Comparing In-person vs. Live-streamed Osteopathic Manual Medicine Lab Instruction

Practicing osteopathic manual medicine (OMM) requires medical students to learn a unique psychomotor skill. OMM techniques are taught during hands-on laboratory sessions in osteopathic medical schools across the country. Determining the optimal delivery of OMM training in the first and second years of medical school is instrumental in maximizing student engagement and confidence for future use in practice. In the academic year of 2020–2021, public health guidelines for COVID-19 forced Des Moines University College of Osteopathic Medicine to restructure their OMM laboratory sessions to include in-person and live-stream demonstrations of somatic dysfunction diagnoses and treatments. To determine if there was a difference in students’ perception of the learning experience and exam performance between in-person and live-streamed osteopathic manual medicine (OMM) laboratory instruction. An online 8-question survey was sent to 225 first year medical students from Des Moines University at the end of their first year. The survey contained a combination of Likert scale, dichotomous, and open-ended questions. Statistical analysis for the Likert scale questions included paired-t test given the nature of correlated responses by the same cohort of students. A non-parametric permutation test was used to compare Fall 2020 practical exam grades due to the heavy skewness and ties of the exam score distributions. All computations were also made using the statistical computing software R. Free text was qualitatively analyzed for recurrent themes. The survey response rate was 67.1% with 151 respondents. When students were asked to rate their learning experience (engagement, comfort asking questions, understanding of material, ability to retain and recall lab material) between in-person vs. live-stream delivery of OMM lab material on a 5-point Likert Scale, there was a statistically significant mean difference for all of the responses, indicating a preference for in-person delivery method. Comparisons of the mean practical exam scores revealed no statistically significant differences. When asked to choose between in-person vs. live-stream, 83% of students reported a preference for in-person OMM laboratory demonstrations. The students’ perceptions suggest that in-person delivery of OMM was superior to live-stream instruction based on higher rankings of engagement, comfort in asking questions, understanding material to practice, and recall of material in preparation of practical exams.