Application of Knowledge for Osteopathic Medical Practice

Overview

Osteopathic physicians must demonstrate the understanding and application of established and evolving principles of foundational biomedical and clinical sciences integral to the practice of patient-centered osteopathic medical care. As with the other competency domains, application of knowledge is about ability (i.e., knowledge put into action).

Cognitive and other learning science theorists explain that the acquisition of declarative knowledge in biomedical and clinical sciences, the conscious knowledge that something is the case, progressively transforms into procedural knowledge (knowing how to do something). This gradual transformation leads the osteopathic physician to develop a problem- and task-specific knowledge base that is integrated across individual disciplines. It is this knowledge base that provides a foundation for competent patient-centered osteopathic medical care. An osteopathic physician with a fluent knowledge base in foundational biomedical and clinical sciences, for example, would be able to explain principles of health, disease, and diagnostic and treatment options to patients.

Included in this knowledge base is the articulation of core scientific and clinical practice principles relevant to osteopathic medical practice (e.g., health and the body’s innate capacity to heal, differential diagnoses, disease etiologies, indications and contraindications, assessment of the risks and benefits of diagnostic and therapeutic interventions). Knowledge fluency is fundamental to a generalist osteopathic physician’s competency to practice osteopathic medicine, and it is demonstrated by the ability to efficiently interpret, process, and skillfully apply principles of foundational biomedical and clinical sciences in a timely manner.

Also important to an osteopathic physician’s knowledge competency is the ability to formulate appropriate clinical questions, retrieve evidence to inform patient care, acquire additional and evolving knowledge for lifelong learning, and apply this knowledge for continuous practice improvement. Demonstration of the understanding and application of core knowledge is fundamental to the incorporation of new knowledge. Continuous quality improvement, however, is primarily addressed in the practice-based learning and improvement domain (Domain 4).

As osteopathic medical knowledge provides the foundation for many physician competency domains, considerable overlap exists between this competency domain and the other six. Testing concepts are mapped here when the primary component being assessed is application of knowledge (e.g., the knowledge of the scientific understanding of mechanisms of action; molecular and macro systems including biomolecules, molecules, cells, and organs; origins of disease processes; why certain diagnostic tests and treatments are used). The principles that underlie the human condition, including its biologic complexity, genetic diversity, homeostatic mechanisms, structure-function interrelationships, development, and interactions of systems and environmental influences, guide the osteopathic physician in the understanding of health and the diagnosis and treatment of disease.

While these foundational principles often cross biomedical science and clinical disciplines in the practice of osteopathic medicine, they are mapped here for primary characterization.