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JAOA/AACOM Medical Education  |   April 2020
Assessment of the Research Interests and Perceptions of First-Year Medical Students at 4 Colleges of Osteopathic Medicine
Author Notes
  • From Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest in Lebanon, Oregon (Student Doctors Nguyen and Kaneshiro and Dr Kisby); Marian University College of Osteopathic Medicine in Indianapolis, Indiana (Student Doctors Nallamala, Kirby, Cho, and Messer and Drs Zahl, Hum, and Lowery); West Virginia School of Osteopathic Medicine in Lewisburg (Dr Modrzakowski); University of Pikeville Kentucky College of Osteopathic Medicine (Drs Atchley and Ziegler); and Samaritan Health Services in Corvallis, Oregon (Ms Pipitone). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Jonathan W. Lowery, PhD, Marian University College of Osteopathic Medicine, 3200 Cold Spring Rd, Indianapolis, IN 46222-1960. Email: jlowery@marian.edu
     
Article Information
Medical Education
JAOA/AACOM Medical Education   |   April 2020
Assessment of the Research Interests and Perceptions of First-Year Medical Students at 4 Colleges of Osteopathic Medicine
The Journal of the American Osteopathic Association, April 2020, Vol. 120, 236-244. doi:https://doi.org/10.7556/jaoa.2020.040
The Journal of the American Osteopathic Association, April 2020, Vol. 120, 236-244. doi:https://doi.org/10.7556/jaoa.2020.040
Web of Science® Times Cited: 1
Abstract

Context: There are limited data regarding the experiences of and attitudes toward research participation among osteopathic medical students despite rapidly increasing enrollment and expansion of the number of osteopathic medical schools.

Objective: To assess first-year osteopathic medical students’ experience with research, their interest in it, their perceptions of its value, and barriers to participation.

Methods: An anonymous, online survey was sent to 868 medical students in the class of 2021 at 4 colleges of osteopathic medicine. The survey consisted of 14 multiple-choice items (7 of which offered the option of a written response) and 1 open-ended item that asked them to report their age. The survey remained open for 2 weeks, with 1 reminder email sent on the last day of the survey. Incomplete responses were excluded from the analysis.

Results: A total of 328 participants were included, for a response rate of 38%. A majority of respondents reported previous research experience (261 [79.6%]), consistent with a strong perception that research participation is important (315 [96.0%]). Fewer students (177 [54.0%]) were either currently participating in research or affirmed interest in performing research during medical school, with the highest level of interest in clinical research (259 [79.0%]) followed by basic science (166 [50.6%]). Regarding incentives that might encourage participation in research, students preferred monetary compensation (213 [64.9%]) or extra credit in courses (195 [59.5%]). A commonly reported barrier to performing research during medical school was the possibility of a negative impact on performance in coursework (289 [88.1%]).

Conclusion: First-year osteopathic medical students are interested in research, view research experience as valuable, and consider research experience as beneficial to future career development. This study's findings highlight opportunities for increasing student participation in research through incentives or removal of perceived barriers.

Inquiry-based learning and teaching techniques promote critical thinking, reflection, and discovery to engage learners as active participants in the educational process. Participation in research projects facilitates this approach because students can integrate the knowledge gained from coursework with discoveries made during the research process. Many collateral benefits also accrue for those who participate in original research, including sharpened critical thinking and lifelong learning,1-4 greater appreciation for evidence-based medicine,5 and improved clinical competence.6 Consistent with the collateral benefits of the research and publication, the American Osteopathic Association's Commission on Osteopathic College Accreditation requires that colleges of osteopathic medicine (COMs) provide instruction in the basic scientific principles of research and support student research participation.7 Despite these expectations, for all available years (2013-2018), nearly half of osteopathic graduates reported that their medical school did not devote adequate time to research.8-13 According to the 2018 National Residency Match Program data, only half of osteopathic medical students self-reported that a research experience led to a demonstrable product (eg, publication, abstract)14; this finding contrasts with 78% of allopathic medical students.15 The reasons for this discrepancy are no doubt multifactorial; however, there is a lack of available information regarding the attitudes and perceptions of osteopathic medical students toward research participation. 
Previously, we disseminated an electronic survey to incoming first-year osteopathic medical students at 2 campuses of a single COM and found that the vast majority of students reported previous research experience and affirmed interest in participating in research during medical school.16 These findings suggested that first-year osteopathic medical students were highly motivated to perform research, but this broad generalization was limited because the population came from a single COM. 
The present article is an extension of that study—using the same base survey instrument with slight modifications for wider distribution—to 4 COMs (5 campuses). The purpose of this study was to more broadly examine the research experience, interests, and perceptions of students at 5 COM campuses representing different regions of the country. 
Methods
We distributed a descriptive survey to first-year osteopathic medical students (class of 2021) at 4 osteopathic medical schools: Western University of Health Sciences College of Osteopathic Medicine of the Pacific (WesternU/COMP) in Pomona, California and WesternU/COMP-Northwest in Lebanon, Oregon; University of Pikeville Kentucky College of Osteopathic Medicine (UP-KYCOM); Marian University College of Osteopathic Medicine (MU-COM) in Indianapolis, Indiana; and West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg. This study was approved or deemed exempt by the institutional review boards at all 4 COMs. 
An email was sent to 868 students, who had entered medical school 3 weeks earlier, inviting them to voluntarily participate in the anonymous survey. The invitation provided basic information about the study as well as a statement indicating that submission of the survey by a student constituted informed consent. A hyperlink to the survey was provided at the end of the email invitation. The survey was administered by the online survey service Qualtrics, which allowed for anonymous data collection and concealment of the participants’ identities. 
The survey instrument (eFigure) consisted of 15 items: 14 multiple-choice items (7 offered a write-in response and were categorized by the authors by common language or sentiment) and 1 asked participants to specify their age. The survey remained open for 2 weeks, with 1 reminder email sent on the last day of the survey. Incomplete responses were excluded from the analysis. Data were summarized in aggregate form and by institution. Differences across COMs in previous research experience and current participation interest levels were analyzed using a 2-tailed χ2 test; P<.05 was considered statistically significant. An odds ratio was used to determine whether interest in participating in research during medical school was associated with previous research experience. 
Results
A total of 328 students participated, for an overall response rate of 38% (328 of 868); the response rate for each COM ranged from 25% to 50% (Table 1). Each COM was also represented relatively equally in the final participation group: WesternU/COMP (57 [17%]), WesternU/COMP-Northwest (56 [17%]), UP-KYCOM (69 [21%]), MU-COM (65 [20%]), and WVSOM (81 [25%]) (Table 1). Respondent ages ranged from 20 to 49 years. For the majority of participants (265 [80.8%]; range, 74.1%-87.7%), a baccalaureate degree was the highest degree earned, and basic science was the most prevalent field of study (246 [75.0%]; range, 67.9%-81.5%). 
Table 1.
Demographics of Survey Respondents
Characteristic Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Respondents, No. (%) 328 (100%) 57 (17.4) 56 (17.1) 69 (21.0) 65 (19.8) 81 (24.7)
Response Rate, % 38% 25% 50% 49% 38% 38%
Age Range, y 20-49 21-41 22-36 21-39 21-30 20-49
Field of Bachelor's Degree, No. (%)
 Applied science 13 (4.0) 2 (3.5) 2 (3.6) 3 (4.3) 1 (1.5) 5 (6.2)
 Basic science 246 (75.0) 42 (73.7) 43 (76.8) 53 (76.8) 53 (81.5) 55 (67.9)
 Social science 29 (8.8) 4 (7) 5 (8.9) 7 (10.1) 6 (9.2) 7 (8.6)
 Liberal Arts 11 (3.4) 4 (7) 1 (1.8) 1 (1.4) 1 (1.5) 4 (4.9)
 Other 29 (8.8) 5 (8.8) 5 (8.9) 5 (7.2) 4 (6.2) 10 (12.3)
Highest Degree Earned, No. (%)
 Bachelor's 265 (80.8) 43 (75.4) 49 (87.5) 56 (81.2) 57 (87.7) 60 (74.1)
 Master's 62 (18.9) 13 (22.8) 7 (12.5) 13 (18.8) 8 (12.3) 21 (25.9)
 PhD 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
 Professional 1 (0.3) 1 (1.8) 0 (0) 0 (0) 0 (0) 0 (0)

a Percentages refer to within each column grouping with the exception of “respondents” where referring to the percentage of the overall grouping.

Table 1.
Demographics of Survey Respondents
Characteristic Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Respondents, No. (%) 328 (100%) 57 (17.4) 56 (17.1) 69 (21.0) 65 (19.8) 81 (24.7)
Response Rate, % 38% 25% 50% 49% 38% 38%
Age Range, y 20-49 21-41 22-36 21-39 21-30 20-49
Field of Bachelor's Degree, No. (%)
 Applied science 13 (4.0) 2 (3.5) 2 (3.6) 3 (4.3) 1 (1.5) 5 (6.2)
 Basic science 246 (75.0) 42 (73.7) 43 (76.8) 53 (76.8) 53 (81.5) 55 (67.9)
 Social science 29 (8.8) 4 (7) 5 (8.9) 7 (10.1) 6 (9.2) 7 (8.6)
 Liberal Arts 11 (3.4) 4 (7) 1 (1.8) 1 (1.4) 1 (1.5) 4 (4.9)
 Other 29 (8.8) 5 (8.8) 5 (8.9) 5 (7.2) 4 (6.2) 10 (12.3)
Highest Degree Earned, No. (%)
 Bachelor's 265 (80.8) 43 (75.4) 49 (87.5) 56 (81.2) 57 (87.7) 60 (74.1)
 Master's 62 (18.9) 13 (22.8) 7 (12.5) 13 (18.8) 8 (12.3) 21 (25.9)
 PhD 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
 Professional 1 (0.3) 1 (1.8) 0 (0) 0 (0) 0 (0) 0 (0)

a Percentages refer to within each column grouping with the exception of “respondents” where referring to the percentage of the overall grouping.

×
The majority of participants (261 [79.6%]; range, 68.1%-94.7%; Table 2) reported participation in research before entering a COM. Significant differences were found in previous research experience between COMs (χ2=11.87; df=3; P=.008). Most of those with experience (160 [61.3%]; range, 48.1%-68.7%) had published or presented their research findings. When asked whether they were interested in participating in research during medical school, 177 (54%; range, 36.2%-66.7%) either expressed interest or were currently doing research (Table 3). One hundred fifteen (37.5%) also indicated that they might be interested in participating in research. Significant differences were found in interest in participating in research (χ=15.48; df=3; P=.001) between COMs. The odds of interest in research during medical school were 2 times greater for participants with previous research experience than for those with no previous research experience (OR, 2.00; 95% CI, 1.16-3.46). Fifteen participants (4.6%) reported no interest in research (Table 3). 
Table 2.
Previous Research Experience Among Survey Respondents a
Previous Research Experience Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Yes 261 (79.6) 54 (94.7) 45 (80.4) 47 (68.1) 48 (73.8) 67 (82.7)
Published or presented 160 (61.3) 26 (48.1) 24 (53.3) 31 (66.0) 33 (68.8) 46 (68.7)
Not published or presented 101 (38.7) 28 (51.9) 21 (46.7) 16 (34.0) 15 (31.3) 21 (31.3)
No 67 (20.4) 3 (5.3) 11 (19.6) 22 (31.9) 17 (26.2) 14 (17.3)

a Percentages refer to within each column grouping. Data are given as No. (%).

Table 2.
Previous Research Experience Among Survey Respondents a
Previous Research Experience Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Yes 261 (79.6) 54 (94.7) 45 (80.4) 47 (68.1) 48 (73.8) 67 (82.7)
Published or presented 160 (61.3) 26 (48.1) 24 (53.3) 31 (66.0) 33 (68.8) 46 (68.7)
Not published or presented 101 (38.7) 28 (51.9) 21 (46.7) 16 (34.0) 15 (31.3) 21 (31.3)
No 67 (20.4) 3 (5.3) 11 (19.6) 22 (31.9) 17 (26.2) 14 (17.3)

a Percentages refer to within each column grouping. Data are given as No. (%).

×
Table 3.
Interest in Participating in Research During Osteopathic Medical School Among Survey Respondents
Interested in Participating in Research Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
 Yes 165 (50.3) 28 (49.1) 30 (53.6) 22 (31.9) 31 (47.7) 54 (66.7)
 Maybe 115 (35.1) 20 (35.1) 16 (28.6) 31 (44.9) 26 (40) 22 (27.2)
 Currently participating 12 (3.7) 3 (5.3) 5 (8.9) 3 (4.3) 1 (1.5) 0 (0)
 No 15 (4.6) 2 (3.5) 0 (0) 7 (10.1) 2 (3.1) 4 (4.9)
 No response 21 (6.4) 4 (7) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)
Type of Research Interest
 Clinical research 259 (79.0) 37 (64.9) 43 (76.8) 53 (76.8) 56 (86.2) 70 (86.4)
 Basic science 166 (50.6) 27 (47.4) 29 (51.8) 35 (50.7) 35 (53.8) 40 (49.4)
 Anatomical research 108 (32.9) 13 (22.8) 22 (39.3) 21 (30.4) 23 (35.4) 29 (35.8)
 Osteopathic manipulative medicine 105 (30.0) 16 (28.1) 11 (19.6) 27 (39.1) 21 (32.3) 30 (37.0)
 Social science 101 (30.8) 19 (33.3) 16 (28.6) 23 (33.3) 17 (26.2) 26 (32.1)
 Translational research 48 (14.6) 11 (19.3) 7 (12.5) 8 (11.6) 8 (12.3) 14 (17.3)
 Applied science 30 (9.1) 6 (10.5) 5 (8.9) 5 (7.2) 7 (10.8) 7 (8.6)
 Other 10 (3.0) 3 (5.3) 3 (5.4) 1 (1.4) 1 (1.5) 2 (2.5)
 Not interested in research 21 (6.4) 4 (7.0) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)

a For the type of research, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

Table 3.
Interest in Participating in Research During Osteopathic Medical School Among Survey Respondents
Interested in Participating in Research Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
 Yes 165 (50.3) 28 (49.1) 30 (53.6) 22 (31.9) 31 (47.7) 54 (66.7)
 Maybe 115 (35.1) 20 (35.1) 16 (28.6) 31 (44.9) 26 (40) 22 (27.2)
 Currently participating 12 (3.7) 3 (5.3) 5 (8.9) 3 (4.3) 1 (1.5) 0 (0)
 No 15 (4.6) 2 (3.5) 0 (0) 7 (10.1) 2 (3.1) 4 (4.9)
 No response 21 (6.4) 4 (7) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)
Type of Research Interest
 Clinical research 259 (79.0) 37 (64.9) 43 (76.8) 53 (76.8) 56 (86.2) 70 (86.4)
 Basic science 166 (50.6) 27 (47.4) 29 (51.8) 35 (50.7) 35 (53.8) 40 (49.4)
 Anatomical research 108 (32.9) 13 (22.8) 22 (39.3) 21 (30.4) 23 (35.4) 29 (35.8)
 Osteopathic manipulative medicine 105 (30.0) 16 (28.1) 11 (19.6) 27 (39.1) 21 (32.3) 30 (37.0)
 Social science 101 (30.8) 19 (33.3) 16 (28.6) 23 (33.3) 17 (26.2) 26 (32.1)
 Translational research 48 (14.6) 11 (19.3) 7 (12.5) 8 (11.6) 8 (12.3) 14 (17.3)
 Applied science 30 (9.1) 6 (10.5) 5 (8.9) 5 (7.2) 7 (10.8) 7 (8.6)
 Other 10 (3.0) 3 (5.3) 3 (5.4) 1 (1.4) 1 (1.5) 2 (2.5)
 Not interested in research 21 (6.4) 4 (7.0) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)

a For the type of research, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

×
The majority of participants (259 [78.9%]; range, 64.9%-86.4%) affirmed interest in clinical research (Table 3). Level of interest in other research topic areas were: basic science (166 [50.6%]; range, 47.4%-53.8%), anatomical research (108 [32.9%]; range, 22.8%-39.3%), osteopathic manipulative medicine (105 [32.0%]; range, 19.6%-39.1%), social science (101 [30.8%]; range, 26.2%-33.3%), translational research (48 [14.6%]; range, 11.6%-19.3%), applied science (30 [9.1%]; range, 7.2%-10.8%), and other (10 [3.0%]; range, 1.4%-5.4%). Of the “other” answers, 3 participants indicated an interest in exercise physiology and nutrition, and 1 participant each wrote in concussion, social determinants of health, immunology, education, prehospital care, and gene therapy as their areas of research interest. 
An overwhelming majority of participants (315 [96.0%]; range, 94.6%-97.1%) indicated that they perceived some level of importance to participating in research during their osteopathic medical school tenure; 124 participants indicated that they felt a research experience was “very” or “extremely” important (range, 27.7%-55.4%). Thirteen participants (4.0%) indicated that research participation during medical school was “not important.” Regarding the question of perceived benefits of participating in research during medical school (Table 4), for which participants could identify more than 1 answer, a majority of participants (274 [83.5%]; range, 75.4%-87.7%) believed that research participation would enhance their competitiveness in residency applications. Other perceived benefits included an opportunity to interact with current faculty (222 [67.7%]; range, 61.4%-75.4%), to develop skills for conducting research as a physician (219 [66.8%]; range, 55.4%-73.7%), and to deepen understanding of curricular concepts (212 [64.6%]; range, 59.6%-76.8%). In open-ended answers, some participants (18 [5.5%]) reported other benefits, including “to aid in the advancement of medicine,” “furthering the DO field by supporting techniques with evidence based research,” “contributing to society, patient care, and improving patient outcomes,” and “developing and sharpening one's ability to critically analyze multivariable problems.” Four participants (1.2%) indicated that research participation was not beneficial. 
Table 4.
Survey Respondents’ Perceptions of the Importance and Benefits of Participating in Research During Osteopathic Medical Schoola
Factors Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Importance of Participating in Research Experience
 Extremely important 46 (14.0) 6 (10.5) 10 (17.9) 10 (14.5) 5 (7.7) 15 (18.5)
 Very important 78 (23.8) 16 (28.1) 21 (37.5) 12 (17.4) 13 (20.0) 16 (19.8)
 Moderately important 150 (45.7) 24 (42.1) 19 (33.9) 37 (53.7) 36 (55.4) 34 (42.0)
 Slightly important 41 (12.5) 8 (14.0) 3 (5.4) 8 (11.6) 9 (13.8) 13 (16.0)
 Not important 13 (4.0) 3 (5.3) 3 (5.4) 2 (2.9) 2 (3.1) 3 (3.7)
Benefits of Participating in Research
 Enhancing competitiveness for residency slots 274 (83.5) 43 (75.4) 49 (87.5) 59 (85.5) 57 (87.7) 66 (81.5)
 Engaging with faculty members 222 (67.7) 35 (61.4) 40 (71.4) 47 (68.1) 49 (75.4) 51 (63.0)
 Developing skills for doing research as a physician 219 (66.8) 42 (73.7) 39 (69.6) 43 (62.3) 36 (55.4) 59 (72.8)
 Deepening understanding of curricular concepts 212 (64.6) 34 (59.6) 43 (76.8) 45 (65.2) 40 (61.5) 50 (61.7)
 Other 18 (5.5) 4 (7.0) 8 (14.3) 4 (5.8) 2 (3.1) 1 (1.2)
 No benefit 4 (1.2) 2 (3.5) 1 (17.9) 0 (0.0) 1 (1.5) 0 (0.0)

a For the perceived benefits, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

Table 4.
Survey Respondents’ Perceptions of the Importance and Benefits of Participating in Research During Osteopathic Medical Schoola
Factors Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Importance of Participating in Research Experience
 Extremely important 46 (14.0) 6 (10.5) 10 (17.9) 10 (14.5) 5 (7.7) 15 (18.5)
 Very important 78 (23.8) 16 (28.1) 21 (37.5) 12 (17.4) 13 (20.0) 16 (19.8)
 Moderately important 150 (45.7) 24 (42.1) 19 (33.9) 37 (53.7) 36 (55.4) 34 (42.0)
 Slightly important 41 (12.5) 8 (14.0) 3 (5.4) 8 (11.6) 9 (13.8) 13 (16.0)
 Not important 13 (4.0) 3 (5.3) 3 (5.4) 2 (2.9) 2 (3.1) 3 (3.7)
Benefits of Participating in Research
 Enhancing competitiveness for residency slots 274 (83.5) 43 (75.4) 49 (87.5) 59 (85.5) 57 (87.7) 66 (81.5)
 Engaging with faculty members 222 (67.7) 35 (61.4) 40 (71.4) 47 (68.1) 49 (75.4) 51 (63.0)
 Developing skills for doing research as a physician 219 (66.8) 42 (73.7) 39 (69.6) 43 (62.3) 36 (55.4) 59 (72.8)
 Deepening understanding of curricular concepts 212 (64.6) 34 (59.6) 43 (76.8) 45 (65.2) 40 (61.5) 50 (61.7)
 Other 18 (5.5) 4 (7.0) 8 (14.3) 4 (5.8) 2 (3.1) 1 (1.2)
 No benefit 4 (1.2) 2 (3.5) 1 (17.9) 0 (0.0) 1 (1.5) 0 (0.0)

a For the perceived benefits, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

×
An overwhelming majority of participants (289 [88.1%]; range, 78.6%-94.7%) thought that research would have a negative effect on their coursework performance. Relatively fewer participants indicated that a preference for other extracurricular activities (115 [35.1%]; range, 28.4%-43.9%) might be a reason to not participate in research. Lack of opportunity for a specific kind of research was a less prevalent concern (38 [11.6%]; range, 7.0%-17.9%). Some students (17 [5.2%]) reported additional concerns, most of which pertained to other types of obligations (eg, spending time with family and military service). 
More than half of the participants indicated that monetary compensation would motivate them to engage in research (213 [64.9%]; range, 53.6%-72.5%), as would extra credit in coursework (195 [59.5%]; range, 51.9%-68.1%) (Table 5). Some participants (101 [30.8%]; range, 23.1%-37.0%) reported that an opportunity for a specific type of research might encourage their participation. 
Table 5.
Survey Respondents’ Perceptions of the Reasons to Not Participate in and Possible Enablers to Encourage Participating in Research During Osteopathic Medical Schoola
Factors Affecting Research Interest Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Reasons to Not Participate
 Concern about academic performance 289 (88.1) 54 (94.7) 44 (78.6) 63 (91.3) 60 (92.3) 68 (84.0)
 Prefer other extracurricular activities 115 (35.1) 25 (43.9) 22 (39.3) 24 (34.8) 21 (32.3) 23 (28.4)
 Lack of opportunity for a specific kind of research 38 (11.6) 4 (7.0) 10 (17.9) 6 (8.7) 6 (9.2) 12 (14.8)
 Not applicable 12 (3.7) 4 (7.0) 3 (5.4) 4 (5.8) 2 (3.1) 4 (4.9)
 Other 17 (5.2) 0 (0.0) 4 (7.1) 2 (2.9) 2 (3.1) 4 (4.9)
Possible Enablers
 Monetary compensation 213 (64.9) 39 (68.4) 30 (53.6) 50 (72.5) 43 (66.2) 51 (63.0)
 Extra credit 195 (59.5) 33 (57.9) 31 (55.4) 47 (68.1) 42 (64.6) 42 (51.9)
 Specific type of research 101 (30.8) 18 (31.6) 17 (30.4) 21 (30.4) 15 (23.1) 30 (37.0)
 Nothing 29 (8.8) 7 (12.3) 8 (14.3) 3 (4.3) 5 (7.7) 6 (7.4)
 Other 25 (7.6) 5 (8.8) 9 (16.1) 2 (2.9) 2 (3.1) 7 (8.6)

a Participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

Table 5.
Survey Respondents’ Perceptions of the Reasons to Not Participate in and Possible Enablers to Encourage Participating in Research During Osteopathic Medical Schoola
Factors Affecting Research Interest Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Reasons to Not Participate
 Concern about academic performance 289 (88.1) 54 (94.7) 44 (78.6) 63 (91.3) 60 (92.3) 68 (84.0)
 Prefer other extracurricular activities 115 (35.1) 25 (43.9) 22 (39.3) 24 (34.8) 21 (32.3) 23 (28.4)
 Lack of opportunity for a specific kind of research 38 (11.6) 4 (7.0) 10 (17.9) 6 (8.7) 6 (9.2) 12 (14.8)
 Not applicable 12 (3.7) 4 (7.0) 3 (5.4) 4 (5.8) 2 (3.1) 4 (4.9)
 Other 17 (5.2) 0 (0.0) 4 (7.1) 2 (2.9) 2 (3.1) 4 (4.9)
Possible Enablers
 Monetary compensation 213 (64.9) 39 (68.4) 30 (53.6) 50 (72.5) 43 (66.2) 51 (63.0)
 Extra credit 195 (59.5) 33 (57.9) 31 (55.4) 47 (68.1) 42 (64.6) 42 (51.9)
 Specific type of research 101 (30.8) 18 (31.6) 17 (30.4) 21 (30.4) 15 (23.1) 30 (37.0)
 Nothing 29 (8.8) 7 (12.3) 8 (14.3) 3 (4.3) 5 (7.7) 6 (7.4)
 Other 25 (7.6) 5 (8.8) 9 (16.1) 2 (2.9) 2 (3.1) 7 (8.6)

a Participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

×
Discussion
This study is an extension of previous study by WesternU/COMP-Northwest,16 in which experience with and attitudes toward research were examined among first-year osteopathic medical students at WesternU/COMP and WesternU/COMP-Northwest. Those data revealed that the vast majority of students reported prior research experience and were interested in participating in research during medical school. Additionally, osteopathic medical students at 1 COM reported that there were perceived barriers and benefits to participating in research during medical school.16 However, the generalizability of those findings to other COMs was unclear because of the limitation of surveying students at only 1 COM. Using the same survey instrument, with slight modifications for broader distribution, the current study allowed aggregate analysis of cohort-matched osteopathic medical students at 4 COMs and revealed institution-specific differences between students. Similar to Carter et al,16 the vast majority of students at each COM reported previous research experience (79.6% overall in our study vs 81% in the Carter et al study) and potential participation in research during medical school (89.0% vs 75%). That said, χ2 analyses revealed institution-specific differences in research interests and experience, with COMP/WesternU and COMP-Northwest students reporting the highest amount of previous research experience, WVSOM students reporting the highest interest in participating in research, and UP-KYCOM students reporting the lowest amount of research experience and interest in research. Across campuses, the majority of students reported interest in clinical research, which is consistent with Carter et al,16 Pheley et al,19 and Licciardone et al20 regarding clinical research electives. Moreover, approximately half of the students in the current study and in Carter et al16 reported interest in basic science research, while approximately one-third of students in both studies reported interest in osteopathic manipulative medicine research. Notably, interest in research participation during osteopathic medical school was significantly greater for students with previous research experience when compared with students with no research experience. These findings may have important implications for COMs that are considering expanding their research programs and increasing research opportunities for students, potentially through recruitment and admission practices, faculty hiring in particular research areas, and intramural research funding and infrastructure. 
Ample evidence shows that research participation provides many collateral benefits to medical professionals, including sharpened critical thinking and lifelong learning skills,1-4 greater appreciation for evidence-based medicine5; and improvement in clinical competency scores.6 It is important to keep in mind that the primary benefit ascribed to research participation by students in the current study and in Carter et al16 was the potential for enhanced competitiveness in residency applications (83.5% vs 91.0%, respectively). This finding is striking considering that, for all available years (2013-2018), nearly half of recent osteopathic graduates reported that their medical school did not devote adequate time to research.8-13 Previous studies of allopathic medical students reported that they value research participation as contributing to their career development and that it increased their confidence about placement into their desired residency.21-23 Previous reports24-26 found that research experience increased the likelihood of allopathic medical students matching into their desired residency program for many specialties. Corresponding data are limited regarding osteopathic medical students.26 Furthermore, the 2018 NRMP Program Director survey indicated that, in certain specialties (eg, radiation oncology, plastic surgery, neurosurgery, interventional radiology), more than 75% of program directors surveyed felt that “demonstrated involvement and interest in research” was a key factor in the selection of applicants for an interview.27 Therefore, it is important to identify the motivations and real or perceived barriers to participating in research during osteopathic medical school. 
In the present study and in Carter et al,16 the overwhelmingly predominant barrier or concern was the potential for research to negatively affect performance in coursework (88.1% vs 87.2%, respectively), which we suspect is due to the time commitment required for conducting meaningful research. Similar barriers to those reported in the current study have been reported by US and international allopathic medical students, including time, funding, research mentor availability, research techniques training, and receiving appropriate acknowledgment for their research contributions.22,28,29 In the changing landscape of the residency match process, osteopathic medical schools should be encouraged to provide more research opportunities for their medical students because evidence suggests that research experience during medical school correlates with matching into residency programs and is considered a key factor by residency program directors.25,26 Directly addressing research barriers may lead to increased opportunities for research experience during medical training. For instance, by implementing specific tools and resources (added mentorship, protected time, biostatistical assistance), resident physicians increased their publication and national presentation rates.30 Therefore, institutions that emphasize medical student research should consider instituting similar types of incentives (eg, monetary compensation, dedicated time in the curriculum, or a pass-fail grading system) to encourage research participation. 
The current study has several important limitations that may affect its generalization to osteopathic medical students nationwide. First, the response rate (38%) was relatively low. Second, our survey instrument, while anonymous, relied on the accuracy of self-reported information. Third, the experience and perceptions of first-year osteopathic medical students at the COMs may have been influenced by regional or institution-specific factors that were beyond the scope of the study. Similarly, institution-specific admission criteria may have underpinned differences between the COMs. Taking these limitations into consideration, overall consistency was observed between the campuses and our prior study,16 which had a response rate of 77%. Thus, we cautiously generalize our findings and interpret them in the context of undergraduate osteopathic medical education overall. 
Conclusion
Our findings indicate that first-year osteopathic medical students are interested in research, view research experience as valuable, and perceive research experience as beneficial to future career development. These findings should compel COMs to provide sufficient research opportunities and resources to students. We hope that all COMs will address the interests, attitudes, and perceptions toward research of their students, promoting a greater awareness and practice of research within the osteopathic medical community. 
Acknowledgment
We thank Brian Kraatz, PhD, at WesternU/COMP for helping us facilitate the administration of the survey. 
References
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Table 1.
Demographics of Survey Respondents
Characteristic Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Respondents, No. (%) 328 (100%) 57 (17.4) 56 (17.1) 69 (21.0) 65 (19.8) 81 (24.7)
Response Rate, % 38% 25% 50% 49% 38% 38%
Age Range, y 20-49 21-41 22-36 21-39 21-30 20-49
Field of Bachelor's Degree, No. (%)
 Applied science 13 (4.0) 2 (3.5) 2 (3.6) 3 (4.3) 1 (1.5) 5 (6.2)
 Basic science 246 (75.0) 42 (73.7) 43 (76.8) 53 (76.8) 53 (81.5) 55 (67.9)
 Social science 29 (8.8) 4 (7) 5 (8.9) 7 (10.1) 6 (9.2) 7 (8.6)
 Liberal Arts 11 (3.4) 4 (7) 1 (1.8) 1 (1.4) 1 (1.5) 4 (4.9)
 Other 29 (8.8) 5 (8.8) 5 (8.9) 5 (7.2) 4 (6.2) 10 (12.3)
Highest Degree Earned, No. (%)
 Bachelor's 265 (80.8) 43 (75.4) 49 (87.5) 56 (81.2) 57 (87.7) 60 (74.1)
 Master's 62 (18.9) 13 (22.8) 7 (12.5) 13 (18.8) 8 (12.3) 21 (25.9)
 PhD 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
 Professional 1 (0.3) 1 (1.8) 0 (0) 0 (0) 0 (0) 0 (0)

a Percentages refer to within each column grouping with the exception of “respondents” where referring to the percentage of the overall grouping.

Table 1.
Demographics of Survey Respondents
Characteristic Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Respondents, No. (%) 328 (100%) 57 (17.4) 56 (17.1) 69 (21.0) 65 (19.8) 81 (24.7)
Response Rate, % 38% 25% 50% 49% 38% 38%
Age Range, y 20-49 21-41 22-36 21-39 21-30 20-49
Field of Bachelor's Degree, No. (%)
 Applied science 13 (4.0) 2 (3.5) 2 (3.6) 3 (4.3) 1 (1.5) 5 (6.2)
 Basic science 246 (75.0) 42 (73.7) 43 (76.8) 53 (76.8) 53 (81.5) 55 (67.9)
 Social science 29 (8.8) 4 (7) 5 (8.9) 7 (10.1) 6 (9.2) 7 (8.6)
 Liberal Arts 11 (3.4) 4 (7) 1 (1.8) 1 (1.4) 1 (1.5) 4 (4.9)
 Other 29 (8.8) 5 (8.8) 5 (8.9) 5 (7.2) 4 (6.2) 10 (12.3)
Highest Degree Earned, No. (%)
 Bachelor's 265 (80.8) 43 (75.4) 49 (87.5) 56 (81.2) 57 (87.7) 60 (74.1)
 Master's 62 (18.9) 13 (22.8) 7 (12.5) 13 (18.8) 8 (12.3) 21 (25.9)
 PhD 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
 Professional 1 (0.3) 1 (1.8) 0 (0) 0 (0) 0 (0) 0 (0)

a Percentages refer to within each column grouping with the exception of “respondents” where referring to the percentage of the overall grouping.

×
Table 2.
Previous Research Experience Among Survey Respondents a
Previous Research Experience Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Yes 261 (79.6) 54 (94.7) 45 (80.4) 47 (68.1) 48 (73.8) 67 (82.7)
Published or presented 160 (61.3) 26 (48.1) 24 (53.3) 31 (66.0) 33 (68.8) 46 (68.7)
Not published or presented 101 (38.7) 28 (51.9) 21 (46.7) 16 (34.0) 15 (31.3) 21 (31.3)
No 67 (20.4) 3 (5.3) 11 (19.6) 22 (31.9) 17 (26.2) 14 (17.3)

a Percentages refer to within each column grouping. Data are given as No. (%).

Table 2.
Previous Research Experience Among Survey Respondents a
Previous Research Experience Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Yes 261 (79.6) 54 (94.7) 45 (80.4) 47 (68.1) 48 (73.8) 67 (82.7)
Published or presented 160 (61.3) 26 (48.1) 24 (53.3) 31 (66.0) 33 (68.8) 46 (68.7)
Not published or presented 101 (38.7) 28 (51.9) 21 (46.7) 16 (34.0) 15 (31.3) 21 (31.3)
No 67 (20.4) 3 (5.3) 11 (19.6) 22 (31.9) 17 (26.2) 14 (17.3)

a Percentages refer to within each column grouping. Data are given as No. (%).

×
Table 3.
Interest in Participating in Research During Osteopathic Medical School Among Survey Respondents
Interested in Participating in Research Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
 Yes 165 (50.3) 28 (49.1) 30 (53.6) 22 (31.9) 31 (47.7) 54 (66.7)
 Maybe 115 (35.1) 20 (35.1) 16 (28.6) 31 (44.9) 26 (40) 22 (27.2)
 Currently participating 12 (3.7) 3 (5.3) 5 (8.9) 3 (4.3) 1 (1.5) 0 (0)
 No 15 (4.6) 2 (3.5) 0 (0) 7 (10.1) 2 (3.1) 4 (4.9)
 No response 21 (6.4) 4 (7) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)
Type of Research Interest
 Clinical research 259 (79.0) 37 (64.9) 43 (76.8) 53 (76.8) 56 (86.2) 70 (86.4)
 Basic science 166 (50.6) 27 (47.4) 29 (51.8) 35 (50.7) 35 (53.8) 40 (49.4)
 Anatomical research 108 (32.9) 13 (22.8) 22 (39.3) 21 (30.4) 23 (35.4) 29 (35.8)
 Osteopathic manipulative medicine 105 (30.0) 16 (28.1) 11 (19.6) 27 (39.1) 21 (32.3) 30 (37.0)
 Social science 101 (30.8) 19 (33.3) 16 (28.6) 23 (33.3) 17 (26.2) 26 (32.1)
 Translational research 48 (14.6) 11 (19.3) 7 (12.5) 8 (11.6) 8 (12.3) 14 (17.3)
 Applied science 30 (9.1) 6 (10.5) 5 (8.9) 5 (7.2) 7 (10.8) 7 (8.6)
 Other 10 (3.0) 3 (5.3) 3 (5.4) 1 (1.4) 1 (1.5) 2 (2.5)
 Not interested in research 21 (6.4) 4 (7.0) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)

a For the type of research, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

Table 3.
Interest in Participating in Research During Osteopathic Medical School Among Survey Respondents
Interested in Participating in Research Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
 Yes 165 (50.3) 28 (49.1) 30 (53.6) 22 (31.9) 31 (47.7) 54 (66.7)
 Maybe 115 (35.1) 20 (35.1) 16 (28.6) 31 (44.9) 26 (40) 22 (27.2)
 Currently participating 12 (3.7) 3 (5.3) 5 (8.9) 3 (4.3) 1 (1.5) 0 (0)
 No 15 (4.6) 2 (3.5) 0 (0) 7 (10.1) 2 (3.1) 4 (4.9)
 No response 21 (6.4) 4 (7) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)
Type of Research Interest
 Clinical research 259 (79.0) 37 (64.9) 43 (76.8) 53 (76.8) 56 (86.2) 70 (86.4)
 Basic science 166 (50.6) 27 (47.4) 29 (51.8) 35 (50.7) 35 (53.8) 40 (49.4)
 Anatomical research 108 (32.9) 13 (22.8) 22 (39.3) 21 (30.4) 23 (35.4) 29 (35.8)
 Osteopathic manipulative medicine 105 (30.0) 16 (28.1) 11 (19.6) 27 (39.1) 21 (32.3) 30 (37.0)
 Social science 101 (30.8) 19 (33.3) 16 (28.6) 23 (33.3) 17 (26.2) 26 (32.1)
 Translational research 48 (14.6) 11 (19.3) 7 (12.5) 8 (11.6) 8 (12.3) 14 (17.3)
 Applied science 30 (9.1) 6 (10.5) 5 (8.9) 5 (7.2) 7 (10.8) 7 (8.6)
 Other 10 (3.0) 3 (5.3) 3 (5.4) 1 (1.4) 1 (1.5) 2 (2.5)
 Not interested in research 21 (6.4) 4 (7.0) 5 (8.9) 6 (8.7) 5 (7.7) 1 (1.2)

a For the type of research, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

×
Table 4.
Survey Respondents’ Perceptions of the Importance and Benefits of Participating in Research During Osteopathic Medical Schoola
Factors Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Importance of Participating in Research Experience
 Extremely important 46 (14.0) 6 (10.5) 10 (17.9) 10 (14.5) 5 (7.7) 15 (18.5)
 Very important 78 (23.8) 16 (28.1) 21 (37.5) 12 (17.4) 13 (20.0) 16 (19.8)
 Moderately important 150 (45.7) 24 (42.1) 19 (33.9) 37 (53.7) 36 (55.4) 34 (42.0)
 Slightly important 41 (12.5) 8 (14.0) 3 (5.4) 8 (11.6) 9 (13.8) 13 (16.0)
 Not important 13 (4.0) 3 (5.3) 3 (5.4) 2 (2.9) 2 (3.1) 3 (3.7)
Benefits of Participating in Research
 Enhancing competitiveness for residency slots 274 (83.5) 43 (75.4) 49 (87.5) 59 (85.5) 57 (87.7) 66 (81.5)
 Engaging with faculty members 222 (67.7) 35 (61.4) 40 (71.4) 47 (68.1) 49 (75.4) 51 (63.0)
 Developing skills for doing research as a physician 219 (66.8) 42 (73.7) 39 (69.6) 43 (62.3) 36 (55.4) 59 (72.8)
 Deepening understanding of curricular concepts 212 (64.6) 34 (59.6) 43 (76.8) 45 (65.2) 40 (61.5) 50 (61.7)
 Other 18 (5.5) 4 (7.0) 8 (14.3) 4 (5.8) 2 (3.1) 1 (1.2)
 No benefit 4 (1.2) 2 (3.5) 1 (17.9) 0 (0.0) 1 (1.5) 0 (0.0)

a For the perceived benefits, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

Table 4.
Survey Respondents’ Perceptions of the Importance and Benefits of Participating in Research During Osteopathic Medical Schoola
Factors Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Importance of Participating in Research Experience
 Extremely important 46 (14.0) 6 (10.5) 10 (17.9) 10 (14.5) 5 (7.7) 15 (18.5)
 Very important 78 (23.8) 16 (28.1) 21 (37.5) 12 (17.4) 13 (20.0) 16 (19.8)
 Moderately important 150 (45.7) 24 (42.1) 19 (33.9) 37 (53.7) 36 (55.4) 34 (42.0)
 Slightly important 41 (12.5) 8 (14.0) 3 (5.4) 8 (11.6) 9 (13.8) 13 (16.0)
 Not important 13 (4.0) 3 (5.3) 3 (5.4) 2 (2.9) 2 (3.1) 3 (3.7)
Benefits of Participating in Research
 Enhancing competitiveness for residency slots 274 (83.5) 43 (75.4) 49 (87.5) 59 (85.5) 57 (87.7) 66 (81.5)
 Engaging with faculty members 222 (67.7) 35 (61.4) 40 (71.4) 47 (68.1) 49 (75.4) 51 (63.0)
 Developing skills for doing research as a physician 219 (66.8) 42 (73.7) 39 (69.6) 43 (62.3) 36 (55.4) 59 (72.8)
 Deepening understanding of curricular concepts 212 (64.6) 34 (59.6) 43 (76.8) 45 (65.2) 40 (61.5) 50 (61.7)
 Other 18 (5.5) 4 (7.0) 8 (14.3) 4 (5.8) 2 (3.1) 1 (1.2)
 No benefit 4 (1.2) 2 (3.5) 1 (17.9) 0 (0.0) 1 (1.5) 0 (0.0)

a For the perceived benefits, participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

×
Table 5.
Survey Respondents’ Perceptions of the Reasons to Not Participate in and Possible Enablers to Encourage Participating in Research During Osteopathic Medical Schoola
Factors Affecting Research Interest Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Reasons to Not Participate
 Concern about academic performance 289 (88.1) 54 (94.7) 44 (78.6) 63 (91.3) 60 (92.3) 68 (84.0)
 Prefer other extracurricular activities 115 (35.1) 25 (43.9) 22 (39.3) 24 (34.8) 21 (32.3) 23 (28.4)
 Lack of opportunity for a specific kind of research 38 (11.6) 4 (7.0) 10 (17.9) 6 (8.7) 6 (9.2) 12 (14.8)
 Not applicable 12 (3.7) 4 (7.0) 3 (5.4) 4 (5.8) 2 (3.1) 4 (4.9)
 Other 17 (5.2) 0 (0.0) 4 (7.1) 2 (2.9) 2 (3.1) 4 (4.9)
Possible Enablers
 Monetary compensation 213 (64.9) 39 (68.4) 30 (53.6) 50 (72.5) 43 (66.2) 51 (63.0)
 Extra credit 195 (59.5) 33 (57.9) 31 (55.4) 47 (68.1) 42 (64.6) 42 (51.9)
 Specific type of research 101 (30.8) 18 (31.6) 17 (30.4) 21 (30.4) 15 (23.1) 30 (37.0)
 Nothing 29 (8.8) 7 (12.3) 8 (14.3) 3 (4.3) 5 (7.7) 6 (7.4)
 Other 25 (7.6) 5 (8.8) 9 (16.1) 2 (2.9) 2 (3.1) 7 (8.6)

a Participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

Table 5.
Survey Respondents’ Perceptions of the Reasons to Not Participate in and Possible Enablers to Encourage Participating in Research During Osteopathic Medical Schoola
Factors Affecting Research Interest Overall WesternU/COMP WesternU/COMP-Northwest UP-KYCOM MU-COM WVSOM
Reasons to Not Participate
 Concern about academic performance 289 (88.1) 54 (94.7) 44 (78.6) 63 (91.3) 60 (92.3) 68 (84.0)
 Prefer other extracurricular activities 115 (35.1) 25 (43.9) 22 (39.3) 24 (34.8) 21 (32.3) 23 (28.4)
 Lack of opportunity for a specific kind of research 38 (11.6) 4 (7.0) 10 (17.9) 6 (8.7) 6 (9.2) 12 (14.8)
 Not applicable 12 (3.7) 4 (7.0) 3 (5.4) 4 (5.8) 2 (3.1) 4 (4.9)
 Other 17 (5.2) 0 (0.0) 4 (7.1) 2 (2.9) 2 (3.1) 4 (4.9)
Possible Enablers
 Monetary compensation 213 (64.9) 39 (68.4) 30 (53.6) 50 (72.5) 43 (66.2) 51 (63.0)
 Extra credit 195 (59.5) 33 (57.9) 31 (55.4) 47 (68.1) 42 (64.6) 42 (51.9)
 Specific type of research 101 (30.8) 18 (31.6) 17 (30.4) 21 (30.4) 15 (23.1) 30 (37.0)
 Nothing 29 (8.8) 7 (12.3) 8 (14.3) 3 (4.3) 5 (7.7) 6 (7.4)
 Other 25 (7.6) 5 (8.8) 9 (16.1) 2 (2.9) 2 (3.1) 7 (8.6)

a Participants were allowed to choose ≥1 factors. Percentages refer to within each column grouping. Data are given as No. (%).

×