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Original Contribution  |   February 2020
Attitudes Toward Osteopathic Recognition Under the Single GME Accreditation System: A Survey of Deans at Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments
Author Notes
  • From the proposed Noorda College of Osteopathic Medicine in Provo, Utah (Dr Dougherty); the Oklahoma State University Center for Health Sciences in Tulsa (Dr Bray); and the Touro University Nevada in Henderson (Dr Vanier). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to John J. Dougherty, DO, the proposed Noorda College of Osteopathic Medicine, Academic Affairs, 122 E 1700 S, Provo, UT 84606-5644. Email: jdougherty@noordacom.org
     
Article Information
Medical Education / Graduate Medical Education
Original Contribution   |   February 2020
Attitudes Toward Osteopathic Recognition Under the Single GME Accreditation System: A Survey of Deans at Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments
The Journal of the American Osteopathic Association, February 2020, Vol. 120, 81-89. doi:https://doi.org/10.7556/jaoa.2020.018
The Journal of the American Osteopathic Association, February 2020, Vol. 120, 81-89. doi:https://doi.org/10.7556/jaoa.2020.018
Abstract

Objective: To assess the attitudes of academic deans at colleges of osteopathic medicine (COMs) and chairs of COMs’ osteopathic manipulative medicine (OMM) departments toward osteopathic recognition under the single graduate medical education (GME) accreditation system.

Methods: An 11-item Likert-type survey with additional demographic questions was distributed via email to deans and OMM department chairs at 51 COMs and additional locations in September 2017. Items were formulated to assess survey participants’ understanding and beliefs regarding the value and support of the establishment of osteopathic recognition within the single GME accreditation system. Demographic information gathered was limited to role (ie, dean or OMM department chair). Survey items were ranked on a 5-point Likert-type scale from strongly disagree to strongly agree.

Results: A total of 39 COMs deans and 24 OMM chairs indicated they understood the intent of osteopathic recognition in a single GME accreditation system, but OMM chairs felt less informed about osteopathic recognition than deans (17% vs 3% disagreeing with the statement, “I have been adequately informed about osteopathic recognition”). There was no difference between deans and chairs regarding their attitudes toward osteopathic recognition in residency training programs, though a minority of deans (n=2) disagreed that osteopathic recognition benefits programs and indicated that they did not recommend it for surgical specialties (n=2) or fellowship programs (n=3). Deans and chairs generally agreed on their overall support of osteopathic recognition, the perceptions of osteopathic medical students toward osteopathic recognition, and the value that osteopathic recognition brings to COMs, with 2 deans dissenting on each item. A moderate correlation was found between information of and attitude toward osteopathic recognition for the deans (r=0.72, n=39), but a much weaker relationship was observed between information and attitude for the chairs (r=0.37, n=24) (difference between the correlations: z=1.89, P=.06).

Conclusion: Although the deans and OMM chairs agreed that they support, believe in the value of, and find that osteopathic medical students are interested in osteopathic recognition, there is an opportunity for improvement of deans’ and COMs chairs’ understanding of osteopathic recognition.

The American Osteopathic Association (AOA), the American Association of Colleges of Osteopathic Medicine (AACOM), and the Accreditation Council for Graduate Medical Education (ACGME) established a single graduate medical education (GME) accreditation system in 2014. During the transition to the single GME accreditation system, which began July 1, 2015, and ends June 30, 2020, the 1244 AOA-accredited GME programs may pursue ACGME accreditation. 
Residency and fellowship programs that achieve ACGME accreditation have the opportunity to apply for osteopathic recognition, which is overseen by the ACGME Osteopathic Principles Committee. Osteopathic recognition demonstrates a commitment by GME programs to integrate osteopathic principles and practice into the specialty patient care learning environment.1 Programs applying for osteopathic recognition must submit an application and demonstrate substantial compliance with osteopathic recognition requirements.2 Achievement of osteopathic recognition by a GME program represents dedication to providing requisite education in osteopathic principles and practice (OPP) throughout the ACGME competencies as applicable to the specialty. Research regarding the attitudes of osteopathic medical students and program directors toward osteopathic recognition within the ACGME accreditation system has demonstrated support for the system and process.3,4 
As of March 1, 2019, of the 1244 AOA-accredited GME programs (including fellowships and traditional internship programs), 928 have achieved or applied for ACGME accreditation under the single GME accreditation system. This number represents continued growth from February 2018, when 853 were in the process of applying.5 As of December 17, 2019, osteopathic recognition has been obtained by 215 programs, of which 41% were previously dually accredited, 15% were ACGME accredited with no prior osteopathic accreditation, and 44% were solely AOA accredited.6 
In undergraduate medical education, colleges of osteopathic medicine (COMs), which are accredited by the AOA Commission on Osteopathic College Accreditation (COCA), have a responsibility to ensure that their graduates have access to GME. The COCA standards, effective July 1, 2019, state that COMs must support the osteopathic education continuum, assist in the transition of existing GME and new GME in meeting ACGME standards, and provide a mechanism to assist programs in meeting the requirements of osteopathic recognition (Figure 1).7 Under the new standard, COMs' support of GME is reaffirmed. However, the academic deans and faculty of OMM departments are now responsible for the development and delivery of content for this standard. The present study was designed to assess the attitudes of deans and OMM department chairs of accredited COMs regarding the understanding of, perceived value of, and institutional support for osteopathic recognition. 
Figure 1.
New accreditation standards from the American Osteopathic Association's Commission on Osteopathic College Accreditation, effective July 1, 2019.7 Abbreviation: COM, college of osteopathic medicine.
Figure 1.
New accreditation standards from the American Osteopathic Association's Commission on Osteopathic College Accreditation, effective July 1, 2019.7 Abbreviation: COM, college of osteopathic medicine.
Methods
Participants
To recruit participants, an email was sent from AACOM to the Board of Deans listserve for the 51 COCA-accredited COMs, branch campuses, and additional locations. An email was also sent by the AACOM Educational Council on Osteopathic Principles to the listserve for the 51 OMM department chairs. Approval for this survey-based study was sought through the Touro University Nevada Institutional Review Board, which determined that the project was exempt. 
Survey Tool
In addition to demographic questions, an 11-item survey was developed to discern the understanding, attitudes, and beliefs of COMs deans and OMM department chairs regarding osteopathic recognition through the ACGME's single GME accreditation system using a cross-sectional design. The survey questions were conceptually related to 1 of 3 areas: how well informed a person believed he or she was regarding osteopathic recognition, the person's attitudes and actions regarding osteopathic recognition and residency training programs, and the person's beliefs and personal experiences regarding osteopathic recognition. 
The demographic information gathered was limited to roles within the COMs (dean or OMM department chair). Consent was obtained verifying that study participation was voluntary and anonymous and that participants were under no obligation to complete all items in the study. Survey items were ranked on a 5-point Likert-type scale ranging from 2 (“strongly disagree”) to 6 (“strongly agree”), with 1 representing “no opinion.” The no-opinion data were omitted from data analyses. The survey was distributed electronically via Survey Monkey on September 26, 2017. A reminder email was sent in October, and the survey was closed on November 20, 2017. 
Statistical Analyses
Analysis of data collected via Survey Monkey was performed using R statistical software (R Core Team 2017). Parametric statistics have been shown to be robust to deviation from assumptions associated with the Likert scale,8 so the average responses of deans and chairs were compared using a t test. One dean and 2 OMM department chairs partially completed the survey, and the data from these 3 individuals were incorporated in the analysis when available. 
The relationship between the information an individual stated to know and the perception he or she held regarding osteopathic recognition was investigated. All response scores related to information (questions listed in Figure 2) were averaged to provide an “information” score. The response values for the remaining questions (listed in Figure 3 and Figure 4) were averaged to provide an “attitudes and beliefs” score for each individual. A Pearson correlation coefficient was estimated between the information score and the attitudes and beliefs score separately for deans and chairs. The 2 correlations were compared using a z test.9 Statistical significance was defined as P≤.05. 
Figure 2.
Mean (error bars denote standard error) opinion regarding information about osteopathic recognition (OR). Sample size was 39 for deans and 24 for chairs, except for the last item, which had sample sizes of 38 and 22 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. aStatistically significant difference at P<.001. bStatistically significant difference at P=.021.
Figure 2.
Mean (error bars denote standard error) opinion regarding information about osteopathic recognition (OR). Sample size was 39 for deans and 24 for chairs, except for the last item, which had sample sizes of 38 and 22 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. aStatistically significant difference at P<.001. bStatistically significant difference at P=.021.
Figure 3.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs, except for the fourth item (“I recommend fellowship…”), which had sample sizes of 37 and 24 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 3.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs, except for the fourth item (“I recommend fellowship…”), which had sample sizes of 37 and 24 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 4.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 4.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Results
Of the 51 deans contacted, 39 responded, for a response rate of 76.4%; of the 51 OMM department chairs, 24 responded, for a response rate of 47.1%. Table 1 presents survey responses, and Table 2 presents the raw frequency data. Although COMs deans and OMM chairs agreed that they understood the intent of osteopathic recognition in a single GME accreditation system, OMM chairs were less likely to agree that they had been adequately informed about osteopathic recognition and the process of achieving it (Figure 2). 
Table 1.
Survey Responses of Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments Regarding Osteopathic Recognitiona
Mean (SE)      
Survey Item Deans (n=39) Chairs (n=24) t test df P Value
Information      
 I understand the intent of OR. 5.69 (0.08) 5.13 (0.13) 3.8 43 <.001
 I have been adequately informed about OR. 5.33 (0.12) 4.38 (0.18) 4.5 43 <.001
 I understand the process of achieving OR. 5.26 (0.14) 4.13 (0.24) 4 38 <.001
 I provide faculty towards support of residency programs to achieve OR. 5.53 (0.11)b 4.91 (0.23)c 2.4 31 <.021
Attitudes      
 I believe OR benefits residency training programs. 5.26 (0.17) 5.38 (0.15) −0.5 60 .594
 I recommend residency programs in primary care achieve OR. 5.56 (0.11) 5.63 (0.10) 59 .683
 I recommend residency programs in surgical specialties achieve OR. 5.13 (0.16)b 5.29 (0.19) −0.7 52 .517
 I recommend fellowship programs achieve OR. 5.03 (0.16)d 5.42 (0.15) −1.8 58 .080
 I find osteopathic medical students have interest in residency programs that achieve OR. 4.87 (0.15)b 5 (0.16)c −0.6 51 .549
Beliefs  
 I believe that OR adds value to my institution (COM). 5.31 (0.16) 5.21 (0.15) 0.5 59 .650
 I support OR. 5.51 (0.14) 5.63 (0.12) −0.6 61 .545

a Data are reported based on the following numerical coding of survey responses: 1, no opinion; 2, strongly disagree; 3, disagree; 4, neither agree nor disagree; 5, agree; 6, strongly agree. No opinion data were omitted.

b n=38

c n=22

d n=37

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

Table 1.
Survey Responses of Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments Regarding Osteopathic Recognitiona
Mean (SE)      
Survey Item Deans (n=39) Chairs (n=24) t test df P Value
Information      
 I understand the intent of OR. 5.69 (0.08) 5.13 (0.13) 3.8 43 <.001
 I have been adequately informed about OR. 5.33 (0.12) 4.38 (0.18) 4.5 43 <.001
 I understand the process of achieving OR. 5.26 (0.14) 4.13 (0.24) 4 38 <.001
 I provide faculty towards support of residency programs to achieve OR. 5.53 (0.11)b 4.91 (0.23)c 2.4 31 <.021
Attitudes      
 I believe OR benefits residency training programs. 5.26 (0.17) 5.38 (0.15) −0.5 60 .594
 I recommend residency programs in primary care achieve OR. 5.56 (0.11) 5.63 (0.10) 59 .683
 I recommend residency programs in surgical specialties achieve OR. 5.13 (0.16)b 5.29 (0.19) −0.7 52 .517
 I recommend fellowship programs achieve OR. 5.03 (0.16)d 5.42 (0.15) −1.8 58 .080
 I find osteopathic medical students have interest in residency programs that achieve OR. 4.87 (0.15)b 5 (0.16)c −0.6 51 .549
Beliefs  
 I believe that OR adds value to my institution (COM). 5.31 (0.16) 5.21 (0.15) 0.5 59 .650
 I support OR. 5.51 (0.14) 5.63 (0.12) −0.6 61 .545

a Data are reported based on the following numerical coding of survey responses: 1, no opinion; 2, strongly disagree; 3, disagree; 4, neither agree nor disagree; 5, agree; 6, strongly agree. No opinion data were omitted.

b n=38

c n=22

d n=37

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

×
Table 2.
Raw Frequency Data for Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments
Position No Opiniona Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
I understand the intent of OR.
 Deans 0 0 0 1 10 28
 Chairs 0 0 0 3 15 6
I have been adequately informed about OR.
 Deans 0 0 1 3 17 18
 Chairs 0 0 4 9 9 2
I understand the process of achieving OR.
 Deans 0 0 3 2 16 18
 Chairs 0 1 9 3 8 3
I provide faculty toward support of residency programs to achieve OR.
 Deans 1 0 1 1 13 23
 Chairs 2 0 3 4 7 8
I believe OR benefits residency training programs.
 Deans 0 2 0 5 11 21
 Chairs 0 0 0 3 9 12
I recommend residency programs in primary care achieve OR.
 Deans 0 0 0 4 9 26
 Chairs 0 0 0 0 9 15
I recommend residency programs in surgical specialties achieve OR.
 Deans 1 1 1 7 12 17
 Chairs 0 0 1 4 6 13
I recommend fellowship programs achieve OR.
 Deans 2 0 3 8 11 15
 Chairs 0 0 0 3 8 13
I find osteopathic medical students have interest in residency programs that achieve OR.
 Deans 1 1 2 6 21 8
 Chairs 2 0 0 6 10 6
I believe that OR adds value to my institution (COM).
 Deans 0 1 1 6 8 23
 Chairs 0 0 0 4 11 9
I support OR.
 Deans 0 1 1 1 10 26
 Chairs 0 0 0 1 7 16

a The “no opinion” data were not used for the group comparisons.

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

Table 2.
Raw Frequency Data for Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments
Position No Opiniona Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
I understand the intent of OR.
 Deans 0 0 0 1 10 28
 Chairs 0 0 0 3 15 6
I have been adequately informed about OR.
 Deans 0 0 1 3 17 18
 Chairs 0 0 4 9 9 2
I understand the process of achieving OR.
 Deans 0 0 3 2 16 18
 Chairs 0 1 9 3 8 3
I provide faculty toward support of residency programs to achieve OR.
 Deans 1 0 1 1 13 23
 Chairs 2 0 3 4 7 8
I believe OR benefits residency training programs.
 Deans 0 2 0 5 11 21
 Chairs 0 0 0 3 9 12
I recommend residency programs in primary care achieve OR.
 Deans 0 0 0 4 9 26
 Chairs 0 0 0 0 9 15
I recommend residency programs in surgical specialties achieve OR.
 Deans 1 1 1 7 12 17
 Chairs 0 0 1 4 6 13
I recommend fellowship programs achieve OR.
 Deans 2 0 3 8 11 15
 Chairs 0 0 0 3 8 13
I find osteopathic medical students have interest in residency programs that achieve OR.
 Deans 1 1 2 6 21 8
 Chairs 2 0 0 6 10 6
I believe that OR adds value to my institution (COM).
 Deans 0 1 1 6 8 23
 Chairs 0 0 0 4 11 9
I support OR.
 Deans 0 1 1 1 10 26
 Chairs 0 0 0 1 7 16

a The “no opinion” data were not used for the group comparisons.

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

×
There was no difference between deans and OMM chairs regarding recommending that residency programs in primary care achieve osteopathic recognition (Figure 3), though a minority of deans disagreed with the benefits of osteopathic recognition for residency training programs (n=2), surgical specialties (n=2), and fellowship programs (n=3). Deans and chairs also generally agreed on the belief that osteopathic recognition brings value to their COM, on their overall support of osteopathic recognition, and on the perception that osteopathic medical students are interested in residency programs with osteopathic recognition, with a minority (n=2) dissenting from those views (Figure 4). 
A moderate correlation was found between information and attitude for the deans (r=0.72, n=39), but a much weaker relationship was observed for the chairs (r=0.37, n=24) (difference between the correlations: z=1.89, P=.06). When taken in aggregate, 3 deans had an overall negative view of osteopathic recognition, whereas no chairs took a negative view overall (Figure 5). 
Figure 5.
Correlations of mean responses regarding information about osteopathic recognition (OR) vs mean perception of OR, plotted by respondent. Separate lines are provided for deans of colleges of osteopathic medicine and chairs of departments of osteopathic manipulative medicine.
Figure 5.
Correlations of mean responses regarding information about osteopathic recognition (OR) vs mean perception of OR, plotted by respondent. Separate lines are provided for deans of colleges of osteopathic medicine and chairs of departments of osteopathic manipulative medicine.
Discussion
The findings suggest an opportunity to improve communication about osteopathic recognition between deans and their OMM department chairs. It would be anticipated that as the COMs move through the accreditation oversight process, the expectations implicit in COCA's Standard 10 will become self-evident. The negative perception of osteopathic recognition that was demonstrated by 3 COMs deans raises concern about the mentorship and osteopathic learning environment at their respective COMs. In light of the observation from Hempstead et al3 that program directors in family medicine programs lacking osteopathic components have lower perceptions of osteopathic residents than do directors of programs with osteopathic curricula, the ongoing engagement of COMs deans will be critical to ensure the successful continuation of OPP in GME. 
In this study, there was overall agreement by COMs deans and OMM chairs that they believe in the value of, support, and detect interest by osteopathic medical students in osteopathic recognition of ACGME-accredited programs. This agreement is in line with the importance that osteopathic medical students, residents, and GME faculty assigned to attaining osteopathic competencies.10 Additionally, Hempstead et al4 found that a majority of residents and GME faculty rank osteopathic curricular components as highly important. There was equally defined support of osteopathic recognition in primary care residencies and slightly increased support in surgical specialty residency programs and fellowship programs by OMM chairs. 
The success of osteopathic recognition faces several challenges. One such challenge is that the residency program leaders may not recognize the value of the additional recognition and thus not encourage its pursuit among their faculty and students. An underlying premise of this study was to initiate a broader discussion among administrative leaders given their direct and indirect role in promoting and executing the infrastructure for osteopathic recognition. 
Another challenge is that pursuing osteopathic recognition requires additional resources, such as time and financial reimbursement for those submitting the application for osteopathic recognition or those ensuring that the osteopathic recognition standards are met. Additional discussions around these issues should include prerequisites training and board certification status of faculty contributing to osteopathic recognition at the GME level. How COMs allocate resources to be successful in both the undergraduate and graduate medical education arenas will continue to be a challenge. 
Additionally, future research will be required to determine the effectiveness of teaching OPP to novices at the GME level, best practices in curricular delivery and outcome assessment, creation of scholarly environments to promote and disseminate research, and allocation of financial resources to different training programs. Results can help guide the successful integration of OPP into the educational continuum of the future. 
Limitations of this study include a relatively low response rate for OMM chairs compared with deans. As with any voluntary survey, the sample was self-selected. Whether individuals are more likely to respond when they are highly supportive or well informed, as opposed to when they do not support an initiative or are poorly informed, is beyond the scope of this study. The study was intended as a single assessment to inform education and policy efforts moving forward with the understanding that attitudes can and should evolve over time. Future follow-up surveys and research articles on osteopathic recognition are recommended, particularly considering that the survey data were collected around the midpoint of the transition to the single GME accreditiaton system. 
Conclusion
This study characterized attitudes regarding osteopathic recognition of COMs deans and OMM chairs, who set the tone for faculty and students. The AOA, AACOM, and ACGME have engaged in widespread email and social media campaigns, as well as recurrent educational sessions at their respective annual meetings to educate everyone in the osteopathic medical profession regarding osteopathic recognition. The COMs chairs and deans should be the most informed, as students and faculty look to them for guidance on such topics. Results from the survey show that COMs deans feel better informed than OMM chairs regarding osteopathic recognition, which suggests that future efforts regarding osteopathic recognition should target OMM chairs. The correlation findings also suggest that more information on this topic may lead to a higher opinion regarding osteopathic recognition. Education and experience are predicted to increase knowledge and positive perceptions of osteopathic recognition going forward. 
References
Buser BR, Swartwout J, Lischka T, Biszewski M, DeVine K. Single accreditation system update: gaining momentum. J Am Osteopath Assoc. 2017;117(4):211-215. doi: 10.7556/jaoa.2017.038 [CrossRef] [PubMed]
Osteopathic Recognition Requirements. Chicago, IL: Accreditation Council for Graduate Medical Education; 2018. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/801OsteopathicRecognition2018.pdf?ver=2018-02-20-154513-650. Accessed September 8, 2018.
Hempstead LK, Shaffer TD, Williams KB, Arnold LC. Attitudes of family medicine program directors toward osteopathic residents under the single accreditation system. J Am Osteopath Assoc. 2017;117(4):216-224. doi: 10.7556/jaoa.2017.039 [CrossRef] [PubMed]
Hempstead LK, Rosemergey B, Foote S, Swade K, Williams KB. Resident and faculty attitudes toward osteopathic-focused education. J Am Osteopath Assoc. 2018;118(4):253-263. doi: 10.7556/jaoa.2018.050 [CrossRef] [PubMed]
Buser BR, Swartwout J, Lischka T, Biszewski M. Single accreditation system for graduate medical education: transition update. J Am Osteopath Assoc. 2019;119(4):257-262. doi: 10.7556/jaoa.2019.043 [CrossRef] [PubMed]
List of programs applying for and with osteopathic recognition by specialty. Accreditation Council for Graduate Medical Education website. https://apps.acgme.org/ads/Public/Reports/ReportRun?ReportId=17&CurrentYear=2017&SpecialtyCode=&OsteopathicRecognitionStatusId. Accessed December 17, 2019.
Commission on Osteopathic College Accreditation. Accreditation of Colleges of Osteopathic Medicine: COM Continuing Accreditation Standards. Chicago, IL: Commission on Osteopathic College Accreditation; 2019. http://www.osteopathic.org/inside-aoa/accreditation/COM-accreditation/Documents/com-continuing-accreditation-standards.pdf. Accessed December 18, 2019.
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Cohen J, Cohen P, West SG, Aiken LS. Applied Multiple Regression/Correlation Analysis for the Behavioral Aciences. 3rd ed. Mahwah, NJ: L. Erlbaum Associates; 2003.
Hortos K, Corser W, Church B, Rohrer J, Waarala K. Perceived important of pursuing osteopathic recognition in the single accreditation system: a survey of medical students, residents, and faculty. J Am Osteopath Assoc. 2017;117(10): 651-659. [CrossRef] [PubMed]
Figure 1.
New accreditation standards from the American Osteopathic Association's Commission on Osteopathic College Accreditation, effective July 1, 2019.7 Abbreviation: COM, college of osteopathic medicine.
Figure 1.
New accreditation standards from the American Osteopathic Association's Commission on Osteopathic College Accreditation, effective July 1, 2019.7 Abbreviation: COM, college of osteopathic medicine.
Figure 2.
Mean (error bars denote standard error) opinion regarding information about osteopathic recognition (OR). Sample size was 39 for deans and 24 for chairs, except for the last item, which had sample sizes of 38 and 22 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. aStatistically significant difference at P<.001. bStatistically significant difference at P=.021.
Figure 2.
Mean (error bars denote standard error) opinion regarding information about osteopathic recognition (OR). Sample size was 39 for deans and 24 for chairs, except for the last item, which had sample sizes of 38 and 22 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. aStatistically significant difference at P<.001. bStatistically significant difference at P=.021.
Figure 3.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs, except for the fourth item (“I recommend fellowship…”), which had sample sizes of 37 and 24 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 3.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs, except for the fourth item (“I recommend fellowship…”), which had sample sizes of 37 and 24 for deans and chairs, respectively. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 4.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 4.
Mean (error bars denote standard error) opinion regarding attitudes about osteopathic recognition (OR) in residency training programs. Sample size was 39 for deans and 24 for chairs. The number of individuals who disagreed or strongly disagreed with each statement is provided within each bar. There were no significant differences between chairs and deans (P<.05).
Figure 5.
Correlations of mean responses regarding information about osteopathic recognition (OR) vs mean perception of OR, plotted by respondent. Separate lines are provided for deans of colleges of osteopathic medicine and chairs of departments of osteopathic manipulative medicine.
Figure 5.
Correlations of mean responses regarding information about osteopathic recognition (OR) vs mean perception of OR, plotted by respondent. Separate lines are provided for deans of colleges of osteopathic medicine and chairs of departments of osteopathic manipulative medicine.
Table 1.
Survey Responses of Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments Regarding Osteopathic Recognitiona
Mean (SE)      
Survey Item Deans (n=39) Chairs (n=24) t test df P Value
Information      
 I understand the intent of OR. 5.69 (0.08) 5.13 (0.13) 3.8 43 <.001
 I have been adequately informed about OR. 5.33 (0.12) 4.38 (0.18) 4.5 43 <.001
 I understand the process of achieving OR. 5.26 (0.14) 4.13 (0.24) 4 38 <.001
 I provide faculty towards support of residency programs to achieve OR. 5.53 (0.11)b 4.91 (0.23)c 2.4 31 <.021
Attitudes      
 I believe OR benefits residency training programs. 5.26 (0.17) 5.38 (0.15) −0.5 60 .594
 I recommend residency programs in primary care achieve OR. 5.56 (0.11) 5.63 (0.10) 59 .683
 I recommend residency programs in surgical specialties achieve OR. 5.13 (0.16)b 5.29 (0.19) −0.7 52 .517
 I recommend fellowship programs achieve OR. 5.03 (0.16)d 5.42 (0.15) −1.8 58 .080
 I find osteopathic medical students have interest in residency programs that achieve OR. 4.87 (0.15)b 5 (0.16)c −0.6 51 .549
Beliefs  
 I believe that OR adds value to my institution (COM). 5.31 (0.16) 5.21 (0.15) 0.5 59 .650
 I support OR. 5.51 (0.14) 5.63 (0.12) −0.6 61 .545

a Data are reported based on the following numerical coding of survey responses: 1, no opinion; 2, strongly disagree; 3, disagree; 4, neither agree nor disagree; 5, agree; 6, strongly agree. No opinion data were omitted.

b n=38

c n=22

d n=37

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

Table 1.
Survey Responses of Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments Regarding Osteopathic Recognitiona
Mean (SE)      
Survey Item Deans (n=39) Chairs (n=24) t test df P Value
Information      
 I understand the intent of OR. 5.69 (0.08) 5.13 (0.13) 3.8 43 <.001
 I have been adequately informed about OR. 5.33 (0.12) 4.38 (0.18) 4.5 43 <.001
 I understand the process of achieving OR. 5.26 (0.14) 4.13 (0.24) 4 38 <.001
 I provide faculty towards support of residency programs to achieve OR. 5.53 (0.11)b 4.91 (0.23)c 2.4 31 <.021
Attitudes      
 I believe OR benefits residency training programs. 5.26 (0.17) 5.38 (0.15) −0.5 60 .594
 I recommend residency programs in primary care achieve OR. 5.56 (0.11) 5.63 (0.10) 59 .683
 I recommend residency programs in surgical specialties achieve OR. 5.13 (0.16)b 5.29 (0.19) −0.7 52 .517
 I recommend fellowship programs achieve OR. 5.03 (0.16)d 5.42 (0.15) −1.8 58 .080
 I find osteopathic medical students have interest in residency programs that achieve OR. 4.87 (0.15)b 5 (0.16)c −0.6 51 .549
Beliefs  
 I believe that OR adds value to my institution (COM). 5.31 (0.16) 5.21 (0.15) 0.5 59 .650
 I support OR. 5.51 (0.14) 5.63 (0.12) −0.6 61 .545

a Data are reported based on the following numerical coding of survey responses: 1, no opinion; 2, strongly disagree; 3, disagree; 4, neither agree nor disagree; 5, agree; 6, strongly agree. No opinion data were omitted.

b n=38

c n=22

d n=37

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

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Table 2.
Raw Frequency Data for Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments
Position No Opiniona Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
I understand the intent of OR.
 Deans 0 0 0 1 10 28
 Chairs 0 0 0 3 15 6
I have been adequately informed about OR.
 Deans 0 0 1 3 17 18
 Chairs 0 0 4 9 9 2
I understand the process of achieving OR.
 Deans 0 0 3 2 16 18
 Chairs 0 1 9 3 8 3
I provide faculty toward support of residency programs to achieve OR.
 Deans 1 0 1 1 13 23
 Chairs 2 0 3 4 7 8
I believe OR benefits residency training programs.
 Deans 0 2 0 5 11 21
 Chairs 0 0 0 3 9 12
I recommend residency programs in primary care achieve OR.
 Deans 0 0 0 4 9 26
 Chairs 0 0 0 0 9 15
I recommend residency programs in surgical specialties achieve OR.
 Deans 1 1 1 7 12 17
 Chairs 0 0 1 4 6 13
I recommend fellowship programs achieve OR.
 Deans 2 0 3 8 11 15
 Chairs 0 0 0 3 8 13
I find osteopathic medical students have interest in residency programs that achieve OR.
 Deans 1 1 2 6 21 8
 Chairs 2 0 0 6 10 6
I believe that OR adds value to my institution (COM).
 Deans 0 1 1 6 8 23
 Chairs 0 0 0 4 11 9
I support OR.
 Deans 0 1 1 1 10 26
 Chairs 0 0 0 1 7 16

a The “no opinion” data were not used for the group comparisons.

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

Table 2.
Raw Frequency Data for Deans of Colleges of Osteopathic Medicine and Chairs of Osteopathic Manipulative Medicine Departments
Position No Opiniona Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
I understand the intent of OR.
 Deans 0 0 0 1 10 28
 Chairs 0 0 0 3 15 6
I have been adequately informed about OR.
 Deans 0 0 1 3 17 18
 Chairs 0 0 4 9 9 2
I understand the process of achieving OR.
 Deans 0 0 3 2 16 18
 Chairs 0 1 9 3 8 3
I provide faculty toward support of residency programs to achieve OR.
 Deans 1 0 1 1 13 23
 Chairs 2 0 3 4 7 8
I believe OR benefits residency training programs.
 Deans 0 2 0 5 11 21
 Chairs 0 0 0 3 9 12
I recommend residency programs in primary care achieve OR.
 Deans 0 0 0 4 9 26
 Chairs 0 0 0 0 9 15
I recommend residency programs in surgical specialties achieve OR.
 Deans 1 1 1 7 12 17
 Chairs 0 0 1 4 6 13
I recommend fellowship programs achieve OR.
 Deans 2 0 3 8 11 15
 Chairs 0 0 0 3 8 13
I find osteopathic medical students have interest in residency programs that achieve OR.
 Deans 1 1 2 6 21 8
 Chairs 2 0 0 6 10 6
I believe that OR adds value to my institution (COM).
 Deans 0 1 1 6 8 23
 Chairs 0 0 0 4 11 9
I support OR.
 Deans 0 1 1 1 10 26
 Chairs 0 0 0 1 7 16

a The “no opinion” data were not used for the group comparisons.

Abbreviations: COM, college of osteopathic medicine; OR, osteopathic recognition.

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