Free
Medical Education  |   November 2011
Osteopathic Medical Students' Beliefs About Osteopathic Manipulative Treatment at 4 Colleges of Osteopathic Medicine
Author Notes
  • From Des Peres Hospital in St Louis, Missouri (Dr Draper); from the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Ms Johnson and Mr Fossum); and from the Department of Microbiology/Immunology at A.T. Still University-Kirksville College of Osteopathic Medicine (ATSU-KCOM), also in Missouri (Dr Chamberlain). Dr Draper was an osteopathic medical student at ATSU-KCOM when this study was conducted. Mr Fossum is also affiliated with the Department of Osteopathic Manipulative Medicine at ATSU-KCOM 
  • Address correspondence to Brian B. Draper, DO, 735 Country Stone Ct, Manchester, MO 63021-7069. E-mail: bbdraper@gmail.com  
Article Information
Medical Education / Osteopathic Manipulative Treatment / Being a DO
Medical Education   |   November 2011
Osteopathic Medical Students' Beliefs About Osteopathic Manipulative Treatment at 4 Colleges of Osteopathic Medicine
The Journal of the American Osteopathic Association, November 2011, Vol. 111, 615-630. doi:10.7556/jaoa.2011.111.11.615
The Journal of the American Osteopathic Association, November 2011, Vol. 111, 615-630. doi:10.7556/jaoa.2011.111.11.615
Abstract

Context: Osteopathic manipulative treatment (OMT) is a distinctive and foundational aspect of osteopathic medicine. Several studies have reported a decline in the use of OMT by practicing osteopathic physicians, but the reasons for this decline have not been fully investigated.

Objective: To investigate osteopathic medical students' attitudes and beliefs regarding osteopathic philosophy, including OMT.

Methods: A self-administered, 21-item, electronic questionnaire developed specifically for the current study was distributed to first- and second-year osteopathic medical students at 4 colleges of osteopathic medicine. The questionnaire contained items addressing student attitudes toward osteopathic philosophy, including OMT; perceptions of osteopathic predoctoral education; and plans for integrating OMT into future practice.

Results: Of 1478 questionnaires sent, 491 students completed the questionnaire for an overall response rate of 33%. Analysis of student responses revealed that a majority of first- and second-year osteopathic medical students (95%-76%, depending on the question asked) expressed agreement with osteopathic philosophy. Students who reported prior exposure to OMT had higher levels of agreement with osteopathic philosophy statements (P<.04) and with the intention to use OMT (P<.02) than students with no prior exposure. However, students who were drawn to an osteopathic medical school by the desire to become a physician regardless of degree reported lower levels of agreement with osteopathic philosophy and the intention to use OMT. Students' levels of agreement with osteopathic philosophy and intention to use OMT varied significantly based on the school that they attended, their current year of study, and whether or not they were participating in clinical rotations.

Conclusion: The reason why a student decided to study osteopathic medicine was strongly associated with the level of agreement with osteopathic philosophy and the intention to use OMT in future practice. Prior experience receiving OMT, the medical school that a student attends, and the current year of study appear to be related to the students' levels of agreement with osteopathic philosophy and intention to use OMT.

The 4 tenets of osteopathic philosophy have often been cited as the factors that make osteopathic medicine distinctive.1 These tenets, as stated by the American Osteopathic Association,2 are as follows:
  1.  
    The body is a unit; the person is a unit of body, mind, and spirit.
  2.  
    The body is capable of self-regulation, self-healing, and health maintenance.
  3.  
    Structure and function are reciprocally interrelated.
  4.  
    Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.
The interactions between the structure and the function of the body have encouraged the development and continued implementation of treatments unique to osteopathic medicine. Osteopathic manipulative treatment (OMT) is 1 aspect of osteopathic philosophy that has been used to demonstrate how osteopathic medicine produces a distinctive physician.
A number of articles have examined the association between the perceived lack of distinctiveness between osteopathic and allopathic medicine and a decline in the belief in the tenets of osteopathic medicine.3-9 Miller7 has suggested that the osteopathic medical profession has come to resemble the profession it originally revolted against. A study published in 19819 reported only 48% of second-year osteopathic medical students believed that the difference between an osteopathic physician (ie, DO) and an allopathic physician (ie, MD) was sufficient to justify the existence of 2 separate medical professions. In a survey of osteopathic interns published in 1991, Shlapentokh et al10 reported that differences in beliefs about and attitudes toward OMT were present before students applied to medical school and persisted throughout the students' education. In a prospective study reported in 2003, Chamberlain and Yates11 demonstrated that as students progressed through osteopathic medical education, they became less likely to use OMT when treating their patients. In a retrospective study published the same year, Nichols12 indicated that osteopathic medical students viewed themselves as becoming progressively “more osteopathic” as they approached graduation. However, because the students were asked to think back to when they entered medical school rather than provide their thoughts at the time of matriculation, recall bias may have affected the results of the study. Thus, these studies9-12 suggest a need to assess the attitudes and beliefs of students entering osteopathic medical school. 
However, in a study published in 2009, Bates et al13 indicated that teaching medical students the differences between osteopathic and allopathic medicine resulted in students who were less likely to support a change in their degrees from DO to MD. Bates et al13 also encouraged osteopathic physicians to mentor students by demonstrating the osteopathic difference in their practice. 
With the recent increase in the number of colleges of osteopathic medicine (COMs)—currently, there are 26 COMs operating in 34 locations—it is important to address how osteopathic medical students are being taught and mentored in osteopathic principles and practice and to assess the factors that influence student attitudes and beliefs about OMT before entering medical school. Some of the factors that could be assessed include prior exposure to OMT, preference to attend an osteopathic or allopathic medical school, undergraduate major, and whether the student is related to a physician. 
In the current study, we hypothesized that among first- and second-year osteopathic medical students, attitudes about osteopathic philosophy, perception of osteopathic medical education, and plans for integrating OMT into future practice would vary according to the COM that the student attended, their current year of study, and the factors that drew them to osteopathic medicine. We tested this hypothesis at 4 COMs using an electronic questionnaire that was developed specifically for the current study. After the data collection was completed, we conducted focus groups to refine further the questionnaire for use in future studies. 
Methods
The institutional review board at A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine (ATSU-KCOM) in Missouri reviewed and approved the current study. Four COMs were selected to participate based on the authors' associations with the schools and the schools' geographic locations: ATSU-KCOM, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona (ATSU-SOMA) in Mesa, Des Moines University College of Osteopathic Medicine (DMU-COM) in Iowa, and Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine (KCUMB-COM) in Missouri. The dean of each school was contacted for approval, and all 4 schools agreed to participate. 
Questionnaire
A questionnaire was developed specifically for the current study and was used to survey first- and second-year osteopathic medical students in 3 areas: attitudes about osteopathic philosophy, perception of osteopathic predoctoral education, and plans to integrate OMT into future practice (Figure). The questionnaire items were on the basis of the authors' knowledge of the existing literature in this area and included questions similar to those in the literature that had face validity. Response options for questions in the 3 areas were based on the Likert scale (ie, strongly agree, agree, neutral, disagree, or strongly disagree). In addition, the questionnaire included questions concerning the student's relationship to various medical professions and 1 open-ended question regarding what drew the student to osteopathic medicine (1). The questionnaire also included questions regarding which COM the student attended and the student's current year of study. 
Figure.
Description of constructs and survey questions used to assess osteopathic medical students' beliefs about osteopathic manipulative treatment. Abbreviation: OMT, osteopathic manipulative treatment.
Figure.
Description of constructs and survey questions used to assess osteopathic medical students' beliefs about osteopathic manipulative treatment. Abbreviation: OMT, osteopathic manipulative treatment.
An electronic version of the questionnaire was created using Zoomerang software (Zoomerang, San Francisco, California) for online surveys.14 The questionnaire was set up through the Research Support office at A.T. Still University. 
An e-mail explaining the study was sent in March 2009 to every first- and second-year student at the 4 COMs participating in the study. The students were informed of the purpose of the study and the identity of the investigators, and that their participation in the study was optional, their responses would be kept confidential, they could end their participation at any time, and they were not required to respond to statements that they did not want to answer. To encourage participation, students who completed the questionnaire were given the chance to enter into a raffle to win a $10 gift card redeemable at a retail store. A link providing access to the questionnaire on a Web site was included in the e-mail. Students were informed that by clicking on the link they were giving their consent to participate in the study. The questionnaire was open to student access for 4 weeks. A follow-up e-mail was sent 2 weeks later to encourage further participation. 
Statistical Analysis
All questionnaire data were collected in a confidential manner to ensure that the researchers did not have access to any identifiable student information. All responses to each question were included in statistical analysis, even when the entire questionnaire was not completed. Undergraduate major was categorized as science, health, or other. Reasons for attending a COM (in response to the question “What drew you to osteopathy?”) were qualitatively analyzed by 2 members of the research team (B.B.D. and N.R.C.). χ2 tests were used to determine whether the reason for choosing to attend a COM was related to the specific school, their current year of study, relationship to a physician (a DO, an MD, neither, or both), prior experience receiving OMT, and whether the student applied to both osteopathic and allopathic medical schools. 
The responses to individual questions were analyzed using Kruskal-Wallis tests15 to determine whether the responses were related to the school attended, their current year of study, relationship to a physician, prior experience receiving OMT, whether the student applied to both osteopathic and allopathic medical schools, and reasons for choosing to attend a COM. These comparisons were made to test the hypothesis that first- and second-year osteopathic medical student attitudes about osteopathic philosophy, perceptions of osteopathic medical education, and plans for integrating OMT into future practice would vary based on the school attended, the current year of study, and the reason they were drawn to osteopathic medicine. 
Significance level was set at P⩽.05. Statistical tests were conducted using SAS software (version 9.2; SAS Institute Inc, Cary, North Carolina). 
Focus Groups
After the data were collected, 4 focus groups were conducted at ATSU-KCOM. The purpose of the focus groups was to gain insight into how the questionnaire was perceived and was the first step in validating the questionnaire for use in future studies. First- and second-year medical students were contacted by e-mail and were asked to join a focus group regardless of whether they had completed the study questionnaire. Two of the focus groups included first-year students, and the other 2 groups included second-year students. The focus groups discussed the questionnaire, addressing the layout, length, gift card incentive, and wording of each question. Two of 3 of the authors (B.B.D., J.C.J., C.F.) conducted each of the focus groups, made independent notes during the focus group sessions, and collaborated to analyze the feedback. 
Results
Of 1478 students at the 4 COMs, 491 students completed the questionnaire, for an overall response rate of 33% (Table 1). There were 257 first-year students (52%) and 234 second-year students (48%) who participated in the study. Thirty respondents did not indicate which medical school they attended. The response rates for the individual COMs ranged from 15% to 49%. 
Table 1.
Study Participants Among First- and Second-Year Students at Each COM
COM No. of First- and and Second-Year Students No. of Participants (n=491)* Response Rate, % Participant
ATSU-KCOM 340 165 49 36
ATSU-SOMA 204 70 34 15
DMU-COM 425 151 36 33
KCUMB-COM 509 75 15 16
  * Thirty respondents did not indicate which college of osteopathic medicine (COM) they attended.
  The overall response rate was 33%.
  Abbreviations: DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; KCUMB-COM, Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa.
Table 1.
Study Participants Among First- and Second-Year Students at Each COM
COM No. of First- and and Second-Year Students No. of Participants (n=491)* Response Rate, % Participant
ATSU-KCOM 340 165 49 36
ATSU-SOMA 204 70 34 15
DMU-COM 425 151 36 33
KCUMB-COM 509 75 15 16
  * Thirty respondents did not indicate which college of osteopathic medicine (COM) they attended.
  The overall response rate was 33%.
  Abbreviations: DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; KCUMB-COM, Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa.
×
Table 2 summarizes demographic information about the relationship of the students to various types of healthcare professionals, whether the respondents had previously received OMT or chiropractic treatment, and the types of medical schools (ie, osteopathic or allopathic) to which the respondents applied. Regarding being related to a physician, 20% of respondents were related to an MD only, 5% to a DO only, 4% to both, and 71% to neither. Of 449 students who responded to the question “What was your undergraduate major?” 311 (69%) were science majors, 68 (15%) were health majors, 21 (5%) were dual science and health majors, and 49 (11%) majored in other fields. 
Table 2.
Respondents' Relationships to Various Medical Professionals, Previous Exposure to Osteopathic Manipulative Treatment, and Application to Osteopathic and Allopathic Medical Schools (N=491)
Survey Question No. (%)
Are you related to an osteopathic physician (DO)? 42 (9)
Are you related to an allopathic physician (MD)? 116 (24)
Are you related to or are you a chiropractor (DC)? 22 (4)
Are you related to or are you a physical therapist? 31 (6)
Have you received an OMT? 327 (67)
Have you received a chiropractic treatment? 189 (39)
Have you applied to both osteopathic and allopathic medical schools? 356 (73)
  Abbreviation: OMT, osteopathic manipulative treatment.
Table 2.
Respondents' Relationships to Various Medical Professionals, Previous Exposure to Osteopathic Manipulative Treatment, and Application to Osteopathic and Allopathic Medical Schools (N=491)
Survey Question No. (%)
Are you related to an osteopathic physician (DO)? 42 (9)
Are you related to an allopathic physician (MD)? 116 (24)
Are you related to or are you a chiropractor (DC)? 22 (4)
Are you related to or are you a physical therapist? 31 (6)
Have you received an OMT? 327 (67)
Have you received a chiropractic treatment? 189 (39)
Have you applied to both osteopathic and allopathic medical schools? 356 (73)
  Abbreviation: OMT, osteopathic manipulative treatment.
×
Responses to the open-ended question “What drew you to osteopathy?” from 443 students were categorized into 6 themes, listed in order of prevalence: osteopathic philosophy (included interest in a holistic approach to medicine and the concept of body, mind, and spirit; 259 respondents [53%]), OMT (included interest in OMT as an additional healthcare tool; 132 [27%]), factors associated with a specific school (included location and curriculum; 78 [16%]), other influences (included encouragement from relatives, friends, or other mentors; 52 [11%]), desire to become a physician regardless of degree (included acceptance only at a COM; 47 [10%]), and service (included desire to help the underserved; 14 [3%]). 
The percentage of students who stated that osteopathic philosophy was what drew them to osteopathic medicine was significantly different based on school (P=.05), with students from KCUMB-COM (63%) and ATSU-SOMA (61%) stating this reason more frequently than students from ATSU-KCOM (51%) and DMU-COM (46%). First-year students were more likely than second-year students to cite osteopathic philosophy as a reason for attending osteopathic medical school (58% vs 47%; P=.009). Students who had previously received OMT were less likely than those who had not received OMT to cite the desire to become a physician regardless of degree as the reason for attending osteopathic medical school (7% vs 14%; P=.01). Also, students who applied only to COMs were less likely to cite the desire to become a physician regardless of degree as the reason for attending osteopathic medical school than were students who applied to both osteopathic and allopathic medical schools (2% vs 12%; P=.0007). 
Table 3 summarizes responses to statements concerning student attitudes toward osteopathic philosophy, beliefs about osteopathic predoctoral education, and intentions to use OMT in future practice. 
Table 3.
Responses to Study Questionnaire (No. [%])* Assessing Attitudes, Beliefs, and Intentions Regarding Osteopathic Medicine
Area Assessed and Statement Strongly Agree Agree Neutral Disagree Strongly Disagree
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 390 (79) 81 (17) 11 (2) 3 (1) 6 (1)
□ I believe OMT is a legitimate means of treatment for patients. 215 (44) 199 (41) 50 (10) 17 (3) 10 (2)
□ I believe OMT is an effective treatment method. 185 (38) 212 (43) 63 (13) 20 (4) 11 (2)
□ OMT is a major distinguishing factor between a DO and an MD. 202 (41) 170 (35) 63 (13) 37 (8) 19 (4)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 107 (22) 124 (25) 102 (21) 103 (21) 55 (11)
□ Learning OMT will provide an additional tool I will use to treat patients. 203 (41) 164 (33) 69 (14) 37 (8) 18 (4)
□ I want to learn OMT as part of medical school curriculum. 207 (42) 156 (32) 68 (14) 38 (8) 22 (4)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 104 (21) 201 (41) 95 (19) 62 (13) 29 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 119 (24) 191 (39) 107 (22) 49 (10) 24 (5)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 67 (14) 146 (30) 128 (26) 96 (20) 53 (11)
□ As an osteopathic physician, I do not plan on using OMT.† 46 (9) 53 (11) 84 (17) 142 (29) 165 (34)
  * Some percentages do not total 100 because of rounding.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 3.
Responses to Study Questionnaire (No. [%])* Assessing Attitudes, Beliefs, and Intentions Regarding Osteopathic Medicine
Area Assessed and Statement Strongly Agree Agree Neutral Disagree Strongly Disagree
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 390 (79) 81 (17) 11 (2) 3 (1) 6 (1)
□ I believe OMT is a legitimate means of treatment for patients. 215 (44) 199 (41) 50 (10) 17 (3) 10 (2)
□ I believe OMT is an effective treatment method. 185 (38) 212 (43) 63 (13) 20 (4) 11 (2)
□ OMT is a major distinguishing factor between a DO and an MD. 202 (41) 170 (35) 63 (13) 37 (8) 19 (4)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 107 (22) 124 (25) 102 (21) 103 (21) 55 (11)
□ Learning OMT will provide an additional tool I will use to treat patients. 203 (41) 164 (33) 69 (14) 37 (8) 18 (4)
□ I want to learn OMT as part of medical school curriculum. 207 (42) 156 (32) 68 (14) 38 (8) 22 (4)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 104 (21) 201 (41) 95 (19) 62 (13) 29 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 119 (24) 191 (39) 107 (22) 49 (10) 24 (5)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 67 (14) 146 (30) 128 (26) 96 (20) 53 (11)
□ As an osteopathic physician, I do not plan on using OMT.† 46 (9) 53 (11) 84 (17) 142 (29) 165 (34)
  * Some percentages do not total 100 because of rounding.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Attitudes Toward Osteopathic Philosophy
Students at ATSU-KCOM more strongly agreed that OMT is a legitimate means of treatment compared to students at KCUMB-COM (50% strongly agreed vs 29%; P=.04) (Table 4). Overall, first-year students agreed that OMT is a major distinguishing factor between a DO and an MD more strongly than second-year students (44% strongly agreed vs 38%; P=.03) (Table 5). First-year students at ATSU-KCOM, DMU-COM, and ATSU-SOMA were in more agreement with this statement than second-year students at DMU-COM and first-year students at KCUMB-COM (P=.03) (Table 6). Students who had received OMT previously more strongly agreed with statements regarding attitudes toward osteopathic philosophy than did students who had not (P<.04) (Table 7), as did students who were drawn to osteopathic medicine by osteopathic philosophy or OMT (P<.03 for all except 1 statement) (Table 8). Students who said that the desire to become a physician regardless of degree is what drew them to osteopathic medicine less strongly agreed with statements regarding osteopathic philosophy (P<.02) (Table 8). Additionally, students who applied only to COMs were more strongly in agreement with statements regarding the legitimacy (59% strongly agreed vs 38%; P<.0001) and effectiveness (47% strongly agreed vs 34%; P=.002) of OMT than students who applied to both osteopathic and allopathic medical schools (Table 9). Students who were related to both a DO and an MD more strongly agreed with the statement regarding the legitimacy of OMT than did students who were related to a DO only (P=.05) (Table 10). 
Table 4.
Comparison of Responses of Students Who Strongly Agreed With Questionnaire Statements (No. [%]), by College of Osteopathic Medicine
Area Assessed and Statement ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 139 (84) 56 (80) 111 (74) 61 (81) .10
□ I believe OMT is a legitimate means of treatment for patients. 83 (50) 26 (37) 68 (45) 22 (29) .04
□ I believe OMT is an effective treatment method. 69 (42) 25 (36) 58 (38) 18 (24) .20
□ OMT is a major distinguishing factor between a DO and an MD. 75 (45) 29 (41) 61 (40) 22 (29) .18
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 46 (28) 17 (24) 23 (15) 12 (16) .02
□ Learning OMT will provide an additional tool I will use to treat patients. 76 (46) 29 (41) 50 (33) 30 (40) .08
□ I want to learn OMT as part of medical school curriculum. 80 (48) 31 (44) 52 (34) 27 (36) .02
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 43 (26) 19 (27) 27 (18) 4 (5) .0003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 54 (33) 4 (6) 40 (27) 10 (13) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 30 (18) 11 (16) 14 (9) 8 (11) .02
□ As an osteopathic physician, I do not plan on using OMT.† 15 (9) 4 (6) 15 (10) 10 (13) .63
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 4.
Comparison of Responses of Students Who Strongly Agreed With Questionnaire Statements (No. [%]), by College of Osteopathic Medicine
Area Assessed and Statement ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 139 (84) 56 (80) 111 (74) 61 (81) .10
□ I believe OMT is a legitimate means of treatment for patients. 83 (50) 26 (37) 68 (45) 22 (29) .04
□ I believe OMT is an effective treatment method. 69 (42) 25 (36) 58 (38) 18 (24) .20
□ OMT is a major distinguishing factor between a DO and an MD. 75 (45) 29 (41) 61 (40) 22 (29) .18
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 46 (28) 17 (24) 23 (15) 12 (16) .02
□ Learning OMT will provide an additional tool I will use to treat patients. 76 (46) 29 (41) 50 (33) 30 (40) .08
□ I want to learn OMT as part of medical school curriculum. 80 (48) 31 (44) 52 (34) 27 (36) .02
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 43 (26) 19 (27) 27 (18) 4 (5) .0003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 54 (33) 4 (6) 40 (27) 10 (13) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 30 (18) 11 (16) 14 (9) 8 (11) .02
□ As an osteopathic physician, I do not plan on using OMT.† 15 (9) 4 (6) 15 (10) 10 (13) .63
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 5.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School
Area Assessed and Statement First Year (n=257) Second Year (n=234) P Value*
Attitudes Toward OMT
□ I believe the person is made up of body, mind, and spirit. 204 (79) 186 (79) .90
□ I believe OMT is a legitimate means of treatment for patients. 107 (42) 108 (46) .91
□ I believe OMT is an effective treatment method. 90 (35) 95 (41) .96
□ OMT is a major distinguishing factor between a DO and an MD. 113 (44) 89 (38) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 58 (23) 49 (21) .30
□ Learning OMT will provide an additional tool I will use to treat patients. 109 (42) 94 (40) .29
□ I want to learn OMT as part of medical school curriculum. 115 (45) 92 (39) .23
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 52 (20) 52 (22) .61
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 72 (28) 47 (20) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 36 (14) 31 (13) .04
□ As an osteopathic physician, I do not plan on using OMT.† 20 (8) 26 (11) .44
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 5.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School
Area Assessed and Statement First Year (n=257) Second Year (n=234) P Value*
Attitudes Toward OMT
□ I believe the person is made up of body, mind, and spirit. 204 (79) 186 (79) .90
□ I believe OMT is a legitimate means of treatment for patients. 107 (42) 108 (46) .91
□ I believe OMT is an effective treatment method. 90 (35) 95 (41) .96
□ OMT is a major distinguishing factor between a DO and an MD. 113 (44) 89 (38) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 58 (23) 49 (21) .30
□ Learning OMT will provide an additional tool I will use to treat patients. 109 (42) 94 (40) .29
□ I want to learn OMT as part of medical school curriculum. 115 (45) 92 (39) .23
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 52 (20) 52 (22) .61
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 72 (28) 47 (20) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 36 (14) 31 (13) .04
□ As an osteopathic physician, I do not plan on using OMT.† 20 (8) 26 (11) .44
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 6.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School and Institution
Area Assessed, Statement, and Year in School ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. .39
– First year 58 (87) 28 (82) 59 (71) 47 (81)
– Second year 81 (83) 28 (78) 52 (76) 14 (82)
□ I believe OMT is a legitimate means of treatment for patients. .08
– First year 37 (55) 12 (35) 35 (42) 15 (26)
– Second year 46 (47) 14 (39) 33 (49) 7 (41)
□ I believe OMT is an effective treatment method. .46
– First year 29 (43) 13 (38) 30 (36) 11 (19)
– Second year 40 (41) 12 (33) 28 (41) 7 (41)
□ OMT is a major distinguishing factor between a DO and an MD. .03
– First year 35 (52) 15 (44) 39 (47) 15 (26)
– Second year 40 (41) 14 (39) 22 (32) 7 (41)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. .05
– First year 18 (27) 8 (24) 14 (17) 12 (21)
– Second year 28 (29) 9 (25) 9 (13) 0
□ Learning OMT will provide an additional tool I will use to treat patients. .15
– First year 35 (52) 15 (44) 26 (31) 23 (40)
– Second year 41 (42) 14 (39) 24 (35) 7 (41)
□ I want to learn OMT as part of medical school curriculum. .04
– First year 37 (55) 15 (44) 32 (39) 21 (36)
– Second year 43 (44) 16 (44) 20 (29) 6 (35)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. .0004
– First year 21 (31) 12 (35) 12 (14) 3 (5)
– Second year 22 (22) 7 (19) 15 (22) 1 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† <.0001
– First year 32 (48) 3 (9) 22 (27) 9 (16)
– Second year 22 (22) 1 (3) 18 (26) 1 (6)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† .01
– First year 13 (19) 6 (18) 8 (10) 7 (12)
– Second year 17 (17) 5 (14) 6 (9) 1 (6)
□ As an osteopathic physician, I do not plan on using OMT.† .58
– First year 2 (3) 2 (6) 8 (10) 7 (12)
– Second year 13 (13) 2 (6) 7 (10) 3 (18)
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, AT. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, AT. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 6.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School and Institution
Area Assessed, Statement, and Year in School ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. .39
– First year 58 (87) 28 (82) 59 (71) 47 (81)
– Second year 81 (83) 28 (78) 52 (76) 14 (82)
□ I believe OMT is a legitimate means of treatment for patients. .08
– First year 37 (55) 12 (35) 35 (42) 15 (26)
– Second year 46 (47) 14 (39) 33 (49) 7 (41)
□ I believe OMT is an effective treatment method. .46
– First year 29 (43) 13 (38) 30 (36) 11 (19)
– Second year 40 (41) 12 (33) 28 (41) 7 (41)
□ OMT is a major distinguishing factor between a DO and an MD. .03
– First year 35 (52) 15 (44) 39 (47) 15 (26)
– Second year 40 (41) 14 (39) 22 (32) 7 (41)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. .05
– First year 18 (27) 8 (24) 14 (17) 12 (21)
– Second year 28 (29) 9 (25) 9 (13) 0
□ Learning OMT will provide an additional tool I will use to treat patients. .15
– First year 35 (52) 15 (44) 26 (31) 23 (40)
– Second year 41 (42) 14 (39) 24 (35) 7 (41)
□ I want to learn OMT as part of medical school curriculum. .04
– First year 37 (55) 15 (44) 32 (39) 21 (36)
– Second year 43 (44) 16 (44) 20 (29) 6 (35)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. .0004
– First year 21 (31) 12 (35) 12 (14) 3 (5)
– Second year 22 (22) 7 (19) 15 (22) 1 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† <.0001
– First year 32 (48) 3 (9) 22 (27) 9 (16)
– Second year 22 (22) 1 (3) 18 (26) 1 (6)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† .01
– First year 13 (19) 6 (18) 8 (10) 7 (12)
– Second year 17 (17) 5 (14) 6 (9) 1 (6)
□ As an osteopathic physician, I do not plan on using OMT.† .58
– First year 2 (3) 2 (6) 8 (10) 7 (12)
– Second year 13 (13) 2 (6) 7 (10) 3 (18)
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, AT. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, AT. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 7.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Prior Experience With OMT
Area Assessed and Statement Prior OMT (n=327) No Prior OMT (n=161) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 269 (82) 119 (74) .03
□ I believe OMT is a legitimate means of treatment for patients. 160 (49) 55 (34) .003
□ I believe OMT is an effective treatment method. 140 (43) 45 (28) .0006
□ OMT is a major distinguishing factor between a DO and an MD. 148 (45) 53 (33) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 90 (28) 16 (10) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 146 (45) 57 (35) .01
□ I want to learn OMT as part of medical school curriculum. 148 (45) 58 (36) .005
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 79 (24) 24 (15) .003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 91 (28) 28 (17) .03
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 57 (17) 10 (6) .01
□ As an osteopathic physician, I do not plan on using OMT.† 32 (10) 14 (9) .0006
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 7.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Prior Experience With OMT
Area Assessed and Statement Prior OMT (n=327) No Prior OMT (n=161) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 269 (82) 119 (74) .03
□ I believe OMT is a legitimate means of treatment for patients. 160 (49) 55 (34) .003
□ I believe OMT is an effective treatment method. 140 (43) 45 (28) .0006
□ OMT is a major distinguishing factor between a DO and an MD. 148 (45) 53 (33) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 90 (28) 16 (10) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 146 (45) 57 (35) .01
□ I want to learn OMT as part of medical school curriculum. 148 (45) 58 (36) .005
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 79 (24) 24 (15) .003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 91 (28) 28 (17) .03
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 57 (17) 10 (6) .01
□ As an osteopathic physician, I do not plan on using OMT.† 32 (10) 14 (9) .0006
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 8.
Comparison of Responses of Study Participants (%) Who Strongly Agreed With Questionnaire Statements, by Reason for Attending a College of Osteopathic Medicine*
Osteopathic Philosophy OMT Desire to Become a Physican
Study Participants, % P Value‡ Study Participants, % P Value‡ Study Participants, % P Value‡
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 87 vs 71 <.0001 87 vs 77 .02 66 vs 81 .01
□ I believe OMT is a legitimate means of treatment for patients. 50 vs 37 .0001 58 vs 39 <.0001 26 vs 46 <.0001
□ I believe OMT is an effective treatment method. 43 vs 31 .0007 52 vs 33 <.0001 11 vs 41 <.0001
□ OMT is a major distinguishing factor between a DO and an MD. 43 vs 39 .09 60 vs 34 <.0001 17 vs 44 <.0001
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 25 vs 19 <.0001 45 vs 13 <.0001 2 vs 24 <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 47 vs 35 .0001 59 vs 35 <.0001 17 vs 44 <.0001
□ I want to learn OMT as part of medical school curriculum. 51 vs 32 <.0001 59 vs 36 <.0001 13 vs 45 <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 20 vs 22 .44 30 vs 18 .002 17 vs 22 .02
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.‡ 25 vs 24 .09 30 vs 22 .36 15 vs 25 .003
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.‡ 15 vs 13 .002 23 vs 10 <.0001 0 vs 15 <.0001
□ As an osteopathic physician, I do not plan on using OMT.‡ 4 vs 15 .002 2 vs 12 <.0001 30 vs 7 <.0001
  * Data are presented as the percentage of study participants who were influenced by the reason for attending a college of osteopathic medicine vs the percentage of study participants who were not influenced by the reason, except where otherwise specified.
  P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 8.
Comparison of Responses of Study Participants (%) Who Strongly Agreed With Questionnaire Statements, by Reason for Attending a College of Osteopathic Medicine*
Osteopathic Philosophy OMT Desire to Become a Physican
Study Participants, % P Value‡ Study Participants, % P Value‡ Study Participants, % P Value‡
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 87 vs 71 <.0001 87 vs 77 .02 66 vs 81 .01
□ I believe OMT is a legitimate means of treatment for patients. 50 vs 37 .0001 58 vs 39 <.0001 26 vs 46 <.0001
□ I believe OMT is an effective treatment method. 43 vs 31 .0007 52 vs 33 <.0001 11 vs 41 <.0001
□ OMT is a major distinguishing factor between a DO and an MD. 43 vs 39 .09 60 vs 34 <.0001 17 vs 44 <.0001
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 25 vs 19 <.0001 45 vs 13 <.0001 2 vs 24 <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 47 vs 35 .0001 59 vs 35 <.0001 17 vs 44 <.0001
□ I want to learn OMT as part of medical school curriculum. 51 vs 32 <.0001 59 vs 36 <.0001 13 vs 45 <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 20 vs 22 .44 30 vs 18 .002 17 vs 22 .02
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.‡ 25 vs 24 .09 30 vs 22 .36 15 vs 25 .003
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.‡ 15 vs 13 .002 23 vs 10 <.0001 0 vs 15 <.0001
□ As an osteopathic physician, I do not plan on using OMT.‡ 4 vs 15 .002 2 vs 12 <.0001 30 vs 7 <.0001
  * Data are presented as the percentage of study participants who were influenced by the reason for attending a college of osteopathic medicine vs the percentage of study participants who were not influenced by the reason, except where otherwise specified.
  P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 9.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Application to Medical Schools
Area Assessed and Statement Osteopathic and Allopathic (n=356) Osteopathic Only (n=133) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 278 (78) 111 (83) .21
□ I believe OMT is a legitimate means of treatment for patients. 136 (38) 79 (59) <.0001
□ I believe OMT is an effective treatment method. 122 (34) 63 (47) .002
□ OMT is a major distinguishing factor between a DO and an MD. 139 (39) 63 (47) .09
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 55 (15) 52 (39) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 133 (37) 70 (53) .002
□ I want to learn OMT as part of medical school curriculum. 128 (36) 79 (59) <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 73 (21) 31 (23) .40
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 82 (23) 37 (28) .37
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 34 (10) 33 (25) .0002
□ As an osteopathic physician, I do not plan on using OMT.† 38 (11) 8 (6) .0001
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 9.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Application to Medical Schools
Area Assessed and Statement Osteopathic and Allopathic (n=356) Osteopathic Only (n=133) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 278 (78) 111 (83) .21
□ I believe OMT is a legitimate means of treatment for patients. 136 (38) 79 (59) <.0001
□ I believe OMT is an effective treatment method. 122 (34) 63 (47) .002
□ OMT is a major distinguishing factor between a DO and an MD. 139 (39) 63 (47) .09
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 55 (15) 52 (39) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 133 (37) 70 (53) .002
□ I want to learn OMT as part of medical school curriculum. 128 (36) 79 (59) <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 73 (21) 31 (23) .40
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 82 (23) 37 (28) .37
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 34 (10) 33 (25) .0002
□ As an osteopathic physician, I do not plan on using OMT.† 38 (11) 8 (6) .0001
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 10.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Relationship to Physicians
Related to…
Area Assessed and Statement DO Only (n=25) MD Only (n=99) Both (n=17) Neither (n=350) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 16 (64) 76 (77) 12 (71) 282 (82) .15
□ I believe OMT is a legitimate means of treatment for patients. 7 (28) 38 (38) 10 (59) 160 (46) .05
□ I believe OMT is an effective treatment method. 7 (28) 34 (34) 8 (47) 136 (39) .13
□ OMT is a major distinguishing factor between a DO and an MD. 9 (36) 41 (41) 9 (53) 143 (41) .60
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 5 (20) 14 (14) 4 (24) 84 (24) .18
□ Learning OMT will provide an additional tool I will use to treat patients. 9 (36) 32 (32) 11 (65) 151 (43) .04
□ I want to learn OMT as part of medical school curriculum. 10 (40) 36 (36) 10 (59) 151 (43) .21
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 6 (24) 17 (17) 7 (41) 74 (21) .23
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 6 (25) 21 (21) 10 (59) 82 (23) .02
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 1 (4) 12 (12) 12 (18) 51 (15) .39
□ As an osteopathic physician, I do not plan on using OMT.† 2 (8) 10 (10) 1 (6) 33 (9) .61
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 10.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Relationship to Physicians
Related to…
Area Assessed and Statement DO Only (n=25) MD Only (n=99) Both (n=17) Neither (n=350) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 16 (64) 76 (77) 12 (71) 282 (82) .15
□ I believe OMT is a legitimate means of treatment for patients. 7 (28) 38 (38) 10 (59) 160 (46) .05
□ I believe OMT is an effective treatment method. 7 (28) 34 (34) 8 (47) 136 (39) .13
□ OMT is a major distinguishing factor between a DO and an MD. 9 (36) 41 (41) 9 (53) 143 (41) .60
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 5 (20) 14 (14) 4 (24) 84 (24) .18
□ Learning OMT will provide an additional tool I will use to treat patients. 9 (36) 32 (32) 11 (65) 151 (43) .04
□ I want to learn OMT as part of medical school curriculum. 10 (40) 36 (36) 10 (59) 151 (43) .21
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 6 (24) 17 (17) 7 (41) 74 (21) .23
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 6 (25) 21 (21) 10 (59) 82 (23) .02
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 1 (4) 12 (12) 12 (18) 51 (15) .39
□ As an osteopathic physician, I do not plan on using OMT.† 2 (8) 10 (10) 1 (6) 33 (9) .61
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Perception of Osteopathic Predoctoral Education
With the exception of the statement “Learning OMT will provide an additional tool I will use to treat patients,” there were significant differences (P<.03) between the schools in agreement with all statements assessing beliefs about osteopathic predoctoral education (Table 4). Students at ATSU-KCOM most strongly agreed with these statements and KCUMBCOM students agreed least. First-year students responded more in agreement than second-year students that OMT would be sufficiently integrated throughout the medical school curriculum (28% strongly agreed vs 20%; P<.0001) (Table 5). First- and second-year students at ATSU-KCOM and DMU-COM and first-year students at ATSU-SOMA had higher agreement with the statements regarding learning enough OMT in medical school (P=.0004) and believing that there would be sufficient integration of OMT throughout the medical school cur riculum (P<.0001), while second-year students at ATSUSOMA and KCUMB-COM had lower agreement with these statements (Table 6). Students who said they had received OMT previously were more strongly in agreement with statements regarding osteopathic predoctoral education than students who had not received OMT (P⩽.03) (Table 7). 
Students who were drawn to osteopathic medicine by osteopathic philosophy or OMT more strongly agreed with the statements regarding OMT being a major factor in deciding which COM to attend, that OMT will provide an additional tool students will use to treat patients, and that they want to learn OMT than students who did not cite these factors (P⩽.0001) (Table 8). Students who were drawn to osteopathic medical school by OMT more strongly agreed that they will learn enough OMT to be proficient in treating patients at the start of postgraduate training compared with students not drawn to osteopathic medicine by OMT (30% strongly agreed vs 18%; P=.002) (Table 8). Students who said that the desire to become a physician regardless of degree is what drew them to osteopathic medicine less strongly agreed with all the statements regarding perceptions of osteopathic predoctoral education (P<.03) (Table 8). Students who said that they were drawn to a specific school less strongly agreed with the statement that OMT was a major factor in deciding which COM to attend (8% strongly agreed vs 24%; P<.0001). 
Students who applied only to COMs were more strongly in agreement with statements regarding OMT being a major factor in deciding which COM to attend (39% strongly agreed vs 15%; P<.0001), that OMT would provide an additional tool for treating patients (53% strongly agreed vs 37%; P=.002), and that they wanted to learn OMT as part of the medical school curriculum (59% strongly agreed vs 36%; P<.0001) (Table 9). Students who were related to both a DO and an MD more strongly agreed that OMT will provide an additional treatment tool and that it will be integrated throughout the medical school curriculum than students who were related to a DO only, to an MD only, or to neither (P⩽.04) (Table 10). 
Intentions to Use OMT in Medical Practice
Compared with students at KCUMB-COM and DMU-COM, students at ATSU-KCOM more strongly agreed that they plan to use OMT to treat a majority of patients when indicated (P=.02) (Table 4), and first-year students responded more in agreement with this statement than second-year students (14% strongly agreed vs 13%; P=.04) (Table 5). First- and second-year students at ATSU-KCOM and first-year students at ATSUSOMA most strongly agreed with the statement that they plan to use OMT to treat a majority of patients (P=.01) (Table 6). Students who indicated that they had previously received OMT were more favorable toward using OMT to treat a majority of patients than students who had not received OMT (17% strongly agreed vs 6%; P=.01) (Table 7), as were students who were drawn to osteopathic medicine by osteopathic philosophy or OMT (P<.003 and P<.0001, respectively) (Table 8) and students who applied only to osteopathic schools (25% strongly agreed vs 10%; P=.0002) (Table 9). Students who were drawn to osteopathic medicine by the desire to become a physician regardless of degree were less favorable about using OMT for a majority of patients in future practice compared with students who were not drawn to osteopathic medicine by the desire to become a physician regardless of degree (0% strongly agreed vs 15%; P<.0001) (Table 8). 
Focus Groups
Fourteen first-year students and 14 second-year students participated in the 4 focus groups at ATSU-KCOM. In general, their comments were positive regarding the clarity of the questions and the time needed to complete the questionnaire. The students thought the length of the questionnaire was manageable, and that they needed, on average, less than 5 minutes to complete the questionnaire. The majority of the students thought that the opportunity to win a gift card was adequate incentive to increase their likelihood of completing the questionnaire. Many students stated that knowing the researchers was a reason for participating. On the basis of these results, the authors concluded that the best way to distribute the questionnaire would be to have a contact person from each school distribute the e-mail to the students. 
The statement “OMT is a major distinguishing factor between a DO and an MD” evoked a large amount of discussion and resulted in the addition of 2 statements to include in future questionnaires regarding other distinguishing factors of osteopathic medicine. The statement “I will learn enough OMT in medical school to be proficient to begin treating patients at the start of post-graduate training” was reported to be confusing and too long. On the basis of feedback from the students, 5 questions were added to the questionnaire, and other questions were modified for clarity. These changes will be included in future studies. 
Comment
The main objective of the current study was to assess the beliefs and attitudes of first- and second-year osteopathic medical students regarding osteopathic philosophy in order to determine whether there were any differences in their attitudes based on various factors (eg, the COM they attended and their current year of study). The analysis of responses by certain subgroups of students revealed a number of statistically significant differences in agreement with osteopathic philosophy and intention to use OMT in future practice. Specifically, prior experience receiving OMT, reasons for attending osteopathic medical school, the medical school that a student chose to attend, and the student's current year of study were related to student attitudes about osteopathic philosophy. Students who had previously received OMT, students who applied only to COMs, and first-year students overall more strongly agreed with the questionnaire's statements about osteopathic philosophy and intention to use OMT than did those students' counterparts. 
Using a similar study design, Miller16 surveyed osteopathic medical students and found that undergraduate major, preference to attend an osteopathic or allopathic medical school, and level of previous osteopathic knowledge predicted a student's level of commitment to OMT. The current study did not show any differences among students in their agreement with the use of OMT based on their undergraduate major. However, students who stated they were drawn to osteopathic medicine by the desire to become a physician regardless of degree and students who applied to both osteopathic and allopathic medical schools were in less agreement with statements about osteopathic beliefs, OMT, and predicted OMT use in future practice. Multiple other studies3,5,8,9,17,18 have identified students whose main desire is to become a physician regardless of degree. In the current study, students who stated that osteopathic philosophy or OMT drew them to osteopathic medicine expressed more agreement with osteopathic beliefs, OMT, and predicted OMT use in future practice than did those who did not indicate that osteopathic philosophy or OMT drew them to osteopathic medicine. 
Also in the current study, students with prior exposure to OMT showed more agreement with osteopathic beliefs, OMT, and predicted OMT use in future practice than students without prior exposure, showing statistically significant differences in responses to every statement in the first 3 sections (Attitudes, Education, and Future Practice) of the questionnaire. Teitelbaum et al19 found that a higher percentage of osteopathic medical students were convinced to follow the osteopathic approach after the first year of medical school compared to the percentage of students who were convinced before matriculation. This finding may explain why students in the current study who were related to both a DO and an MD were more in agreement with the statements that OMT provides an additional treatment tool and OMT would be sufficiently integrated throughout their medical education. Perhaps these students are better able to compare the differences between osteopathic and allopathic medicine while also being more in agreement with osteopathic philosophy and the utilization of OMT. However, students in the current study who were related to physicians from both professions may have self-selected before attending medical school, based on the philosophy of medicine with which they most agreed. Further research is needed to assess this association before any definite causal relationship can be declared. 
According to the findings of the current study, beliefs about OMT being a major distinguishing factor between a DO and an MD, wanting to learn OMT, and planning to use OMT in future practice differed among students attending the 4 COMS. In general, students at ATSU-KCOM were more in agreement with the utilization of OMT than students from the other schools. KCUMB-COM had the highest percentage of students who stated that osteopathic philosophy was the reason they were drawn to osteopathic medical school. These results suggest that students agree with osteopathic philosophy but are not planning to use OMT in their medical practice. Possible reasons for these results may be that the schools have different styles of teaching OMT and place a different emphasis on osteopathic philosophy, and that students who are more favorable toward OMT choose to attend certain schools. Further research is needed to assess how OMT and osteopathic philosophy are taught at each school before any definite conclusions can be drawn about these differences. 
The current study did show differences among the COMs, with students at certain COMs agreeing more strongly with osteopathic philosophy and intended use of OMT. This information may be an important tool in the assessment of osteopathic medical education regarding osteopathic philosophy and OMT. It may also help undergraduate students who are applying to COMs decide which schools are more appropriate to help them achieve their goals. For example, students who are more interested in learning and using OMT may want to apply to a school that emphasizes and teaches more OMT. 
In a study by Miller,16 no differences among schools were found regarding commitment to OMT. However, there were differences among the schools regarding behavioral intentions. Chamberlain and Yates20 also demonstrated that students with adequate osteopathic knowledge and skills do not always use OMT when they are placed in a standardized patient encounter. Bates et al14 suggested that although teaching osteopathic philosophy is helpful in showing medical students the osteopathic difference, mentoring students in a clinical situation may better demonstrate the use of OMT in clinical practice. 
Studies21-23 have shown that student attitudes toward OMT decline during clinical rotations and that students have more favorable attitudes toward OMT if they complete an OMT rotation. One study showed that standardized OMT instruction during the clinical years increased OMT use in hospitalized patients.24 However, further research is needed to assess student attitudes during clinical training and to determine what instruction is provided to those students during their 4 years of medical education. 
In the current study, first-year students agreed more strongly with the use of OMT than did second-year students. First-year students at ATSU-KCOM expressed the strongest desire to learn OMT and believed that OMT would be integrated throughout their medical education curriculum. Second-year students at ATSU-SOMA reported less agreement with learning OMT and with using it in future practice; however, these students were the only ones who had begun clinical rotations. These results may be due to first-year students having little information on subsequent years of medical school and second-year students learning more about those subsequent years through discussions with third- and fourth-year students, on- and off-campus faculty, and administrators. Perhaps future studies could address this issue by integrating OMT into clinical rotations and demonstrating the use of OMT in clinical practice. We are currently conducting a longitu dinal study to assess student attitudes from matriculation to graduation. The study is designed to determine how student attitudes change during each year of osteopathic predoctoral education and to further establish the differences between COMs seen in the current study. 
Many studies8,9,11,16,17,18-23 have been conducted assessing various beliefs and attitudes held by students at various times during their education. However, we found no studies that surveyed students at matriculation. Miller16 conducted a survey of osteopathic medical students and suggested that results could be explained by the predispositions and attitudes of students before entering osteopathic medical school. However, students in Miller's study were evaluated after they had attended a COM for at least 6 months, so further examination is required to determine the validity of this finding. Students should be evaluated before they begin their osteopathic medical education to establish a baseline of attitudes and beliefs. After establishing that baseline, students can be reassessed throughout their medical education to determine how their attitudes and beliefs progress. 
As an osteopathic medical student, Nemon8 surveyed second-, third-, and fourth-year medical students at the New York College of Osteopathic Medicine of the New York Institute of Technology regarding their beliefs about and perceptions of osteopathic medicine, their osteopathic predoctoral education, and their future graduate medical education. A surprising number of students indicated that they felt dissociated from A.T. Still and 49% indicated they did not want osteopathic medicine to be more distinctive from allopathic medicine. Yet in Nemon's study, published in 1998, 54% of students believed that OMT and osteopathic principles should be more positively reinforced, and 79% of students said they would like to be more competent in using OMT.8 These results suggest a strong belief in OMT, but there seems to be a disconnection with some aspect of osteopathic medical education. However, more evaluation is necessary. Our ongoing longitudinal study follows students throughout their osteopathic medical training to assess how their attitudes are changed and influenced during training. 
In a study of second-year osteopathic medical students, Teitelbaum et al19 found that after the first year of osteopathic medical school, 43% more of the students were convinced of the validity of osteopathic medicine compared to their beliefs about its validity before they began school. The study by Teitelbaum et al19 also stressed the need for both a longitudinal study and a concurrent study of all COMs. 
A prospective investigation of all COMs may be instructive in determining if trends are consistent among all osteopathic medical students from matriculation to graduation. A baseline evaluation of the attitudes and beliefs of osteopathic medical students toward osteopathic philosophy and OMT would be instructive. Further, a longitudinal prospective study could provide valuable insight into when and how the attitudes of medical students change as they progress through their education. Such a study would also help to identify specific factors that either promote or discourage learning and the eventual use of OMT. An assessment of the current state of osteopathic predoctoral education regarding osteopathic philosophy and OMT could be used by COMs to change the curriculum and learning environment and to enhance the willingness of students to maintain the distinctiveness of the osteopathic medical profession. 
Limitations
The current study has several limitations. One limitation is a self-selection bias. Data on demographic information for population comparison were not collected. Thus, a comparison between students who participated in the study and those who did not could not be made. At 3 of the COMs, however, a relatively large percentage of the student body responded, making self-selection bias less likely. Questions about demographic characteristics should be included in future studies to control for the effects of self-selection. 
Another limitation of the current study is general bias. Student responses may have been influenced by the language of the questionnaire, which specifically addressed osteopathic philosophy and OMT. This bias may not hold for all students who responded, though, because for most of the statements, very few students responded that they strongly disagreed, and when asked what drew them to osteopathic medicine, this minority stated that their desire was to become a physician regardless of the degree. The data used to compare schools were limited by the small response rate at KCUMB-COM. The 3 other schools (ATSU-KCOM, ATSU-SOMA, and DMU-COM) had a response rate greater of 34% or greater, while KCUMB-COM had a response rate of 15%. Therefore, study results should be interpreted with caution because of the increased uncertainty arising from the limited responses from students at KCUMB-COM. 
Finally, it is difficult to draw conclusions about the use of OMT in practice on the basis of student projections of future OMT use. At this point in their medical training, students have not been sufficiently exposed to actual patient care. Therefore, the conclusions of the current study are limited to the projected future use of OMT and not the actual use of OMT in practice. 
Conclusion
Osteopathic medical students who stated that osteopathic philosophy or OMT drew them to attend osteopathic medical school and osteopathic medical students who had previously received OMT had higher levels of agreement with osteopathic philosophy and reflected a greater intention to use OMT in future practice than did students who applied to both osteopathic and allopathic medical schools or students who chose osteopathic medical school only as a means to become a physician regardless of the degree. The attitudes of the students varied based on the COM that they attended and their year of study. Specifically, students at ATSU-KCOM more strongly agreed with the legitimacy of OMT and positive statements regarding OMT as part of their osteopathic predoctoral education than did students from KCUMB-COM. Students at ATSU-KCOM and DMU-COM had stronger agreement with statements about OMT being integrated throughout the medical school curriculum than did students at KCUMBCOM and ATSU-SOMA. 
Student agreement with osteopathic philosophy and the use of OMT appeared to be higher in first-year medical students. The level of agreement with statements regarding the sufficient integration of OMT throughout the curriculum and the intention to use OMT in clinical practice decreased after students started their clinical rotations. Because the osteopathic medical students of today will define and shape the osteopathic medical profession of tomorrow, administration of a refined questionnaire to students from a variety of COMs as they progress through their education should provide insight into how COMs can help the profession maintain its distinctiveness. 
Acknowledgments
We thank the deans of the 4 COMs at the time of this study for their support: Philip C. Slocum, DO, at ATSU-KCOM; Douglas L. Wood, DO, PhD, at ATSU-SOMA; Kendall Reed, DO, at DMU-COM; and Darin L. Haug, DO, at KCUMB-COM. We also thank Lisa Small, research assistant at ATSU, for administering the questionnaire, and Deborah Goggin, MA, scientific writer at ATSU, for editorial assistance. 
Appendix
Questionnaire distributed to students at 4 colleges of osteopathic medicine to assess osteopathic medical students beliefs about osteopathic manipulative treatment.
Image Not Available
Questionnaire distributed to students at 4 colleges of osteopathic medicine to assess osteopathic medical students beliefs about osteopathic manipulative treatment.
Image Not Available×
   Financial Disclosures: Funding for this study was provided in whole by a medical education mini-grant from the American Association of Colleges of Osteopathic Medicine. The funding was used to purchase and distribute gift cards to students who were selected as winners of the prize drawing. All authors have no relevant conflicts of interest to disclose.
 
References
Tenets of osteopathic medicine. American Osteopathic Association Web site. http://www.osteopathic.org/inside-aoa/about/leadership/Pages/tenets-of-osteopathic-medicine.aspx. Accessed October 17, 2011.
Stark J. Basic principles of osteopathy. Osteopath Today. 2006;13:14-15.
Eckberg DL. The dilemma of osteopathic physicians and the rationalization of medical practice. Soc Sci Med. 1987;25(10):1111-1120. [CrossRef] [PubMed]
Johnson SM, Bordinat D. Professional identity: key to the future of the osteopathic medical profession in the United States. J Am Osteopath Assoc. 1998;98(6):325-331. [PubMed]
Johnson SM, Kurtz ME. Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of the osteopathic profession. Acad Med. 2001;76(8):821-828. [CrossRef] [PubMed]
Leahy J. Manipulation: a survey of how DOs feel about it. Osteopath Physician. 1972;38:31-38.
Miller K. The evolution of professional identity: the case of osteopathic medicine. Soc Sci Med. 1998;47(11):1739-1748. [CrossRef] [PubMed]
Nemon BM. Osteopathic medical profession: who are we & where are we going? a student's perspective. Am Acad Osteopath J. 1997;7(1):10-15,30-34.
Radis C. Osteopathic education: a student perspective. Osteopath Ann. 1981;9:32-37.
Shlapentokh V, O'Donnell N, Grey MB. Osteopathic interns' attitudes toward their education and training. J Am Osteopath Assoc. 1991;91(8):786-796,801-782. [PubMed]
Chamberlain NR, Yates HA. A prospective study of osteopathic medical students' attitudes toward use of osteopathic manipulative treatment in caring for patients. J Am Osteopath Assoc. 2003;103(10):470-478. [PubMed]
Nichols KJ. Results of a survey of inaugural class graduates of a college of osteopathic medicine. J Am Osteopath Assoc. 2003;103(1):9-15. [PubMed]
Bates BR, Mazer JP, Ledbetter AM, Norander S. The DO difference: an analysis of causal relationships affecting the degree-change debate. J Am Osteopath Assoc. 2009;109(7):359-369. [PubMed]
Zoomerang Online Surveys & Polls. Available at http://www.zoomerang.com. Accessed October 12, 2011.
Daniel WW. Applied Nonparametric Statistics. 2nd ed. Boston, MA: Duxbury Press; 2000.
Miller K. The Use of Osteopathic Principles and Practice: A Study of Osteopathic Medical Students. Final Report. Grant S90-03, September 1992; Arizona State University.
McNamee KP, Magarian K, Phillips RB, Greenman PE. Osteopathic vs. chiropractic education: a student perspective. J Manipulative Physiol Ther. 1991;14(7):422-427. [PubMed]
New PK. The osteopathic students: a study in dilemma. In: Jaco EG, ed. Patients, Physicians, and Illness. Glencoe, IL: Free Press; 1958:413-421.
Teitelbaum HS, Bunn WEII, Brown SA, Burchett AW. Osteopathic medical education: renaissance or rhetoric? J Am Osteopath Assoc. 2003;103(10):489-490. [PubMed]
Chamberlain NR, Yates HA. Use of a computer-assisted clinical case (CACC) SOAP note exercise to assess students' application of osteopathic principles and practice. J Am Osteopath Assoc. 2000;100(7):437-440. [PubMed]
Aguwa MI, Liechty DK. Professional identification and affiliation of the 1992 graduate class of the colleges of osteopathic medicine. J Am Osteopath Assoc. 1999;99(8):408-420. [PubMed]
Gamber RG, Gish EE, Herron KM. Student perceptions of osteopathic manipulative treatment after completing a manipulative medicine rotation. J Am Osteopath Assoc. 2001;101(7):395-400. [PubMed]
Magnus WW, Gamber RG. Osteopathic manipulative treatment: student attitudes before and after intensive clinical exposure. J Am Osteopath Assoc. 1997;97(2):109-113. [PubMed]
Shubrook JHJr, Dooley J. Effects of a structured curriculum in osteopathic manipulative treatment (OMT) on osteopathic structural examinations and use of OMT for hospitalized patients. J Am Osteopath Assoc. 2000;100(9):554-558. [PubMed]
Figure.
Description of constructs and survey questions used to assess osteopathic medical students' beliefs about osteopathic manipulative treatment. Abbreviation: OMT, osteopathic manipulative treatment.
Figure.
Description of constructs and survey questions used to assess osteopathic medical students' beliefs about osteopathic manipulative treatment. Abbreviation: OMT, osteopathic manipulative treatment.
Table 1.
Study Participants Among First- and Second-Year Students at Each COM
COM No. of First- and and Second-Year Students No. of Participants (n=491)* Response Rate, % Participant
ATSU-KCOM 340 165 49 36
ATSU-SOMA 204 70 34 15
DMU-COM 425 151 36 33
KCUMB-COM 509 75 15 16
  * Thirty respondents did not indicate which college of osteopathic medicine (COM) they attended.
  The overall response rate was 33%.
  Abbreviations: DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; KCUMB-COM, Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa.
Table 1.
Study Participants Among First- and Second-Year Students at Each COM
COM No. of First- and and Second-Year Students No. of Participants (n=491)* Response Rate, % Participant
ATSU-KCOM 340 165 49 36
ATSU-SOMA 204 70 34 15
DMU-COM 425 151 36 33
KCUMB-COM 509 75 15 16
  * Thirty respondents did not indicate which college of osteopathic medicine (COM) they attended.
  The overall response rate was 33%.
  Abbreviations: DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; KCUMB-COM, Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa.
×
Table 2.
Respondents' Relationships to Various Medical Professionals, Previous Exposure to Osteopathic Manipulative Treatment, and Application to Osteopathic and Allopathic Medical Schools (N=491)
Survey Question No. (%)
Are you related to an osteopathic physician (DO)? 42 (9)
Are you related to an allopathic physician (MD)? 116 (24)
Are you related to or are you a chiropractor (DC)? 22 (4)
Are you related to or are you a physical therapist? 31 (6)
Have you received an OMT? 327 (67)
Have you received a chiropractic treatment? 189 (39)
Have you applied to both osteopathic and allopathic medical schools? 356 (73)
  Abbreviation: OMT, osteopathic manipulative treatment.
Table 2.
Respondents' Relationships to Various Medical Professionals, Previous Exposure to Osteopathic Manipulative Treatment, and Application to Osteopathic and Allopathic Medical Schools (N=491)
Survey Question No. (%)
Are you related to an osteopathic physician (DO)? 42 (9)
Are you related to an allopathic physician (MD)? 116 (24)
Are you related to or are you a chiropractor (DC)? 22 (4)
Are you related to or are you a physical therapist? 31 (6)
Have you received an OMT? 327 (67)
Have you received a chiropractic treatment? 189 (39)
Have you applied to both osteopathic and allopathic medical schools? 356 (73)
  Abbreviation: OMT, osteopathic manipulative treatment.
×
Table 3.
Responses to Study Questionnaire (No. [%])* Assessing Attitudes, Beliefs, and Intentions Regarding Osteopathic Medicine
Area Assessed and Statement Strongly Agree Agree Neutral Disagree Strongly Disagree
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 390 (79) 81 (17) 11 (2) 3 (1) 6 (1)
□ I believe OMT is a legitimate means of treatment for patients. 215 (44) 199 (41) 50 (10) 17 (3) 10 (2)
□ I believe OMT is an effective treatment method. 185 (38) 212 (43) 63 (13) 20 (4) 11 (2)
□ OMT is a major distinguishing factor between a DO and an MD. 202 (41) 170 (35) 63 (13) 37 (8) 19 (4)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 107 (22) 124 (25) 102 (21) 103 (21) 55 (11)
□ Learning OMT will provide an additional tool I will use to treat patients. 203 (41) 164 (33) 69 (14) 37 (8) 18 (4)
□ I want to learn OMT as part of medical school curriculum. 207 (42) 156 (32) 68 (14) 38 (8) 22 (4)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 104 (21) 201 (41) 95 (19) 62 (13) 29 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 119 (24) 191 (39) 107 (22) 49 (10) 24 (5)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 67 (14) 146 (30) 128 (26) 96 (20) 53 (11)
□ As an osteopathic physician, I do not plan on using OMT.† 46 (9) 53 (11) 84 (17) 142 (29) 165 (34)
  * Some percentages do not total 100 because of rounding.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 3.
Responses to Study Questionnaire (No. [%])* Assessing Attitudes, Beliefs, and Intentions Regarding Osteopathic Medicine
Area Assessed and Statement Strongly Agree Agree Neutral Disagree Strongly Disagree
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 390 (79) 81 (17) 11 (2) 3 (1) 6 (1)
□ I believe OMT is a legitimate means of treatment for patients. 215 (44) 199 (41) 50 (10) 17 (3) 10 (2)
□ I believe OMT is an effective treatment method. 185 (38) 212 (43) 63 (13) 20 (4) 11 (2)
□ OMT is a major distinguishing factor between a DO and an MD. 202 (41) 170 (35) 63 (13) 37 (8) 19 (4)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 107 (22) 124 (25) 102 (21) 103 (21) 55 (11)
□ Learning OMT will provide an additional tool I will use to treat patients. 203 (41) 164 (33) 69 (14) 37 (8) 18 (4)
□ I want to learn OMT as part of medical school curriculum. 207 (42) 156 (32) 68 (14) 38 (8) 22 (4)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 104 (21) 201 (41) 95 (19) 62 (13) 29 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 119 (24) 191 (39) 107 (22) 49 (10) 24 (5)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 67 (14) 146 (30) 128 (26) 96 (20) 53 (11)
□ As an osteopathic physician, I do not plan on using OMT.† 46 (9) 53 (11) 84 (17) 142 (29) 165 (34)
  * Some percentages do not total 100 because of rounding.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 4.
Comparison of Responses of Students Who Strongly Agreed With Questionnaire Statements (No. [%]), by College of Osteopathic Medicine
Area Assessed and Statement ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 139 (84) 56 (80) 111 (74) 61 (81) .10
□ I believe OMT is a legitimate means of treatment for patients. 83 (50) 26 (37) 68 (45) 22 (29) .04
□ I believe OMT is an effective treatment method. 69 (42) 25 (36) 58 (38) 18 (24) .20
□ OMT is a major distinguishing factor between a DO and an MD. 75 (45) 29 (41) 61 (40) 22 (29) .18
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 46 (28) 17 (24) 23 (15) 12 (16) .02
□ Learning OMT will provide an additional tool I will use to treat patients. 76 (46) 29 (41) 50 (33) 30 (40) .08
□ I want to learn OMT as part of medical school curriculum. 80 (48) 31 (44) 52 (34) 27 (36) .02
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 43 (26) 19 (27) 27 (18) 4 (5) .0003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 54 (33) 4 (6) 40 (27) 10 (13) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 30 (18) 11 (16) 14 (9) 8 (11) .02
□ As an osteopathic physician, I do not plan on using OMT.† 15 (9) 4 (6) 15 (10) 10 (13) .63
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 4.
Comparison of Responses of Students Who Strongly Agreed With Questionnaire Statements (No. [%]), by College of Osteopathic Medicine
Area Assessed and Statement ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 139 (84) 56 (80) 111 (74) 61 (81) .10
□ I believe OMT is a legitimate means of treatment for patients. 83 (50) 26 (37) 68 (45) 22 (29) .04
□ I believe OMT is an effective treatment method. 69 (42) 25 (36) 58 (38) 18 (24) .20
□ OMT is a major distinguishing factor between a DO and an MD. 75 (45) 29 (41) 61 (40) 22 (29) .18
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 46 (28) 17 (24) 23 (15) 12 (16) .02
□ Learning OMT will provide an additional tool I will use to treat patients. 76 (46) 29 (41) 50 (33) 30 (40) .08
□ I want to learn OMT as part of medical school curriculum. 80 (48) 31 (44) 52 (34) 27 (36) .02
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 43 (26) 19 (27) 27 (18) 4 (5) .0003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 54 (33) 4 (6) 40 (27) 10 (13) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 30 (18) 11 (16) 14 (9) 8 (11) .02
□ As an osteopathic physician, I do not plan on using OMT.† 15 (9) 4 (6) 15 (10) 10 (13) .63
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, A.T. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 5.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School
Area Assessed and Statement First Year (n=257) Second Year (n=234) P Value*
Attitudes Toward OMT
□ I believe the person is made up of body, mind, and spirit. 204 (79) 186 (79) .90
□ I believe OMT is a legitimate means of treatment for patients. 107 (42) 108 (46) .91
□ I believe OMT is an effective treatment method. 90 (35) 95 (41) .96
□ OMT is a major distinguishing factor between a DO and an MD. 113 (44) 89 (38) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 58 (23) 49 (21) .30
□ Learning OMT will provide an additional tool I will use to treat patients. 109 (42) 94 (40) .29
□ I want to learn OMT as part of medical school curriculum. 115 (45) 92 (39) .23
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 52 (20) 52 (22) .61
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 72 (28) 47 (20) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 36 (14) 31 (13) .04
□ As an osteopathic physician, I do not plan on using OMT.† 20 (8) 26 (11) .44
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 5.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School
Area Assessed and Statement First Year (n=257) Second Year (n=234) P Value*
Attitudes Toward OMT
□ I believe the person is made up of body, mind, and spirit. 204 (79) 186 (79) .90
□ I believe OMT is a legitimate means of treatment for patients. 107 (42) 108 (46) .91
□ I believe OMT is an effective treatment method. 90 (35) 95 (41) .96
□ OMT is a major distinguishing factor between a DO and an MD. 113 (44) 89 (38) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 58 (23) 49 (21) .30
□ Learning OMT will provide an additional tool I will use to treat patients. 109 (42) 94 (40) .29
□ I want to learn OMT as part of medical school curriculum. 115 (45) 92 (39) .23
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 52 (20) 52 (22) .61
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 72 (28) 47 (20) <.0001
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 36 (14) 31 (13) .04
□ As an osteopathic physician, I do not plan on using OMT.† 20 (8) 26 (11) .44
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 6.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School and Institution
Area Assessed, Statement, and Year in School ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. .39
– First year 58 (87) 28 (82) 59 (71) 47 (81)
– Second year 81 (83) 28 (78) 52 (76) 14 (82)
□ I believe OMT is a legitimate means of treatment for patients. .08
– First year 37 (55) 12 (35) 35 (42) 15 (26)
– Second year 46 (47) 14 (39) 33 (49) 7 (41)
□ I believe OMT is an effective treatment method. .46
– First year 29 (43) 13 (38) 30 (36) 11 (19)
– Second year 40 (41) 12 (33) 28 (41) 7 (41)
□ OMT is a major distinguishing factor between a DO and an MD. .03
– First year 35 (52) 15 (44) 39 (47) 15 (26)
– Second year 40 (41) 14 (39) 22 (32) 7 (41)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. .05
– First year 18 (27) 8 (24) 14 (17) 12 (21)
– Second year 28 (29) 9 (25) 9 (13) 0
□ Learning OMT will provide an additional tool I will use to treat patients. .15
– First year 35 (52) 15 (44) 26 (31) 23 (40)
– Second year 41 (42) 14 (39) 24 (35) 7 (41)
□ I want to learn OMT as part of medical school curriculum. .04
– First year 37 (55) 15 (44) 32 (39) 21 (36)
– Second year 43 (44) 16 (44) 20 (29) 6 (35)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. .0004
– First year 21 (31) 12 (35) 12 (14) 3 (5)
– Second year 22 (22) 7 (19) 15 (22) 1 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† <.0001
– First year 32 (48) 3 (9) 22 (27) 9 (16)
– Second year 22 (22) 1 (3) 18 (26) 1 (6)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† .01
– First year 13 (19) 6 (18) 8 (10) 7 (12)
– Second year 17 (17) 5 (14) 6 (9) 1 (6)
□ As an osteopathic physician, I do not plan on using OMT.† .58
– First year 2 (3) 2 (6) 8 (10) 7 (12)
– Second year 13 (13) 2 (6) 7 (10) 3 (18)
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, AT. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, AT. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 6.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Year in School and Institution
Area Assessed, Statement, and Year in School ATSU-KCOM (n=165) ATSU-SOMA (n=70) DMU-COM (n=151) KCUMB-COM (n=75) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. .39
– First year 58 (87) 28 (82) 59 (71) 47 (81)
– Second year 81 (83) 28 (78) 52 (76) 14 (82)
□ I believe OMT is a legitimate means of treatment for patients. .08
– First year 37 (55) 12 (35) 35 (42) 15 (26)
– Second year 46 (47) 14 (39) 33 (49) 7 (41)
□ I believe OMT is an effective treatment method. .46
– First year 29 (43) 13 (38) 30 (36) 11 (19)
– Second year 40 (41) 12 (33) 28 (41) 7 (41)
□ OMT is a major distinguishing factor between a DO and an MD. .03
– First year 35 (52) 15 (44) 39 (47) 15 (26)
– Second year 40 (41) 14 (39) 22 (32) 7 (41)
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. .05
– First year 18 (27) 8 (24) 14 (17) 12 (21)
– Second year 28 (29) 9 (25) 9 (13) 0
□ Learning OMT will provide an additional tool I will use to treat patients. .15
– First year 35 (52) 15 (44) 26 (31) 23 (40)
– Second year 41 (42) 14 (39) 24 (35) 7 (41)
□ I want to learn OMT as part of medical school curriculum. .04
– First year 37 (55) 15 (44) 32 (39) 21 (36)
– Second year 43 (44) 16 (44) 20 (29) 6 (35)
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. .0004
– First year 21 (31) 12 (35) 12 (14) 3 (5)
– Second year 22 (22) 7 (19) 15 (22) 1 (6)
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† <.0001
– First year 32 (48) 3 (9) 22 (27) 9 (16)
– Second year 22 (22) 1 (3) 18 (26) 1 (6)
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† .01
– First year 13 (19) 6 (18) 8 (10) 7 (12)
– Second year 17 (17) 5 (14) 6 (9) 1 (6)
□ As an osteopathic physician, I do not plan on using OMT.† .58
– First year 2 (3) 2 (6) 8 (10) 7 (12)
– Second year 13 (13) 2 (6) 7 (10) 3 (18)
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: ATSU-KCOM, AT. Still University of Health Sciences-Kirksville College of Osteopathic Medicine in Missouri; ATSU-SOMA, AT. Still University of Health Sciences-School of Osteopathic Medicine in Arizona in Mesa; DMU-COM, Des Moines University College of Osteopathic Medicine in Iowa; DO, osteopathic physician; KCUMB-COM, Kansas City University of Medicine and Biosciences' College of Osteopathic Medicine in Missouri; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 7.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Prior Experience With OMT
Area Assessed and Statement Prior OMT (n=327) No Prior OMT (n=161) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 269 (82) 119 (74) .03
□ I believe OMT is a legitimate means of treatment for patients. 160 (49) 55 (34) .003
□ I believe OMT is an effective treatment method. 140 (43) 45 (28) .0006
□ OMT is a major distinguishing factor between a DO and an MD. 148 (45) 53 (33) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 90 (28) 16 (10) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 146 (45) 57 (35) .01
□ I want to learn OMT as part of medical school curriculum. 148 (45) 58 (36) .005
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 79 (24) 24 (15) .003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 91 (28) 28 (17) .03
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 57 (17) 10 (6) .01
□ As an osteopathic physician, I do not plan on using OMT.† 32 (10) 14 (9) .0006
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 7.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Prior Experience With OMT
Area Assessed and Statement Prior OMT (n=327) No Prior OMT (n=161) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 269 (82) 119 (74) .03
□ I believe OMT is a legitimate means of treatment for patients. 160 (49) 55 (34) .003
□ I believe OMT is an effective treatment method. 140 (43) 45 (28) .0006
□ OMT is a major distinguishing factor between a DO and an MD. 148 (45) 53 (33) .03
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 90 (28) 16 (10) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 146 (45) 57 (35) .01
□ I want to learn OMT as part of medical school curriculum. 148 (45) 58 (36) .005
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 79 (24) 24 (15) .003
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 91 (28) 28 (17) .03
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 57 (17) 10 (6) .01
□ As an osteopathic physician, I do not plan on using OMT.† 32 (10) 14 (9) .0006
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 8.
Comparison of Responses of Study Participants (%) Who Strongly Agreed With Questionnaire Statements, by Reason for Attending a College of Osteopathic Medicine*
Osteopathic Philosophy OMT Desire to Become a Physican
Study Participants, % P Value‡ Study Participants, % P Value‡ Study Participants, % P Value‡
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 87 vs 71 <.0001 87 vs 77 .02 66 vs 81 .01
□ I believe OMT is a legitimate means of treatment for patients. 50 vs 37 .0001 58 vs 39 <.0001 26 vs 46 <.0001
□ I believe OMT is an effective treatment method. 43 vs 31 .0007 52 vs 33 <.0001 11 vs 41 <.0001
□ OMT is a major distinguishing factor between a DO and an MD. 43 vs 39 .09 60 vs 34 <.0001 17 vs 44 <.0001
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 25 vs 19 <.0001 45 vs 13 <.0001 2 vs 24 <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 47 vs 35 .0001 59 vs 35 <.0001 17 vs 44 <.0001
□ I want to learn OMT as part of medical school curriculum. 51 vs 32 <.0001 59 vs 36 <.0001 13 vs 45 <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 20 vs 22 .44 30 vs 18 .002 17 vs 22 .02
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.‡ 25 vs 24 .09 30 vs 22 .36 15 vs 25 .003
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.‡ 15 vs 13 .002 23 vs 10 <.0001 0 vs 15 <.0001
□ As an osteopathic physician, I do not plan on using OMT.‡ 4 vs 15 .002 2 vs 12 <.0001 30 vs 7 <.0001
  * Data are presented as the percentage of study participants who were influenced by the reason for attending a college of osteopathic medicine vs the percentage of study participants who were not influenced by the reason, except where otherwise specified.
  P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 8.
Comparison of Responses of Study Participants (%) Who Strongly Agreed With Questionnaire Statements, by Reason for Attending a College of Osteopathic Medicine*
Osteopathic Philosophy OMT Desire to Become a Physican
Study Participants, % P Value‡ Study Participants, % P Value‡ Study Participants, % P Value‡
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 87 vs 71 <.0001 87 vs 77 .02 66 vs 81 .01
□ I believe OMT is a legitimate means of treatment for patients. 50 vs 37 .0001 58 vs 39 <.0001 26 vs 46 <.0001
□ I believe OMT is an effective treatment method. 43 vs 31 .0007 52 vs 33 <.0001 11 vs 41 <.0001
□ OMT is a major distinguishing factor between a DO and an MD. 43 vs 39 .09 60 vs 34 <.0001 17 vs 44 <.0001
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 25 vs 19 <.0001 45 vs 13 <.0001 2 vs 24 <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 47 vs 35 .0001 59 vs 35 <.0001 17 vs 44 <.0001
□ I want to learn OMT as part of medical school curriculum. 51 vs 32 <.0001 59 vs 36 <.0001 13 vs 45 <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 20 vs 22 .44 30 vs 18 .002 17 vs 22 .02
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.‡ 25 vs 24 .09 30 vs 22 .36 15 vs 25 .003
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.‡ 15 vs 13 .002 23 vs 10 <.0001 0 vs 15 <.0001
□ As an osteopathic physician, I do not plan on using OMT.‡ 4 vs 15 .002 2 vs 12 <.0001 30 vs 7 <.0001
  * Data are presented as the percentage of study participants who were influenced by the reason for attending a college of osteopathic medicine vs the percentage of study participants who were not influenced by the reason, except where otherwise specified.
  P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 9.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Application to Medical Schools
Area Assessed and Statement Osteopathic and Allopathic (n=356) Osteopathic Only (n=133) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 278 (78) 111 (83) .21
□ I believe OMT is a legitimate means of treatment for patients. 136 (38) 79 (59) <.0001
□ I believe OMT is an effective treatment method. 122 (34) 63 (47) .002
□ OMT is a major distinguishing factor between a DO and an MD. 139 (39) 63 (47) .09
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 55 (15) 52 (39) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 133 (37) 70 (53) .002
□ I want to learn OMT as part of medical school curriculum. 128 (36) 79 (59) <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 73 (21) 31 (23) .40
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 82 (23) 37 (28) .37
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 34 (10) 33 (25) .0002
□ As an osteopathic physician, I do not plan on using OMT.† 38 (11) 8 (6) .0001
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 9.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Application to Medical Schools
Area Assessed and Statement Osteopathic and Allopathic (n=356) Osteopathic Only (n=133) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 278 (78) 111 (83) .21
□ I believe OMT is a legitimate means of treatment for patients. 136 (38) 79 (59) <.0001
□ I believe OMT is an effective treatment method. 122 (34) 63 (47) .002
□ OMT is a major distinguishing factor between a DO and an MD. 139 (39) 63 (47) .09
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 55 (15) 52 (39) <.0001
□ Learning OMT will provide an additional tool I will use to treat patients. 133 (37) 70 (53) .002
□ I want to learn OMT as part of medical school curriculum. 128 (36) 79 (59) <.0001
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 73 (21) 31 (23) .40
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 82 (23) 37 (28) .37
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 34 (10) 33 (25) .0002
□ As an osteopathic physician, I do not plan on using OMT.† 38 (11) 8 (6) .0001
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Table 10.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Relationship to Physicians
Related to…
Area Assessed and Statement DO Only (n=25) MD Only (n=99) Both (n=17) Neither (n=350) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 16 (64) 76 (77) 12 (71) 282 (82) .15
□ I believe OMT is a legitimate means of treatment for patients. 7 (28) 38 (38) 10 (59) 160 (46) .05
□ I believe OMT is an effective treatment method. 7 (28) 34 (34) 8 (47) 136 (39) .13
□ OMT is a major distinguishing factor between a DO and an MD. 9 (36) 41 (41) 9 (53) 143 (41) .60
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 5 (20) 14 (14) 4 (24) 84 (24) .18
□ Learning OMT will provide an additional tool I will use to treat patients. 9 (36) 32 (32) 11 (65) 151 (43) .04
□ I want to learn OMT as part of medical school curriculum. 10 (40) 36 (36) 10 (59) 151 (43) .21
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 6 (24) 17 (17) 7 (41) 74 (21) .23
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 6 (25) 21 (21) 10 (59) 82 (23) .02
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 1 (4) 12 (12) 12 (18) 51 (15) .39
□ As an osteopathic physician, I do not plan on using OMT.† 2 (8) 10 (10) 1 (6) 33 (9) .61
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
Table 10.
Comparison of Responses of Study Participants Who Strongly Agreed With Questionnaire Statements (No. [%]), by Relationship to Physicians
Related to…
Area Assessed and Statement DO Only (n=25) MD Only (n=99) Both (n=17) Neither (n=350) P Value*
Attitudes Toward Osteopathic Philosophy
□ I believe the person is made up of body, mind, and spirit. 16 (64) 76 (77) 12 (71) 282 (82) .15
□ I believe OMT is a legitimate means of treatment for patients. 7 (28) 38 (38) 10 (59) 160 (46) .05
□ I believe OMT is an effective treatment method. 7 (28) 34 (34) 8 (47) 136 (39) .13
□ OMT is a major distinguishing factor between a DO and an MD. 9 (36) 41 (41) 9 (53) 143 (41) .60
Perception of Osteopathic Predoctoral Education
□ OMT was a major factor in deciding to attend an osteopathic medical school. 5 (20) 14 (14) 4 (24) 84 (24) .18
□ Learning OMT will provide an additional tool I will use to treat patients. 9 (36) 32 (32) 11 (65) 151 (43) .04
□ I want to learn OMT as part of medical school curriculum. 10 (40) 36 (36) 10 (59) 151 (43) .21
□ I will learn enough OMT in medical school to be proficient to begin treating patients at the start of postgraduate training. 6 (24) 17 (17) 7 (41) 74 (21) .23
□ I feel that OMT will be sufficiently integrated throughout the medical school curriculum.† 6 (25) 21 (21) 10 (59) 82 (23) .02
Intentions to Use OMT in Medical Practice
□ As an osteopathic physician, I plan on using OMT to treat a majority of my patients when indicated.† 1 (4) 12 (12) 12 (18) 51 (15) .39
□ As an osteopathic physician, I do not plan on using OMT.† 2 (8) 10 (10) 1 (6) 33 (9) .61
  * P value based on Kruskal-Wallis test. P⩽.05 denotes statistical significance.
  One participant did not respond to this statement.
  Abbreviations: DO, osteopathic physician; MD, allopathic physician; OMT, osteopathic manipulative treatment.
×
Questionnaire distributed to students at 4 colleges of osteopathic medicine to assess osteopathic medical students beliefs about osteopathic manipulative treatment.
Image Not Available
Questionnaire distributed to students at 4 colleges of osteopathic medicine to assess osteopathic medical students beliefs about osteopathic manipulative treatment.
Image Not Available×