How does French initial osteopathic training value relational competency, patient education, and the competency-based approach? A cross-sectional survey

  • Paul Quesnay
    Corresponding author. Laboratoire Educations et Pratiques de Santé UR3412, Université Sorbonne Paris Nord, 74, rue Marcel Cachin, 93017 Bobigny cedex France.
    Laboratoire Educations et Pratiques de Santé UR3412, Université Sorbonne Paris Nord, France

    Laboratoire de Soutien Aux Synergies Education Technologies, Université de Liège, Belgium

    Centre Européen d’Enseignement Supérieur en Ostéopathie Paris, France
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  • Marianne Poumay
    Laboratoire de Soutien Aux Synergies Education Technologies, Université de Liège, Belgium
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  • Rémi Gagnayre
    Laboratoire Educations et Pratiques de Santé UR3412, Université Sorbonne Paris Nord, France
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Published:October 15, 2021DOI:


      • Relational competency remains undervalued in the context of French initial training programs for osteopathy.
      • The standards for osteopathic education and practice need to be clarified before truly integrating patient education into relational competency.
      • Teaching, learning, and assessment methods must evolve to be consistent with a comprehensive competency-based approach.
      • There is a need to train educators in this relational competency and in the competency-based approach.



      Despite the promotion of international osteopathic recommendations and registration guidelines, relational competencies and patient education practices present a challenge in the clinical setting due to lack of training. In France, the latest national osteopathic standards for education and practice defined a relational competency that includes patient education. Little is known about its integration in curricula and how French osteopathic practitioners are subsequently trained for relational competency.


      To determine teaching, learning, and assessment methods related to relational competency in French initial osteopathic training programs and identify the role of patient education in this relational competency.


      An online questionnaire was designed and sent to all initial training institutes in France (n = 28). Eight institutes answered the survey.


      The relational competency appeared in various courses, enhanced by clinical learning. However, the courses were not specific to this competency and the volume of hours was relatively low. Patient education was seen as part of the relational competency but was poorly implemented. This competency-based approach is still considered an emerging practice in these institutes.


      There is a misalignment among intended learning outcomes, teaching, and assessment. The current educational practices are not sufficient to support relational competency, specifically regarding patient education. Further research is needed on how French standards are understood, how they are assimilated by educators, and how they are translated into educational practice. In addition, the adequacy of educators training for effective implementation of the competency-based approach should be questioned.


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