Volume 13, Issue 2 , Page 41, June 2010
On the biopsychosocial model, mindfulness meditation and improving teaching and learning in osteopathy technique
Article Outline
Although musculoskeletal dysfunction, and specifically ‘somatic dysfunction’ is the central focus for much of what osteopaths do, it is not typically a complaint of ‘dysfunction’ that leads a person to present to an osteopath. Although people do present to osteopaths with a wide range of symptoms (“funny heads” being an example in a recent case report in the journal),1 the most common presenting complaint is of discomfort or pain. Indeed, as Penney reminds us in the Masterclass published in this issue (p. 42), pain is the most common reason for self medication, for entry in the healthcare system, and for presentation to osteopaths.
Penney provides a succinct review of the biopsychosocial model and presents an argument that the biopsychosocial model is consistent with osteopathic principles. Although the biopsychosocial model has now been described in print for more than 30 years, there appears to be only sparse acknowledgement of the model within osteopathy literature. This is quite surprising given the obvious elegance of the model’s inclusion of the various domains used to describe health. In my view, the widespread recognition and wholesale adoption of the biopsychosocial model of healthcare by osteopaths is long overdue. Adopting this model would provide a common basis for inter-professional communication and assist greatly in informing the potential role of osteopathy in public and private healthcare. Penney concludes with some interesting commentary regarding the potential of the biopsychosocial model to provide a substantial evidence base from which to practice and points out that it may also enable, with appropriate training, an expansion of the therapeutic tools that we have available. In a climate of “permeable professional boundaries”2 and several disciplines competing for private musculoskeletal conditions, it may well be time that the osteopathic profession strategically considers how it positions itself in the healthcare marketplace. The biopsychosocial model may even provide a more sophisticated and contemporary basis for practice than is currently offered through reference to the classical osteopathic principles. Penney’s contribution is timely given the increasing visibility of inter-disciplinary practice in many publicly funded health services. The use of explanatory models and terminology that is common to all healthcare professions can only lead to better inter-professional communication and hopefully impact favourably on patient care. There are many issues to be teased out here, but I’m hopeful that other authors will engage in scholarship regarding the potential usefulness of the biopsychosocial model to contemporary practice of osteopathy. Penney points out that a greater understanding of pain within a biopsychosocial model may allow a widening of the scope of osteopathic consultation and, somewhat contentiously, he suggests that this may also lead naturally to consideration of therapeutic options being employed beyond the familiar ‘hands on’ techniques that appear to characterize osteopathic treatment. One such option is ‘mindfulness meditation’ and in this issue Mars and Abbey contribute a systematic review of mindfulness meditation as a healthcare intervention (p. 56). The methods section of systematic reviews can be heavy reading for those without much interest or background in research methodology, however, the Introduction and Discussion sections will be of interest to all readers. In their discussion, Mars and Abbey draw an interesting comparison between mindfulness as a health intervention and the principles of osteopathy.
We’re pleased to be publishing a Case Report in this issue (see p. 67). We don’t receive many submissions in this category but we are always very keen to publish Case Reports that have educational value. Chakraverty et al. reports a case of delayed recognition of an odontoid peg fracture in an elderly woman which makes for interesting reading. The CPD section also includes an activity in relation to this case.
Finally, in this issue Browning provides a commentary (see p. 70) about teaching and learning manual osteopathic technique – a topic that is central to the curriculum at all osteopathy teaching programmes. Despite its importance, the use of current teaching and learning theory in educating practical skills in osteopaths have received little attention in the osteopathy literature. Browning reviews the key principles in the development of manual skills and the article will be of particular interest for anyone involved in teaching practical osteopathic skills at any level. As Lucas pointed out in a previous editorial,3 the web brings incredible opportunities for interaction, and the impact of the internet in developing new modes of teaching and learning is rapidly emerging as innovative uses are found for new web 2.0 tools. I wonder how long it’ll be before an osteopathy student presents in technique class with a video camera in hand and instantly posts a clip of their own technique performance to the web for critical feedback from their local and international peers?
References
- . Osteopathic support for a survivor of gastric cancer: a case report. Int J Osteopath Med. 2008;11:106–111
- . The politics of interprofessional working and the struggle for professional autonomy in nursing. Soc Sci Med. 2009;68:1221–1228
- . Osteopathy 2.0: osteopath and the new web. Int J Osteopath Med. 2010;13:1–2
PII: S1746-0689(10)00048-9
doi:10.1016/j.ijosm.2010.04.006
© 2010 Published by Elsevier Inc.
Volume 13, Issue 2 , Page 41, June 2010
