UNASSIGNED: Medication errors can lead to significant adverse events. Nearly 50% of medication errors occur during the prescription-writing stage of the medication use process, and effective interprofessional collaboration and communication are key to reducing error in this process.
UNASSIGNED: We developed a three-part, 60-minute, interprofessional education activity providing medical, physician assistant, and pharmacy students the opportunity to practice collegial interprofessional communication surrounding prescribing practices. Learners met virtually initially as a large group and divided into small groups facilitated by a health professional. Part 1 involved reviewing two prescriptions prepared by learners; part 2 was a discussion about the education, roles, and responsibilities of each profession; and part 3 focused on identifying prescription errors in examples provided by faculty. Students completed a post-pre survey measuring their perception of learning the Interprofessional Collaborative Competency Attainment Survey (ICCAS) areas.
UNASSIGNED: Of 317 participants (151 doctor of osteopathy, 68 master of physician assistant studies, and 98 doctor of pharmacy students), 286 completed the post-pre survey, for a 90% response rate. Students reported statistically significant (p < .001) increases in all 20 questions spanning the six ICCAS areas.
UNASSIGNED: The virtual format allowed multiple institutions to participate from various locations. It broadened the learners\' experience by fostering interaction among those with varied perspectives and allowed collaboration between locations and programs that otherwise could not have participated. The activity introduced students to virtual collaboration and key telehealth skills, enhancing their confidence and familiarity with virtual interactions in a professional setting.

Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pneumonia. The traditional treatment for dysphagia varies based on the patient\'s difficulty of swallowing. The initial phase consists of dietary consistency adjustments, progressing to alternatives like nasogastric tubes or percutaneous endoscopic gastrostomy (PEG) in advanced stages. Osteopathic manipulative treatment (OMT) is a complementary \'hands-on\' approach that has already shown positive results as an add-on therapy in various health conditions. This study is a case report of a man diagnosed with ALS with initial dysphagia, managed with a protocol that extraordinarily included OMT. The patient showed somatic dysfunctions in the mediastinal region, upper cervical region, and occipital area which are all anatomically related to the nervous system, especially the glossopharyngeal reflex. At the end of the rehabilitation protocol, there was a reduction in the swallowing problems measured with Strand Scale and swallowing tests, and the patient reported an improved psycho-physical well-being assessed with the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40). Instead, the neurological function measured with ALSFRS-S remained stable. Although the nature of this study design prevents any causal assumption, the positive results should lead to future randomized controlled trials to assess the effectiveness of OMT as an adjunctive therapeutic proposal to improve the health of ALS patients.

UNASSIGNED: Exercise is beneficial for improving general health, wellbeing, and specific medical conditions. In musculoskeletal conditions such as chronic low back and neck pain, prescribed exercise has been found to be moderately effective in decreasing pain and improving function. Osteopaths are primary contact health professionals who manage predominantly musculoskeletal complaints. This work presents a secondary data analysis of the Australian osteopathy practice-based research network and profiles the characteristics of osteopaths who often use exercise prescription in patient care. Methodology. Secondary analysis of a cross-sectional survey of 992 osteopaths was registered with the Osteopathy Research and Innovation Network, an Australian practice-based research network. Demographics, practice, and treatment characteristics of Australian osteopaths who \"often\" use exercise prescription in patient care were examined.
UNASSIGNED: Seven-hundred and thirty-three Australian osteopaths (74%) indicated that they use exercise prescription \"often\" in patient care. Australian osteopaths who often use exercise prescription are more likely to be colocated with another osteopath (ORa 1.54) and send referrals to an exercise physiologist (ORa 1.94) and a specialist medical practitioner (ORa 1.72). Those osteopaths who often used exercise prescription were also more likely to discuss physical activity (ORa 5.61) and nutrition (ORa 1.90). Australian osteopaths who use exercise prescription often were more likely to treat patients with sports injuries (ORa 2.43) and use soft tissue techniques (ORa 1.92), trigger point techniques (ORa 2.72), and sports taping (ORa 1.78).
UNASSIGNED: Osteopaths who utilise exercise prescription were more likely to discuss physical activity, diet, and nutrition and utilise referral networks with specialist medical practitioners and exercise physiologists. Australian osteopaths who often use exercise prescriptions were also more likely to treat patients with sport injury. The results suggest that most Australian osteopaths use exercise prescription and have referral networks with other health professionals for patient management. Further work is required to explore the type of exercise prescription used and for what conditions.

UNASSIGNED: Given the high rates of burnout and associated negative mental health outcomes (eg, depression, suicidal ideation, substance abuse) among medical students and physicians, it is imperative to identify strategies for supporting the future health workforce, particularly when considering trends indicating a future shortage of physicians. Understanding the associations of medical school students\' learning mindsets (eg, growth mindset, purpose and relevance, and sense of belonging) with indicators of well-being (eg, flourishing) and ill-being (eg, burnout) could provide a foundation for future research to consider when attempting to combat the negative mental health trends among medical students and physicians.
UNASSIGNED: To understand the associations of medical school students\' learning mindsets (ie, their beliefs about themselves as learners and their learning environment) with critical student health outcomes (ie, well-being and ill-being).
UNASSIGNED: This survey study used a nationally representative sample of first-year osteopathic medical school students across the US who responded to a survey of learning mindsets as well as measures of well-being and ill-being in fall 2022. Data were analyzed from January to April 2024.
UNASSIGNED: Learning mindsets were categorized as growth mindset, purpose and relevance, and sense of belonging. Well-being was categorized as flourishing and resilience, and ill-being was categorized as burnout and psychological symptoms. Outcomes were regressed on learning mindset and demographics variables, and interactions of demographic variables and learning mindsets were assessed.
UNASSIGNED: A total of 7839 students were surveyed, and 6622 students (mean [SD] age, 25.05 [3.20]; 3678 [55.5%] women) responded and were included in analyses. The 3 learning mindsets were significantly associated with flourishing (growth mindset: b = 0.34; 95% CI, 0.23 to 0.45; P < .001; purpose and relevance: b = 2.02; 95% CI, 1.83 to 2.20; P < .001; belonging uncertainty: b = -0.98; 95% CI, -1.08 to -0.89; P < .001) and resilience (growth mindset: b = 0.28; 95% CI, 0.17 to 0.40; P < .001; purpose and relevance: b = 1.62; 95% CI, 1.43 to 1.82; P < .001; belonging uncertainty: b = -1.50; 95% CI, -1.60 to -1.40; P < .001) well-being outcomes and burnout (growth mindset: b = -0.09; 95% CI, -0.11 to -0.07; P < .001; purpose and relevance: b = -0.29; 95% CI, -0.32 to -0.25; P < .001; belonging uncertainty: b = 0.28; 95% CI, 0.26 to 0.30; P < .001) and psychological symptoms (growth mindset: b = -0.22; 95% CI, -0.30 to -0.14; P < .001; purpose and relevance: b = -0.51; 95% CI, -0.64 to -0.38; P < .001; belonging uncertainty: b = 1.33; 95% CI, 1.27 to 1.40; P < .001) ill-being outcomes, even when controlling for important demographic characteristics (eg, race and ethnicity, gender identity, age). Furthermore, several significant interactions indicated that these learning mindsets may be particularly salient for students from historically marginalized communities: there was a significant interaction between growth mindset and race and ethnicity (b = 0.58; 95% CI, 0.08 to 1.09, P = .02), such that growth mindset was more strongly associated with flourishing among American Indian or Alaska Native, Black, Latine, or Native Hawaiian students.
UNASSIGNED: These findings suggest that identifying strategies for supporting students\' learning mindsets may be an effective way to support medical student well-being and reduce ill-being, particularly among students from historically marginalized backgrounds.

Pathology is not traditionally chosen by medical students applying to residency. In osteopathic medical schools, limited access to dedicated pathology faculty further complicates this issue. Because of a lack of pathology experiences, osteopathic medical students may not be as familiar with a pathology career. The purpose of this brief report is to describe the pilot experience of implementing a pre-existing web-based, free virtual platform for pathology education as alternative, supplemental exposure to pathology for osteopathic medical students at our institution. We began to offer the online pathology elective for Academic Year 2022-2023. Using the online free service of PathElective, this course provided a valuable exposure to pathology with multiple modules in anatomic, clinical, and digital/molecular pathology, before and after assessments, recorded videos by pathology experts, handouts, and reading assignments. During the first week, three introductory modules were required followed by weeks 2-4, in which the students would complete a total of 10 modules of their own choice. In total, 14 students participated in this virtual rotation from August 2022-May 2023. All chose cardiac pathology as the most popular module. Three of the 14 students matched into pathology residencies. This small cohort of 4th year medical students at our osteopathic medical school successfully completed a virtual elective rotation with the resources of PathElective. We report the success of this experience and hope to continue monitoring progress.

BACKGROUND: Individuals who experience migraines often seek out a variety of treatment options including manual or physical therapy. Evidence suggests that manual therapy, including osteopathy, can play a role in the management of migraines. Whilst there is some literature on the role osteopathy therapy plays in migraine management, none describes the treatment approaches used by practitioners.
OBJECTIVE: To explore the demographic, practice and clinical management characteristics of Australian osteopaths who report treating migraine \'often\' in clinical practice.
METHODS: Secondary analysis of a cross-sectional survey of 988 osteopaths from the Osteopathy Research and Innovation Network (ORION), an Australian practice-based research network. Regression analysis was used to identify demographic, practice and clinical management characteristics of Australian osteopaths who reported \'often\' treating migraine patients.
RESULTS: Over 40% of respondents (n = 400) indicated treating patients with migraines \'often\'. These osteopaths were less likely to be involved in research and be co-located with a dietician compared to osteopaths who do \'not often\' treat migraine. Osteopaths who reported \'often\' treating migraine were: five times as likely to treat non-English speaking ethnic groups; 2.5 times as likely to treat chronic pain, temporomandibular joint disorders and hand musculoskeletal complaints; compared to those that do not treat migraines \'often\'.
CONCLUSIONS: Australian osteopaths who treat migraine are five times more likely to treat non-English speaking ethnic groups; twice as likely to treat chronic pain; temporomandibular joint disorders, and hand musculoskeletal complaints. More research is needed to identify the practices and patient outcomes associated with osteopathy care for those experiencing migraines.

Due to growing health disparities in underserved communities, a comprehensive approach is needed to train physicians to work effectively with patients who have cultures and belief systems different from their own. To address these complex healthcare inequities, Rowan-Virtua SOM implemented a new curriculum, The Tensegrity Curriculum, designed to expand beyond just teaching skills of cultural competence to include trainees\' exploration of cultural humility. The hypothesis is that this component of the curriculum will mitigate health inequity by training physicians to recognize and interrupt the bias within themselves and within systems. Early outcomes of this curricular renewal process reveal increased student satisfaction as measured by course evaluations. Ongoing course assessments examine deeper understanding of the concepts of implicit bias, social determinants of health, systemic discrimination and oppression as measured by performance on graded course content, and greater commitment to continual self-evaluation and critique throughout their careers as measured by course feedback. Structured research is needed to understand the relationship between this longitudinal and integrated curricular design, and retainment or enhancement of empathy during medical training, along with its impact on health disparities and community-based outcomes.

BACKGROUND: Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students\' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change.
METHODS: A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings.
RESULTS: A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants\' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students\' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students.
CONCLUSIONS: Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.

BACKGROUND: It is unknown if US residency applicants of different educational backgrounds (US allopathic [MD], Doctor of Osteopathic Medicine [DO], and international medical graduates [IMG]) but comparable academic performance have similar match success.
OBJECTIVE: Our objective was to compare match probabilities between applicant types after adjusting for specialty choice and United States Medical Licensing Examination (USMLE) Step 1 scores.
METHODS: We performed a secondary analysis of published data in National Resident Matching Program (NRMP) reports from 2016, 2018, 2020, and 2022 for US MD seniors, DO seniors, and IMGs (US citizens and non-US citizens). We examined the 10 specialties with the most available spots in 2022. Average marginal effects from a multiple variable logistic regression model were utilized to estimate each non-MD senior applicant type\'s probability of matching into their preferred specialty compared to MD seniors adjusting for specialty choice, Step 1 score, and match year.
RESULTS: Each non-MD applicant type had a lower adjusted percent difference in matching to their preferred specialty than MD seniors, -7.1 % (95 % confidence interval [CI], -11.3 to -2.9) for DO seniors, -45.6 % (-50.6 to -40.5) for US IMGs, and -56.6 % (-61.5 to -51.6) for non-US IMGs. Similarly, each non-MD applicant type had a lower adjusted percent difference in matching than MD seniors across almost all Step 1 score ranges, except for DO seniors with Step 1 scores <200 (-2.0 % [-9.5 to 5.5]).
CONCLUSIONS: After adjusting for specialty choice, Step 1 score, and match year, non-US MD applicants had lower probabilities of matching into their preferred specialties than their US MD colleagues.

BACKGROUND: Osteopathic manipulative medicine (OMM) encompasses techniques guided by the tenets of osteopathy aimed at facilitating the body\'s natural self-healing capabilities as a treatment option for injury or illness. This approach recognizes the interrelationship of structure and function in promoting overall health. The clinical applications of OMM have been highly researched throughout different subspecialties of medicine; however, there is a notable lack of osteopathic-based research targeted toward neurosurgical patient populations.
METHODS: This cross-sectional descriptive study was conducted via a survey generated using SurveyMonkey (SurveyMonkey, San Mateo, CA, USA; accessed at www.surveymonkey.com). Subjects for this survey were gathered using a convenience sampling method in which emails of all neurosurgeons listed in the \"Member Directory\" on the American Association of Neurological Surgeons website were compiled into a mailing list. The survey was sent to all 6,503 emails collected, and the responses were recorded over the next month. The responses for each survey question were averaged and, when appropriate, compared using a two-tailed T-test, with statistical significance defined as a p<0.05. Where applicable, simple linear regression analysis was used to assess correlations between survey data. The measured outcomes included neurosurgeons\' (1) knowledge of and (2) attitudes toward OMM.
RESULTS: Both MD and DO neurosurgeons reported using OMM (or referring their patients for OMM) less than once per year. In comparison to their MD colleagues, neurosurgeons carrying a DO degree ranked their familiarity with the tenets of osteopathic medicine (p<0.0001) and their knowledge of the applications of OMM in their practice (p=0.0018) significantly higher. Greater reported familiarity with the tenets of osteopathic medicine and applications of OMM showed a positive correlation with neurosurgeons\' comfort in recommending OMM as a nonsurgical, preoperative treatment option, as a post-surgical, rehabilitative treatment option, and as a pain management option (p<0.0001 for all). There was a clear interest in seeing further osteopathic-based neurosurgery research by both MD and DO neurosurgeons, as well as a trend of interest in incorporating OMM into their practice if shown to be clinically beneficial.
CONCLUSIONS: Both MD and DO neurosurgeons are interested in seeing more research into the applications of OMM in their patient populations and, most importantly, are likely to integrate OMM into their practice if presented with research detailing clinical benefits to their patients. This study highlights the clinical interest of neurosurgeons in further research into the applications of OMM specific to the field of neurosurgery.