Integrating Osteopathic Manipulative Treatment into Patient Management:A Case-Based Approach to Resident Instruction and Assessment

Objective. This study was conducted to determine if a case-based instructional model integrating osteopathic manipulative treatment (OMT) into patient management improved residents’ ability to generate osteopathic diagnostic and treatment maneuvers. Background. Since 2004, Family and Internal Medicine residents have participated in workshops at NSU-COM that systematically reviewed OMT by body region in preparation for board exams. In 2008, the instructional program was changed to a case-based approach to prepare residents for both their board exams and future medical practice. This instructional model includes a medical case presentation, a pre-test, discussion, and table practice followed by a post-test one month later. On the tests, the residents described the specific areas of the body most likely involved with the OMT diagnosis and the specific OMT treatment techniques appropriate for this patient. Methods. Data for 5 pre-post tests in 2008-09 and 1 pre-post test in 2009-2010 were analyzed using SPSS. Only data for residents present for both tests for a case were analyzed. 2009-2010 data comparing residents new to the instructional model to those who participated in the previous year were also analyzed. Results. Mean scores on all post-tests were significantly higher (p ranging from .039 to .000) than the pre-test scores. Additionally, the 2009-2010 pre-test mean for prior participants was significantly higher (p=.015) than the mean for the new residents. The same is true for the 2009-2010 post-test means (p=.001). Conclusions. This case-based instructional model significantly increases residents’ ability to generate osteopathic diagnostic and treatment maneuvers when presented with a medical case. Grants. None.