OMM Case Considerations Toolbox
AOA Core Competency #1 OSTEOPATHIC PHILOSOPHY AND OSTEOPATHIC MANIPULATIVE MEDICINE
Global Communication/Professionalism Rating by Simulated Patient
AOA – Core Competency #1 OSTEOPATHIC PHILOSOPHY AND OSTEOPATHIC MANIPULATIVE MEDICINE
COMPETENCY #1:
OSTEOPATHIC PHILOSOPHY AND OSTEOPATHIC MANIPULATIVE MEDICINE
DEFINITION:
Residents are expected to demonstrate and apply knowledge of accepted standards in Osteopathic Manipulative Treatment (OMT) appropriate to their specialty. The educational goal is to train a skilled and competent osteopathic practitioner who remains dedicated to life -long learning and to practice habits in osteopathic philosophy and manipulative medicine.
REQUIRED ELEMENTS:
1. Demonstrate competency in the understanding and application of OMT appropriate to the medical specialty.
Suggested Methodology to Achieve Compliance
2. Integrate Osteopathic Concepts and OMT into the medical care provided to patients as appropriate.
Suggested Methodology to Achieve Compliance
3. Understand and integrate Osteopathic Principles and Philosophy into all clinical and patient care activities.
0Suggested Methodology to Achieve Compliance
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Relevant Concerns with Fluid Congestion (venous & lymphatic, in particular): |
Delineate the drainage pathway for the area, viscus, joint, or other component relevant to the case. Follow this to its terminal drainage. |
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Describe and portray the ‘choke points’ that may impede drainage along this path. |
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Suggest possible Osteopathic manipulative interventions that may assist in drainage of the fluid congestion associated with this case. |
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Relevant Sympathetic Nervous System Concerns: |
Delineate the sympathetic innervations for the area, viscus, joint, or other component relevant to the case. Follow its course to the spinal cord. |
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Describe and portray the fascial ‘choke points’ that may increase tension on this nervous pathway to the spinal cord. |
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Suggest possible Osteopathic manipulative interventions that may assist in normalization of the sympathetic influences associated with this case. |
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Relevant Parasympathetic Nervous System Concerns: |
Delineate the parasympathetic innervation for the area, viscus, joint, or other component relevant to the case. Follow its course to the spinal cord. |
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Describe and portray the fascial ‘choke points’ that may increase tension on this nervous pathway to the spinal cord. |
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Suggest possible Osteopathic manipulative interventions that may assist in normalization of parasympathetic influences associated with this case. |
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Relevant Pain Concerns: |
Delineate the pathway for afferent pain fibers for the area, viscus, joint, or other component relevant to the case. Follow its course to the spinal cord. |
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Describe and portray the fascial ‘choke points’ that may increase tension of this nervous pathway to the spinal cord. |
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Suggest possible Osteopathic manipulative interventions that may assist in normalization of nociceptive influences associated with this case. |
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Relevant Biomechanical Concerns: |
Delineate the local and regional biomechanical concerns that may impact this case. |
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Delineate the inter-regional biomechanical concerns that may impact this case. |
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Suggest possible Osteopathic manipulative interventions that may assist in normalization of biomechanical influences associated with this case. |
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Relevant Psychosocial concerns: |
Delineate the historical psychosocial concerns that could be relevant to this case. |
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Delineate the psychosocial concerns relevant to palpatory contact with the patient in this case. |
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Suggest possible approaches to Osteopathic manipulative management that may assist in acknowledging and/or addressing the psychosocial concerns related to this case. |
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Deficient (Level #0): Has not learned rules or principles. Lacks any sense of the overall task.
o Unorganized attempt to apply rules or plans
o No situational perception
o No discretionary judgment
Novice (Level #1): Operates by consciously-learnt context-free rules. Lacks any sense of the overall task.
o Rigid adherence to taught rules or plans
o Little situational perception
o No discretionary judgment
Competent (Level #2): Has now learnt to recognize many context-free and situational elements. Still lacks any sense of their overall importance to the task, and rapidly becomes overwhelmed. Tries to overcome this by hierarchical goal-based planning. This hierarchical decomposition of the task means that, at any time, the competent pays attention only to that small number of features relevant to a particular sub-goal, thus avoiding being overwhelmed.
o Coping with crowdedness
o Now sees actions at least partially in terms of longer-term goals
o Conscious deliberate planning
o Standardized and routinized procedures
Proficient (Level #3): Performs his/her task logically, almost all the time. Occasionally has to stop and deliberate, but this involves critical reflection on his/her deductions, rather than goal-based planning.
o Readily incorporates rules, guidelines or maxims
o Logical grasp of situations based on understanding
o Analytic approaches to problem solving
o Vision of what is possible
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1. OMM Relevant Concerns Review the existing case. What 2–3 OMM Relevant Concerns would you like to focus on? Circle 2 or 3
● Fluid Congestion ● Parasympathetic ● Biomechanical ● Sympathetic ● Pain ● Psychosocial
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2. Other Case Information Needed Based on your review of the existing case and the OMM Relevant Concerns you just picked, what other information do you need to add to (or have for) this case? ● History 1. 2. 3.
● Musculoskeletal Findings 1. 2. 3. 4. 5.
● Lab Requests 1. . 2. . 3. .
● Imaging Requests 1. . 2. . 3. .
● Other? 1. . 2. . 3. .
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Remember, do not do all 6 Relevant Concerns. Only do the 2 or 3 that you chose early.
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3. Specific information about the Relevant Concerns Based on the specifics of this case, expand the information you need for each of the Relevant Concerns you picked in #1 above. ● Fluid Congestion ● Parasympathetic (See next page for Biomechanical and Psychosocial Concerns) ● Sympathetic ● Pain
List one of your Relevant Concerns ________________________________________________________________________________ a. Delineate the _________________ for the area, viscus, joint, or other component relevant to the case. Follow it’s course:
Teaching Points:
b. Describe and portray the fascial ‘choke points’ and what results this may have
Fascial ‘choke points ’_________________________________________________________________________________________
That may result in ____________________________________________________________________________________________
Teaching Points:
c. Suggest possible Osteopathic manipulative interventions: 1. . 2. . 3. .
Teaching Points:
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4. Specific information about the Relevant Concerns Based on the specifics of this case, expand the information you need for each of the Relevant Concerns you picked in #1 above. ● Fluid Congestion ● Parasympathetic (See next page for Biomechanical and Psychosocial Concerns) ● Sympathetic ● Pain
List one of your Relevant Concerns ________________________________________________________________________________ a. Delineate the _________________ for the area, viscus, joint, or other component relevant to the case. Follow it’s course:
Teaching Points:
b. Describe and portray the fascial ‘choke points’ and what results this may have
Fascial ‘choke points ’_________________________________________________________________________________________
That may result in ____________________________________________________________________________________________
Teaching Points:
c. Suggest possible Osteopathic manipulative interventions: 1. . 2. . 3. .
Teaching Points:
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5. Specific information about the Relevant Biomechanical Concerns Based on the specifics of this case, expand the information you need for the Relevant Biomechanical Concerns.
a. Delineate the local and regional biomechanical concerns that may impact this case.
Teaching Points:
b. Delineate the inter-regional biomechanical concerns that may impact this case.
Teaching Points:
c. Suggest possible Osteopathic manipulative intervention that may assist in normalization of biomechanical influences associated with this case. 1. . 2. . 3. .
Teaching Points:
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6. Specific information about the Relevant Psychosocial Concerns Based on the specifics of this case, expand the information you need for the Relevant Psychosocial Concerns.
a. Delineate the historical psychosocial concerns that could be relevant to this case.
Teaching Points:
b. Delineate the psychosocial concerns relevant to palpatory contact with the patient in this case.
Teaching Points:
c. Suggest possible approaches to Osteopathic manipulative management that may assist in acknowledging and/or addressing the psychosocial concerns related to this case. 1. . 2. . 3. .
Teaching Points:
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7. Overall OMM Management Priorities and Focus:
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8. Areas of Emphasis for Student / Intern Table Time:
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9. Areas of Emphasis for Table Time for Residents in this Specialty:
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10. Additional Resources:
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Name _____________________________________________________
Rotation ___________________________________________________
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Date |
Medical Record # |
Encounter |
IP |
OP |
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Description:
Complaint:
Osteopathic Lesion:
Treatment:
Results:
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Description:
Complaint:
Osteopathic Lesion:
Treatment:
Results:
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Description:
Complaint:
Osteopathic Lesion:
Treatment:
Results:
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Description:
Complaint:
Osteopathic Lesion:
Treatment:
Results:
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