The effect of the COVID-19 pandemic on osteopathic education in ACGME-OR residencies from February 2020 to February 2021.

CONTEXT: It remains to be determined exactly how the COVID-19 pandemic has and will continue to impact osteopathic resident education, in particular as it pertains to treatment with osteopathic manipulative medicine (OMM). Although the long-term effects of the pandemic cannot be determined yet, changes in current resident education can be analyzed. OBJECTIVES: Here, we describe how the format, frequency, and environment of OMM training have changed in residency programs from prior to February 2020 to the "lockdown" period of February 2020 to June 2020, and then to the "recovery" period of July 2020 to February 2021. METHODS: A 19-question survey inquiring about the above three categories was emailed via SurveyMonkey to 282 Accreditation Council for Graduate Medical Education (ACGME) residency programs with osteopathic recognition at the end of January 2021. RESULTS: Of the 282 programs surveyed, 24.5% (69) responded. Osteopathic neuromusculoskeletal medicine (ONMM) programs were excluded from the data analysis, resulting in a modified sample size of n=60. Responses indicated that residency programs dramatically decreased the frequency of OMM didactic education sessions (100.0% [60] reported offering OMM didactic education before the lockdown period; compared to 73.3% [44] during the lockdown period) and shifted their educational programs from an in-person-only environment (88.3% [53] before lockdown; 8.3% [5] during lockdown) to either a combined in-person/virtual platform (6.7% [4] before lockdown; 31.7% [19] during lockdown) or to a virtual-only platform (0.0% [0] before lockdown; 46.7% [28] during lockdown). During the recovery period, 91.7% (55) programs reported giving some form of OMM didactic education. The percentage of programs reporting in-person-only, combined in-person/virtual platform, and virtual-only didactic education were 3.3% (2), 53.3% (32), and 41.7% (25), respectively, during the recovery period. The preferred method of instruction changed from a combination of resident and attending lectures with a hands-on component (55.0%; 33) before lockdown, to the same but without a hands-on component (28.3%; 17) during lockdown, and back to the same but with a hands-on component (36.7%; 22) during the recovery period. Furthermore, the number of programs offering OMM didactic education [OMM patient care] at least once a month decreased from 70.0% (42) [78.3% (47)] before the lockdown period to 46.7% (28) [48.3% (29)] during the lockdown period. It then increased to 55.0% (33) [73.3% (44)] during the recovery period. Finally, before the lockdown period, programs offered OMM patient care predominantly in a combination of an inpatient/outpatient environment (63.3%; 38). The preferred patient care setting changed to an outpatient-only environment (43.3%; 26) during the lockdown period and then back to a combination of an inpatient/outpatient environment (45.0%; 27) during the recovery period. CONCLUSIONS: This study demonstrates that programs have been dramatically impacted by the COVID-19 pandemic, by the augmentation of the osteopathic learning environment, and by the delivery of OMM to patient care within the training programs. These impacts were still present 1 year after the start of the pandemic. It will be imperative for ACGME Osteopathic Recognition (ACGME-OR) programs to continue an assessment of these impacts on resident physicians' learning and preparedness.

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.

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.