The July medical education article by Benjamin R. Bates, PhD, and colleagues titled “The DO Difference: An Analysis of Causal Relationships Affecting the Degree-Change Debate” (J Am Osteopath Assoc. 2009;109:359-369) was well written but also misleading.
The true/false items used in this survey-based study of osteopathic medical students to measure students' “knowledge of OPP [osteopathic principles and practice]” do not measure OPP knowledge. Rather, these items, which did not appear in the study, measure knowledge of certain facts about the osteopathic medical profession.
After reading the article, I contacted the authors, who provided me with a copy of the true/false questions that were used to assess osteopathic medical students' knowledge of OPP, as follows:
These items were verified by JAOA editorial staff.
Had Bates and colleagues used these survey items to evaluate osteopathic medical students' knowledge of certain facts about the DO profession instead of students' OPP knowledge, the authors' article would have some scientific validity. However, based on these survey items, how can the authors make the conclusion that the students' opinions regarding changes in the DO degree name and formal designation are related to their knowledge of OPP?
Moreover, even if the tools used by Bates et al to measure students' OPP knowledge were validated, the conclusions drawn from the survey cannot be generalized to the wider osteopathic medical student population because of the small sample size (N=214) and the sample population's composition (ie, limited to a single osteopathic medical school).
Given the importance of improving the public's perception of, and research quality in, osteopathic medicine, I would like to urge caution and skepticism on the part of both investigators and editors when publishing studies in our most important periodical—JAOA—The Journal of the American Osteopathic Association.