Technical Standards for Admission and Retention

Technical Standards

Lincoln Memorial University-DeBusk College of Osteopathic Medicine

Technical standards are the non-academic skills and abilities necessary for the successful completion of the course of study in osteopathic medicine. The Educational Council on Osteopathic Principles has recommended the following non-academic criteria for admission and continued program participation for osteopathic medical students in programs leading to the doctor of osteopathic medical (DO) degree.

Introduction:

Lincoln Memorial University-DeBusk College of Osteopathic Medicine (LMU-DCOM) is committed to the admission and matriculation of all qualified students and does not discriminate on the basis of race, color, national origin, religion, gender, sexual orientation, or disability. Regarding disabled (or physically challenged) individuals, the College will not discriminate against such individuals who are otherwise qualified, but the College will expect that minimal technical standards be met by all applicants and students as set forth herein. These standards reflect what has been determined to be reasonable expectations of osteopathic medical students and physicians in performing common and important functions, keeping in mind the safety and welfare of the patients for whom our graduates will care.

Technical Standards:

An osteopathic physician must have the knowledge and skills to function in a broad variety of clinical situations and to render a wide spectrum of patient care. In order to perform the activities described below, candidates for the D.O. degree must be able to quickly, accurately, and consistently learn, integrate, analyze, and synthesize data. To facilitate the attainment of optimum care and safety, students at LMU-DCOM must:

1. Behave in a manner exhibiting high moral and behavioral standards reflecting the position and status of an osteopathic physician.
2. Demonstrate respect for individuals and groups with consideration to the diversity of age, gender, nationality, race, religion, sexual orientation, or disability.
3. Students of osteopathic medicine must meet minimal technical and ability standards. The practice of medicine in general and osteopathic medicine in particular, requires the ability to learn, process, and utilize a great deal of knowledge and experience. Students must have the ability to see, hear, and touch independently to optimally assess the physical, mental, and emotional status of patients. Where a deficiency occurs, it must be compensated with the aid of prosthetics to the extent that the student's functioning is equal to that of a non-impaired student. Reasonable adaptations are those that will enable the osteopathic student to function independently and when necessary in a team-like fashion with other health professionals in an unimpaired manner.

LMU-DCOM expects its applicants and students to meet certain minimum technical standards as outlined below. Every applicant and student of LMU-DCOM is expected to possess those intellectual, ethical, physical, and emotional capabilities required to undertake the full curriculum and to achieve the levels of competence required by the faculty. The holder of a doctor of osteopathic medicine degree must have the knowledge and skills to function in a broad variety of clinical situations and to render a wide spectrum of patient care. LMU-DCOM has adopted these standards with due consideration for the safety and well-being of the patients for whom its graduates will eventually care. The specific technical standards recommended by LMU-DCOM are set forth below.

Observation & Visual Integration

Applicants and students must have sufficient visual capabilities to observe demonstrations, experiments, and laboratory exercises in the basic and clinical sciences, as well as proper evaluation and treatment integration in order to assess asymmetry, range of motion, and tissue color and texture changes.

They must be able to observe a patient accurately at varying distances and with the ability to discern non-verbal communication.

Applicants and students must have the ability to determine size and depth of an object in low light at 0.3cm.

Communication

Applicants and students should be able to speak, hear, and observe patients in order to elicit information, examine patients, describe changes in mood, activity and posture, and perceive nonverbal communication. They must be able to communicate effectively and sensitively with patients in English.

Communication includes not only speech but also reading and writing. Applicants and students must be able to communicate effectively and efficiently in oral and written form with all members of the health care team in English.

Motor Function

Applicants and students should have sufficient motor function to execute movements reasonably required to provide general care and emergency treatment to patients. Examples of movements reasonably required of physicians include, but are not limited to, cardiopulmonary resuscitation (CPR), administration of intravenous medication, the application of pressure to stop bleeding, the opening of obstructed airways, the suturing of simple wounds, the performance of obstetrical maneuvers, and osteopathic manipulative medicine. Such actions require coordination of both gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision.

Sensory Skills

Applicants and students of osteopathic medicine must possess an enhanced ability to use their sensory skills. Individuals with disabilities who have significant tactile sensory or proprioceptive disabilities may require a thorough evaluation to determine if they are otherwise qualified, with or without reasonable accommodation. Such individuals may include those with significant previous burns, sensory motor deficits, cicatrix formation, and malformations of the upper extremities.

Strength and Mobility

Medical treatments, such as osteopathic manipulative medicine and cardiopulmonary resuscitation, often require upright posture with sufficient upper & lower extremity and overall body strength and mobility. Individuals with disabilities who have significant limitations in these areas may require evaluation to determine if they are otherwise qualified, with or without reasonable accommodation.

Intellectual, Conceptual, Integrative and Quantitative Abilities

Applicants and students must be able to concentrate, analyze and interpret data, and make decisions within areas in which there is a reasonable amount of visual and auditory distraction. They must perform these functions under a time limitation and do so under a reasonable amount of stress, as physicians are expected to be able to perform such duties in diverse clinical settings where others may be present and where there is a certain degree of noise. Applicants and students must be able to accurately write prescriptions, accurately perform basic mathematical functions, and accurately and quickly read charts with minimal error in areas where there may be distractions. They also must demonstrate ability to comprehend three-dimensional relationships, and to understand spatial relationships of structures.

Behavioral and Social Attributes

Applicants and students must possess the emotional health required for full utilization of their intellectual abilities, exercise good judgment, and promptly complete all responsibilities attendant to the diagnosis and care of patients and the development of mature, sensitive and effective professional relationships with patients. Applicants and students must be able to tolerate physically taxing workloads and adapt to changing environments, display flexibility and learn to function in the face of uncertainties inherent in the clinical problems of many patients. Compassion, integrity, concern for others, interpersonal skills, interest and motivation are all personal qualities that will be assessed during the missions and educational processes.

Participation in Osteopathic Principles and Practice (OPP) Laboratory and Essentials of Patient Care (EPC) Encounters

Active participation in Osteopathic Manipulative Medicine Laboratories and Clinical Care Encounters is an admission, matriculation, and graduation requirement. During Osteopathic Manipulative Medicine laboratory and clinical care encounters, it is imperative to the educational process that the body region being examined and/or treated will need to be exposed for observation, palpation and treatment. The examination and treatment must be conducted in a respectful and professional manner.

The development of palpatory skills used for diagnosis and treatment is significant and required in osteopathic medical schools. Stedman's Medical Dictionary defines "palpation" as examination with the hands and fingers, touching, feeling or perceiving by the sense of touch. Palpation in the osteopathic educational context is the use of touch to examine the body. Palpatory skills are used in all areas of osteopathic medical practice and are especially important in the evaluation and treatment of the musculoskeletal system.

The development of palpatory skills and ability to perform osteopathic treatments are initiated in the first- and second-year labs. This learning requires active participation in all laboratory sessions where students palpate and will experience palpation by their peers and instructors of both genders to enhance the development of their own palpatory skills. Each student will palpate a variety of people with different body types to simulate the diversity of patients expected in a practice setting. Fingernails must be trimmed so as not to impair palpation or cause discomfort to the person being palpated.

The osteopathic medical profession uses a variety of treatment models through which the student will learn the art, science and skills of osteopathic manipulative treatment. Psychomotor skills are developed by repetition and reinforcement. Reading and observation, while helpful in understanding the didactic concepts, do not develop the skills required to perform palpatory diagnosis and manipulative treatment. Each student is required to actively participate in all skill development sessions.

Dress Code in Osteopathic Principles and Practice Laboratories

The dress requirement in clinical skills training sessions is designed to promote learning by providing optimal access to diagnostic observation and palpatory experience. Wearing inappropriate clothing interferes with a partner's experience of diagnosis and treatment.

Appropriate attire must be clean and includes:

• Shorts which are several inches above the knee - (no jean shorts, cut-offs, cargo, thick-seamed shorts, spandex, short shorts or knee length shorts)
• T-shirts - If not wearing the OPP-approved t-shirt with a slit up the back, both genders will be asked to remove t-shirts while acting as patients.
• Bras or bathing suit tops for women with thin straps - these should expose the spine and ribs (not wide t-back styles).
• Students may wear scrubs (or other apparel approved by the course director) over the laboratory attire when not in the role of the patient.
• When in the role of the patient, each student is expected to remove her/his shoes (no shoes are permitted on the tables).
• Hats or head coverings (other than for religious purposes) are not permitted in lab.
• Religious head coverings must be modified when necessary to allow palpation when they would obscure the immediate area to be examined or treated (e.g., head, neck, upper back). Modifications can include: adjustment of the covering permitting unobstructed palpation beneath the covering; or substitution of a thinner material that allows for adequate evaluation and treatment.
• Each student must be appropriately attired before class begins. Failure to be appropriately attired for class impedes the educational process and will not be tolerated.

Any student with a pre-existing health problem that may preclude examination and/or treatment in a clinical skills laboratory is required to submit a written request for limitation and/or exclusion to the department chair (or designee) and present appropriate medical documentation. A physician member of the department will review this information on a case-by-case basis, and may require additional diagnostic measures. The department member reviewing the case will determine any limitation or exclusion from participation, and the student will be notified in writing of the decision.