Research at A.T. Still University’s Kirksville College of Osteopathic Medicine

Background and Overview

The Kirksville College of Osteopathic Medicine (KCOM) was established in 1892 by Dr. Andrew Taylor Still, MD, DO, in the rural Missouri town of Kirksville. As the first of six health professions schools within A.T. Still University (ATSU), KCOM is currently celebrating its 125th year of excellence in osteopathic education, patient care, and research; and it is proud to be the founding college of the osteopathic medical profession. To date, KCOM has graduated an estimated 17,634 osteopathic physicians, approximately 6,487 of whom are currently in practice across all 50 states and in several foreign countries. At present, KCOM has 701 students enrolled in its four-year osteopathic medical education program.

Nationwide, approximately 20% of all students who attend medical schools enroll in Doctor of Osteopathic Medicine (DO) programs. According to the American Association of Colleges of Osteopathic Medicine, 33 colleges of osteopathic medicine are accredited in 48 teaching locales across 31 states. Six schools are state sponsored, 27 are private—including KCOM, and more than 27,000 students are enrolled in total.¹

In 2016, the American Osteopathic Association reported that osteopathic medicine was one of the fastest growing healthcare professions in the nation with 102,137 DOs in the United States (US) and 129,649 total DOs and osteopathic medical students in training.²

To this day, KCOM strives to educate osteopathic physicians who focus on evidence-based, whole-person patient care.

KCOM students spend their first two years studying integrated basic and clinical sciences in a rural campus setting. In the third and fourth years, students are educated through clinical rotations in one of KCOM’s national rotation regions, which include sites in Arizona, Illinois, Iowa, Michigan, Missouri, New Jersey, Ohio, Pennsylvania, and Utah. KCOM graduates are selected to many prestigious residency programs across the nation, including Yale, Johns Hopkins University, the Mayo Clinic, and the Cleveland Clinic Foundation. With an emphasis in primary care and rural health, KCOM graduates enter primary care as well as a variety of specialties such as anesthesiology, dermatology, emergency medicine, diagnostic radiology, and surgery.

KCOM faculty members have developed a stellar anatomical and clinical ultrasound curriculum. Students learn living human anatomy with the use of bedside ultrasound technology that will ultimately enhance their ability to diagnose at the point of care.

Research Perspectives - Past, Present and Future

Both KCOM and ATSU recognize the importance of research and scholarly activity in their strategic plans, and these current plans align because both specify a strategic goal to expand student and faculty scholarship. At ATSU and KCOM, scholarship is defined as being engaged in discipline-based research, clinical studies of illness and treatment, current and future trends in healthcare, and/or the scholarship of teaching and learning. In essence, it is the plan and the practice of KCOM faculty and students to vigorously engage in research and scholarly activity.

KCOM’s clinical and basic science faculty have a long and rich history of engaging in scientific research, including a notable era in the late 1940s and 1950s with the pioneering work of John Stedman Denslow, DO, class of 1929, who studied the osteopathic lesion using electromyographical methods,³ and Irvin M. Korr, PhD, who collaborated with Dr. Denslow and pursued his own line of research into the role of the peripheral nervous system in health and disease.⁴

In the 1970s, Richard J. Cenedella, PhD, former chair and now emeritus professor, KCOM’s Department of Biochemistry, began investigating molecular mechanisms of cataract formation, among other research topics. Throughout his distinguished teaching and research career, he received 35 years of National Institutes of Health (NIH) grant support, published more than 100 research papers, and was the first person at KCOM to be named a Fulbright Scholar (in 2008). Dr. Cenedella has inspired an entire generation of KCOM students and faculty.⁵

In more recent years, KCOM has had active research programs in cancer biology, osteopathic manipulative medicine, medical education, cardiovascular disease, muscle biology, bone and joint disease, neuroscience, and infectious disease.

Given that the specialty of osteopathic manipulative medicine (OMM) originated at KCOM, the A.T. Still Research Institute (ATSRI) was created by ATSU in 2001 to advance and coordinate research into the evidence base of OMM. In 2010, DO-Touch.NET—which focuses on OMM research—was created as the ATSRI’s inaugural practice-based research network. This growing OMM research network is comprised of more than 200 members from 30 states and 11 countries.⁶ The ATSRI and DO-Touch.NET are headed by one of ATSU’s leading OMM researchers, Brian F. Degenhardt, DO, associate professor and director, ATSRI. Dr. Degenhardt and team work alongside Karen T. Snider, DO, professor, Department of Osteopathic Manipulative Medicine, and assistant dean, Osteopathic Principles and Practices Integration, and many of the OMM faculty to pursue osteopathic research.

The ATSRI, along with ATSU and Sigma Xi, hosts an annual Interdisciplinary Biomedical Research Symposium each fall on ATSU’s Missouri campus to promote knowledge and collaboration in biomedical research. This event provides faculty, students, residents, and external researchers the opportunity to hear a keynote presentation with a research focus and to present their own biomedical research studies as oral or poster presentations. More information about this symposium, the ATSRI, and DO-Touch.NET is available at atsu.edu/research.

In 2006, KCOM was the first osteopathic medical school to win a multiyear NIH R25 research education grant from the National Center for Complementary and Integrative Health (formerly the National Center for Complementary and Alternative Medicine). From 2011–2015, KCOM’s R25 grant award focused on the enhancement of evidence-based medicine (EBM) coverage in the college’s clinical training and affiliated residency programs and worked to more deeply entrench preclinical, campus-based advancements in EBM. All of this was accomplished with KCOM’s R25 research-intensive partnering institution, Penn State College of Medicine, located in Hershey, Pennsylvania.

During the past three decades, KCOM has received more than $28 million in federal funding from the Health Resources and Services Administration (HRSA), a division of the US Department of Health and Human Services. The majority of these grant awards supported the infusion of scholarly teaching and learning initiatives at KCOM. Currently, KCOM holds a HRSA Primary Care Training and Enhancement (PCTE) award that focuses on preparing students to reduce health disparities and barriers to care for vulnerable populations, improve patient engagement, and become leaders in the nation’s primary care workforce. In addition, KCOM was recently awarded a PCTE supplement grant to expand medication-assisted treatment training in response to the nation’s current opioid crisis.

In terms of NIH research funding, KCOM has received $11.9 million in recent decades, including more than $4 million for Dr. Cenedella’s research and more than $1.5 million for the R25 research education grant mentioned above.

Today, our broad view of a “research laboratory” at KCOM includes traditional basic science and biomedical laboratories, osteopathic manipulation teaching laboratories, clinical patient examination rooms, human simulation laboratories, electronic and virtual learning environments, and so on. At KCOM, the medical school classroom itself is also considered an important teaching and learning laboratory.

As highlighted in this edition of Missouri Medicine, KCOM investigators are currently engaged in various studies focused on the scholarship of teaching and learning, including maintaining balance through medical humanities electives, integrating ultrasonography into the curriculum, infusing 3-dimensional and 4-dimenstional ultrasound technology into didactics, and assessing human patient simulation as a teaching tool. Each of these medical education studies adds depth to the overall body of knowledge of each topic plus serves to inform and enhance KCOM’s academic program offerings.

In 2001, KCOM added a master of science (MS) degree in biomedical sciences, which is a thesis-based research degree that provides an opportunity for students aspiring to health science careers. Graduate student research projects typically involve the fields of anatomy, biochemistry, cell biology, histology, immunology, microbiology, molecular biology, neuroscience, pharmacology, or physiology. Successful MS graduates often earn subsequent admission into ATSU’s osteopathic medical, dental, or other health professions programs, creating a more research-proficient applicant pool for KCOM and all ATSU schools. Other MS graduates elect to pursue active research careers or matriculate into external PhD training programs.⁷ Without question, the MS research degree program amps up the research culture and atmosphere on KCOM’s rural campus.

Moving forward, KCOM’s biggest challenges include the need for more experienced research mentors to support early career faculty and encourage our ever-growing student interest in research and scholarly studies. Also, dedicated time for faculty research and scholarly activity is always a challenge and must constantly be balanced with other faculty responsibilities (ie, teaching, advising, serving on committees, professional practice, and community service outreach).

KCOM faculty and students welcome the opportunity to share the various studies herein, while aspiring to build stronger research collaborations with internal investigators and external partners and mentors—especially those at more research-intensive universities.

Biography

Margaret A. Wilson, DO, MSMA member since 2012, is Dean, Kirksville College of Osteopathic Medicine, and Professor, Department of Family Medicine, Preventive Medicine, and Community Health, A.T. Still University—Kirksville College of Osteopathic Medicine, Kirksville, Missouri.

Contact: mwilson@atsu.edu