A novel simulation enhanced education for osteopathic manipulation of hospitalized patients.

Context: Simulation-based medical education (SBME) is a method for enhancing learner skill prior to initiating care for real patients. Although the use of SBME continues to grow, there is limited data on simulations related to osteopathic medical training. Osteopathic manipulative medicine (OMM) applies hands-on techniques to facilitate healing. We hypothesized that the use of SBME to closely mimic OMM provided to the hospitalized patient would help to increase individual knowledge and comfort with OMM techniques and increase the likelihood of a learner utilizing OMM techniques on patients.

Objectives: This study aimed to determine the effectiveness of the SBME lab to enhance the learning of medical learners of OMM on hospitalized patients, and to determine the favorability of the OMM SBME experience by learners.

Methods: This was a single-institution pilot quality improvement project that utilized a novel simulation to provide OMM to critically ill and hospitalized patients. The simulation was a single instructor-led event lasting 2 h. The OMM experience utilized specialized simulation gowns and hospital beds to mimic the treatment of postsurgical ileus, acute respiratory failure, and congestive heart failure (CHF) exacerbation. Learners alternated between the role of physician (practicing technique) and the patient (wearing the simulation gown). Pre- and postsurveys evaluated learners' knowledge and comfort regarding OMM in hospitalized patients. Graduate medical residents/fellows from five osteopathic-recognized programs and medical students on rotations (n=35) participated in the simulation, and n=32 completed the postsimulation survey. The survey included 15 questions and utilized a 5-point Likert Scale. Results were analyzed with the chi-square test.

Results: The average knowledge pretest score ranged from 2.5 to 3.5 for the 15 questions. Learner knowledge improved for all areas evaluated, with a range of 3.6-4.6 for the postsurvey. The p-value was significant for each question. In addition, lab, simulation, and lecturers were evaluated and were received positively.

Conclusions: This study demonstrates that simulation may be an effective way to increase knowledge and comfort on how to apply OMM in a hospital setting.