P3.Q326: Impact of Osteopathic Manipulative Medicine (OMM) Training During Graduate Medical Education on Its Integration into Clinical Practice

Background: Osteopathic manipulative medicine (OMM) is a unique skillset taught to DOs in osteopathic medical school and consists of physical manipulations that treat the neuromusculoskeletal system to improve functionality and decrease pain. Although OMM has been shown to improve patient outcomes its use is declining. Barriers include lack of time, reimbursement, and proficiency in OMM. Knowledge gaps remain as to how OMM training during graduate medical education (GME) affect OMM use. This study describes relationships between OMM exposure during GME and use of OMM during clinical practice.

Methods: This survey study was created using the Research Electronic Data Capture (REDCap) software. The survey consisted of 33 questions assessing OMM training during residency and fellowship, use of OMM in current practice, and several demographic characteristics. The survey was distributed to osteopathic medical school alumni groups, professional physician organizations, and osteopathic social media groups. Survey data were analyzed using SPSS software. Comparisons of training characteristics and OMM use were made through Chi-squared tests, t-tests, and binary logistic regression, as well as descriptive statistics of demographic characteristics.

Results: 451 surveys were collected over a three-month period with 152 eliminated for incompleteness and other disqualifying factors resulting in 299 surveys utilized for analysis. Respondents who received formal OMM education during residency (e.g., lectures, rotations, CME opportunities) were more likely to use OMM in medical practice (59.8%) than those who practiced OMM informally (37.8%) [X2(1, N = 182) = 8.81, p = 0.003]. and those who had no OMM exposure during residency (10.3%) [X2(1, N = 209) = 58.00, p < 0.001 (Figure 1). Respondents who trained with more osteopathic attendings (b=-0.015, p=0.001) and co-residents (b=0.010, p=.012) were also more likely to use OMM (Figure 2). Those who completed residencies that were accredited by the ACGME with the Osteopathic recognition track (60%), American Osteopathic Association (AOA) (53%), and dually (ACGME/AOA) accredited (53%) were more likely to use OMM than those who completed residencies with ACGME accreditation alone (22%), X2 (4,N=299)=35.63, p< 0.01.

Conclusion: OMM is a useful skill that can enhance patient outcomes and is developed over hundreds of hours of training during osteopathic medical school, but many DOs do not apply it in their clinical practice. There are many reasons for this, but lack of training after medical school has been identified as a contributing factor. The results of our survey study fill a gap in the literature, illustrating that OMM education during postgraduate training positively influences OMM use in clinical practice. For those who wish to continue using their OMM skills after medical school, it may be beneficial to seek a training program that offers formal OMM education.