authors found no significant relationship between attendance and aggregate mean course grades. Students regarded lecture capture recordings as a practical alternative to attending class; however, podcasts were the preferred modality for receiving didactic content. These findings may help in developing learning-centered curricula at colleges of osteopathic medicine.

The Effectiveness of Anatomy Laboratory Videos on Osteopathic Medical Students' Performance.

This article was migrated. The article was marked as recommended. Introduction: The usage of audio-visual aids in medical education has always been rewarding. This study aimed at evaluating the efficacy of supplementing traditional dissection based laboratories with the video demonstration of specimens. Methods: The study was conducted among first-year osteopathic medical students of two consecutive years. The laboratory demonstration videos were recorded and provided to the experimental group and the previous class served as the historical controls. Two Likert scale based questionnaires were completed by the experimental group before and after their final examination. The students' performance in the Anatomy practical examinations were compared between the two groups. Results: The students' response showed that the videos added value to their knowledge. The videos helped them in understanding the structures in the dissection lab with ease they felt more confident about the examinations. The experimental group scored significantly higher grades in the practical examinations than the control group. The results confirm that the video demonstration has a positive impact on the traditional dissection method. Conclusion: The effect on the student's perception is impressive and the positive outcome in the examination grades adds on to the significance of this teaching methodology. Integration of multimedia with dissection is suggested as a helpful model to improve Anatomy learning process.

Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors.

Skin cancer is the most prevalent cancer in the United States. Training medical students about the importance of sun-protective behaviors is critical to reducing skin cancer rates. However, minimal research has explored osteopathic medical students' knowledge and behaviors with regard to the sun's effect on skin health. To assess first-year osteopathic medical students' knowledge about skin cancer and UV radiation, attitudes toward tanning, and sun-protective behaviors to establish baseline values. Using a descriptive, cross-sectional study design, the authors evaluated students' knowledge, attitudes, and behaviors through a quiz. A total of 121 first-year osteopathic medical students completed the quiz. The mean (SD) score was 74.6% (11.5%). Two-thirds of participants (n=82) correctly identified basal cell carcinoma as the most common skin cancer, and the majority identified the ABCDs (asymmetry, border irregularity, color, and diameter) of melanoma detection (96 [79.3%], 106 [87.6%], 108 [89.3%], and 94 [77.7%], respectively). Most participants were aware that cloud cover and swimming underwater do not provide UV ray protection (121 [100%] and 109 [90.1%], respectively), a fact that is often misconceived. Forty participants (33.1%) usually or always used some form of sun protection when outdoors. Forty-seven participants (38.8%) believed that a tan makes one look healthy, and 43 participants (35.6%) sunbathed with the intention of tanning. Physicians are uniquely positioned to counsel patients regarding sun-protective behaviors. Thus, a medical school curriculum that includes education about the sun's effect on health is needed for the prevention and early recognition of skin cancer in future patients.

First-Year Osteopathic Medical Students' Knowledge of and Attitudes Toward Physical Activity.

Current guidelines recommend that primary care physicians provide physical activity counseling as part of routine preventive health care. However, education regarding physical activity counseling often is not included or is inadequately covered in medical school curriculum, and it is unclear whether future physicians are prepared to offer effective counseling in this area. To examine first-year medical students' knowledge of and attitudes toward physical activity and the importance of physical activity in patient counseling. An anonymous electronic survey was distributed to all first-year students enrolled at the Ohio University Heritage College of Osteopathic Medicine. The survey assessed students' knowledge, beliefs, and behavior regarding physical activity and physical activity counseling for patients. The frequencies of students' weekly physical activity were computed to assess students' physical activity behaviors. Attitudes toward personal importance of physical activity and physical activity counseling in primary care were also assessed by response frequency. The relationship between students' knowledge of and participation in physical activity and the priority placed on exercise for future patients were assessed by correlation. Of 243 potential participants, 144 students (59.3%) returned the survey. The majority of students (131 of 144 [91.0%]) indicated that living a healthy lifestyle was very or extremely important to them, and 125 of 144 (86.9%) prioritized physical activity as moderately, very, or extremely important. Of 122 students, 81 (66.4%) exercised for at least 30 minutes on 3 or more of the past 7 days, and 36 (29.5%) reported doing so on 5 or more of the past 7 days. Nearly all of the students (127 of 133 [95.5%]) indicated that exercise is important for their future patients, 97 of 133 (72.9%) indicated feeling moderately or extremely comfortable counseling patients on exercise, and 113 of 134 (84.3%) desired to include physical activity counseling in their practice. Fifty of 134 students (40.3%) indicated that they were aware of current physical activity recommendations for adults in the United States; however, of these 50 students, 1 (2.0%) provided a correct definition of the national recommendations. Although students prioritized healthy lifestyles for themselves and their future patients and indicated a desire to include physical activity counseling as part of routine clinical care, the majority were unaware of the current physical activity recommendations. Thus, there is a need to address physical activity recommendations in the medical school curriculum.