Preparing medical students for the changing healthcare environment in United States. (9/284)

Future graduates of medical schools in the United States will practice in healthcare environments increasingly predominated by managed care. Thus allopathic and osteopathic undergraduate and postgraduate residency training programs should begin to revise their respective curricula and conduct training in managed healthcare environments to prepare graduates for practice in managed care settings. The demand for curricular revision in medicine comes not only from prospective employers and government agencies, but from students and graduates. Educators, clinicians, and government officials have recently defined core competencies that are requisite to the education and preparation of future physicians through the work of the Council on Graduate Medical Education (COGME). This article discusses these core competencies and suggests strategies by which to implement them in undergraduate and graduate medical education.  (+info)

Objectivity and accuracy of mammogram interpretation using the BI-RADS final assessment categories in 40- to 49-year-old women. (10/284)

To determine if use of the five final assessment categories of the American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS) improved objectivity or accuracy of mammographic evaluation in 40- to 49-year-old women, fifty mammograms of 40- to 49-year-old women that were obtained at a tertiary referral teaching hospital were classified according to those five final assessment categories. The mammograms were blinded to six American Osteopathic Board of Radiology-certified radiologists who were asked to classify each mammogram within the five final BI-RADS categories based on the mediolateral oblique and craniocaudal views presented. No history was allowed. Use of the BI-RADS five final assessment categories provided moderate interobserver objectivity, moderately high agreement among the radiologists' interpretation (reliability), and moderate accuracy of interpretation (validity) when compared to criterion. Moderate interobserver reliability and accuracy has been previously identified; however, no scientific review of the BI-RADS five final assessment categories in 40- to 49-year-old females was discovered in the current literature. No overall improvement of objectivity or accuracy was demonstrated using the five final assessment categories of the BI-RADS lexicon in 40- to 49-year-old women.  (+info)

Galbreath technique: a manipulative treatment for otitis media revisited. (11/284)

Otitis media is a common disorder that results in numerous visits to the physician each year. Antimicrobials, antihistamines, steroids, and surgery have all been used to treat otitis media; however, the literature makes little mention of osteopathic manipulative treatment in this regard. This article describes a technique that was first described in 1929 by William Otis Galbreath, DO. By simple mandibular manipulation, the eustachian tube is made to open and close in a "pumping action" that allows the ear to drain accumulated fluid more effectively. Physicians can easily teach this procedure to parents for use at home.  (+info)

Spirituality in history taking. (12/284)

Andrew Taylor Still, MD, DO, included in his founding postulates of osteopathy the concept that a patient's health includes the health of a patient's spirit. In the recent past, medicine as a whole, and osteopathic medicine specifically, has neglected this postulate. Recent research has confirmed the validity of Still's postulate, and many medical training institutions have received grants and established programs to incorporate spirituality into their curriculum. As with any patient evaluation, the history and physical examination is the starting platform. This article describes several tools that can be easily incorporated into the history and physical examination, along with some of the obstacles in evaluating the health of the patient's spirit.  (+info)

Lake Erie College of Osteopathic Medicine's independent study pathway program: an alternative medical school curriculum design. (13/284)

Lake Erie College of Osteopathic Medicine has developed an independent study pathway as an alternative to the traditional medical school curriculum design. Beginning with the 2001-2002 academic year, three equivalent and distinct curriculum pathways will be available to medical students at the Lake Erie College of Osteopathic Medicine: the lecture/discussion pathway, the problem-based learning pathway, and the independent study pathway (ISP). The ISP program will provide flexibility for students during their preclinical years. Using highly structured faculty-developed modules, students in the ISP program will be responsible for their own learning in a self-directed, independent manner, including when, where, what, and how to study. Examinations will be taken when students consider themselves ready. If examinations reveal deficiencies in student preparation, these deficiencies must be remedied before students continue their studies. Faculty will be available, as needed, to assist the students through difficult concepts and material.  (+info)

Managed care education in osteopathic medical schools: development of a fourth-year predoctoral healthcare management clerkship. (14/284)

This article describes the current managed care curricula in osteopathic medical schools and summarizes the development and implementation of a healthcare management clerkship for fourth-year osteopathic medical students at Ohio University College of Osteopathic Medicine. Results of a survey of the 19 osteopathic medical schools indicated that only three schools currently have a stand-alone, managed care elective. No schools have required managed care courses, clerkships, or rotations. The remaining osteopathic medical schools have incorporated managed care-related topics into courses in their schools' curricula. To produce physicians fully competent to succeed in the 21st century's managed healthcare environment, medical schools need to affiliate with managed care organizations, integrate more managed care components into their curricula, and develop required or elective stand-alone managed care courses and clerkships. This article describes content to be integrated in a predoctoral managed care clerkship, including goals and objectives. It also describes the components and learning activities of Ohio University College of Osteopathic Medicine's Healthcare Management Clerkship.  (+info)

Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia. (15/284)

While osteopathic manipulative treatment (OMT) is thought to be beneficial for patients with pneumonia, there have been few clinical trials--especially in the elderly. The authors' pilot study suggested that duration of intravenous antibiotic use and length of hospital stay were promising measures of outcome. Therefore, a larger randomized controlled study was conducted. Elderly patients hospitalized with acute pneumonia were recruited and randomly placed into two groups: 28 in the treatment group and 30 in the control group. The treatment group received a standardized OMT protocol, while the control group received a light touch protocol. There was no statistical difference between groups for age, sex, or simplified acute physiology scores. The treatment group had a significantly shorter duration of intravenous antibiotic treatment and a shorter hospital stay.  (+info)

Collaboration between pharmacy and osteopathic medicine to teach via the Internet. (16/284)

This article describes the results of a survey from graduate pharmacy students who completed a neurology/psychiatry course taught by a pharmacist and an osteopathic physician via the Internet. Seventeen practicing pharmacists completed the 11-week course, and thirteen students completed the survey provided at the end of the course. Results indicated that students were pleased with the course. Mean evaluation scores ranged from 4.31 to 4.77 on a five-point scale. Additionally, students indicated that the collaboration of medicine and pharmacy provided an educational model that should be duplicated for future courses.  (+info)