This prospective cohort study is approved by the Western University of Health Sciences’ (WesternU) institutional review board and supported by a grant from the American Osteopathic Association. With a nonexperimental design, the study used a convenience sample of in-coming medical students in the classes of 2014-2016. The Western U College of Osteopathic Medicine of the Pacific (WesternU-COMP) research team began collecting data with the class of 2014. The study has expanded to include the WesternU Colleges of Dentistry, Optometry, Podiatry, Graduate Nursing, the Physical Therapy program, medical military students from Rocky Vista College of Osteopathic Medicine and Kansas City University of Medicine and Biosciences, and an Osteopathic Postdoctoral Training Institution-West residency site, affording opportunities for interprofessional and interinstitutional comparisons and postmatriculation analyses. However, it was determined that an initial trend analysis of preliminary osteopathic medical student data could be helpful in guiding the larger scale study.
The team used the Bar-On Emotional Intelligence Inventory/Emotional Quotient Inventory 2.0 (EQ-i 2.0) for Higher Education by Multi-Health Systems (MHS). This inventory is globally recognized and considered valid and reliable. Initially published by Reuvan Bar-On in 1997, the current version has a normative sample of 4000 adults across the United States and Canada, representative of the population of these countries.
23 It consists of 133 items in a self-report format that takes 10 to 15 minutes to complete online. It yields an overall EI score and calculates scores in 5 domains and 15 subscales (
Figure 1).
23 Participants received individualized, confidential summary reports.
The instrument was administered at 3 critical junctures: the start of medical school (baseline), completion of the second year (midway), and at graduation. Upon beginning medical school, the students take a course titled Integrated Skills for the Study of Medicine. During this window, EI is introduced as an important aspect of physician efficacy. Multiple surveys are given during this time to include learning styles and attitudes about osteopathic professional identity, thereby allowing EI to be introduced within an appropriate context. With the first tenet of osteopathic medicine stating “the person is a unit of body, mind, and spirit,” the notion of holistic development for medical students was presented as being consistent with the DO approach to patient care. During EI orientation, students were informed of the study intent, duration, confidentiality, and use of information. They were provided an overview of research on physician performance, a model of professional identity development, and follow-up resources. While it was expected that students complete the Integrated Skills for the Study of Medicine surveys offered, they were provided the email address of the principle investigator for confidential questions or concerns. The course directors understood that students could opt out in this capacity without penalization. After orientation, students were emailed the inventory link using their school email addresses. The agreement used by MHS to access the assessment, which stated the voluntary nature of the survey, was used to obtain informed consent. Students were welcomed to use identification numbers if that was more comfortable. Because initial attempts to hold in-class administrations overloaded the system, students were provided a 2-week timeframe for completion. This strategy encouraged participation, because students were able to take their inventories in private settings where they could thoughtfully reflect. Participants received 2 more emails with links to complete assessments: at the end of their second year and at graduation. With the second and third administrations, strategies to decrease attrition included participation in a drawing with a chance to win 1 of 3 $100 gift cards. Students were informed of the drawing in the email and sent 2 reminders. In addition, subsequent institutional review board approval was granted to offer course points.
All statistical analyses were conducted using the SAS Institute software for Windows version 9.3. Descriptive statistics were presented as mean (SD) for continuous variables and frequencies and proportions for categorical variables. A time variable with the 3 categories, baseline, mid-way, and “at graduation” was created. Repeated measurement analyses of variance were conducted to identify possible longitudinal patterns. A plot of the average of the outcomes (y axis) against time periods (x axis) was used. A score of 100 was considered average; 90, low average; and 110, high average. All statistical analyses were 2-sided. P<.05 was considered statistically significant.