Defining Wellness as a Balance

For nearly 125 years, A.T. Still University’s Kirksville College of Osteopathic Medicine (ATSU-KCOM) has educated students to become highly competent osteopathic physicians and health care leaders. The College has successfully blended time-tested knowledge and methods with cutting-edge technology and modern practices. Today, ATSU-KCOM’s outstanding curricula ensure students receive the best learning experiences possible.

Last year, ATSU-KCOM’s Doctor of Osteopathic Medicine (DO) program fully transitioned to a systems-based curriculum using a patient-case presentation model. In this model, all student learning is clinically contextualized. For instance, the physiology of the gastrointestinal system is taught alongside the principles of medicine and the exam and diagnosis of gastrointestinal issues. This model has proven effective as ATSU-KCOM students’ board scores are above the national average.

ATSU-KCOM has created a phenomenal human patient simulation (HPS) lab that serves as a training site for medical and dental students, residents, and community members. The lab grew significantly within the past year and now includes 12 Laerdal third generation, high fidelity simulators; one Gaumard birthing simulator; and two colonoscopy trainers. The simulators are programmed to parallel the curriculum, and students and residents put their knowledge into practice as they improve their assessment, communication, and interprofessional skills to diagnose and treat patients.

First- and second-year DO students and dental students from ATSU’s Missouri School of Dentistry & Oral Health attend mandatory HPS sessions throughout the year, and DO students have the option of additional training sessions. The HPS lab is unique because it is the first to offer dental students the opportunity to practice emergency medical scenarios that are not typically taught in a dental curriculum.

Taking HPS to an even higher level, the College recently introduced hybrid simulations to students using a combination of simulated patients and standardized patients. In these situations, a student must glean a simulated patient’s health information from a real person acting as a family member or friend – increasing the realism by adding an interpersonal aspect to the situation.

Additionally, the HPS lab serves as an American Heart Association Training Center. Basic Life Support, Advanced Cardiac Life Support, and Heartsaver courses for providers and instructors are offered to individuals on campus and throughout the community. Within the last year, 437 individuals from ATSU’s Missouri campus and more than 2,800 community members received certifications.

ATSU-KCOM students work in teams in the HPS lab.

The ultrasound portion of the ATSU-KCOM curriculum has also grown significantly within the last few years. Ultrasound education, which is completely integrated into the first two years of the DO program, helps students bridge the gap between form and function, didactics and clinical practice. The College began with 10 ultrasound machines, and based on student feedback and interest, the number grew to 25 machines. Now students have ample time for hands-on training with three to four students per machine.

Ultrasound labs for first-year DO students are aligned with the gross anatomy labs and allow students to visualize living anatomy through the correlation with cadaveric dissection. Beginning with the second semester, labs are correlated with the system blocks. Recently a new workshop combining electrocardiography and echocardiography was integrated into the cardiology block of the second semester.

During the second year, students are exposed to clinical applications of ultrasound and its use to diagnose pathological conditions, such as pneumothorax and the presence of pathological fluids in the lung, heart, and abdomen as part of the focused assessment with sonography for trauma (FAST) exam. Second-year students receive additional clinical training by using ultrasound training models, which simulate effusions with different amounts and locations of fluids. They learn to perform central line placement under ultrasound guidance using the central line training model and to safely perform lumbar/epidural injections using the lumbar training model. Simulation training phantoms are also used in conjunction with ultrasound. For example, breast ultrasound phantoms help students learn to perform ultrasound breast examinations and find pathological lesions in the breast in the office. With the curriculum’s emphasis on rural and underserved areas, these training opportunities become even more essential to a student’s future success in the field.

While ATSU-KCOM focuses primarily on education, the College’s research mission is strong considering a small faculty. In 2010–14, clinical researchers published 37 papers, while basic science researchers published 97 papers. Overall, these biomedical research publications averaged 27 per year (2010–14) and primarily focused on bench, patient care, or medical education research. Some of these papers were published in prestigious journals such as Proceedings of the National Academy of Sciences (USA) and PLoS One. Research presentations at national conferences averaged 49 per year (2010–14), and the top six research topics included medical education, cancer biology, osteopathic manipulative medicine, cardiovascular disease, bone and joint disease, and muscle biology. Researchers have benefitted from the College and University’s strong research support. Recent purchases of sophisticated research equipment included a confocal microscope, fluorescence-activated cell sorter, and DNA sequencer.

Coinciding with ATSU-KCOM’s research projects is the College’s ongoing grant activity. The Curriculum and Faculty Development in Evidence-based Medicine (R25) Project,^* funded by the National Institutes of Health, National Center for Complementary and Alternative Medicine, focused on enhancing evidence-based medicine (EBM) coverage in clinical training and affiliated residency programs, while working to more deeply entrench preclinical, campus-based advancements in EBM into the curriculum. Specifically, the project aimed to strengthen faculty knowledge and skills in EBM by expanding training to complementary and alternative medicine (CAM) clinical faculty; increase trainees’ exposure to, understanding, and appreciation of EBM and scientific thinking, especially in clinical settings; and expand opportunities for CAM trainees to seek advanced, hands-on mentored training in applying EBM skills in the clinical environment.

In July, ATSU-KCOM was awarded a $1.2 million, five-year grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration. Grant funding will enhance the College’s primary care education and better prepare medical students to reduce health disparities and barriers to care for vulnerable populations, improve patient engagement, and become leaders in the Primary Care Workforce Competencies endorsed by the Patient-Centered Primary Care Collaborative. Developing leaders for communities to address issues such as chronic disease management, health disparities, and patient engagement will improve health for all.

ATSU-KCOM also received a $21,000 grant from the American Academy of Family Physicians Foundation to fund equipment and supplies for Still Caring Health Connection (SCHC), a free health and dental patient experience that provides high quality, patient-centered education for underserved populations in northeast Missouri. SCHC is affiliated with Volunteers in Medicine, an organization that promotes development of free healthcare services to improve access to care for underserved, especially uninsured, populations. Through grant funding, SCHC’s student, resident, dental, and medical volunteers will be able to better promote health to patients.

The updates to ATSU-KCOM’s curriculum mentioned within this report are just some the main highlights of the College’s continual efforts to do what it does best – educate students. However, the College also focuses on students’ wellbeing, inside and outside the classroom. Through the Still-Well Student Wellness Program, students learn the value of balancing rigorous academics with other parts of life. ATSU defines wellness as a balance of intellectual, physical, spiritual, emotional, social, environmental, and professional development. This has become increasingly important as demands on aspiring health care providers are at an all-time high.

Without resting on its laurels, ATSU-KCOM is doing everything possible to ensure its students are thriving professionally and personally. Going forward, the College will remain committed to providing a quality osteopathic medical education in a research environment that prepares students for graduate medical training and clinical service. Ultimately, by providing students with the resources and skills to succeed, the College continues to produce graduates who will improve the state of health care in communities locally and around the world.

Biography

Margaret Wilson, DO, ’82, MSMA member since 2012, is the dean and a professor at ATSU-KCOM.

Contact: mwilson@atsu.edu