Table 1. Rotated Factor Loadings(a), Corrected Item-Total Score Correlations(b), and Effect Sizes of Item Discrimination Indices(c) for the Attitudes Toward Osteopathic Medicine Scale (ATOMS) in a National Sample of First Year Matriculants of 33 U.S. Colleges of Osteopathic Medicine
Item Factor1 Factor2 Factor3 Corrected item-total score correlation Item discrimination index effect size
Physicians who strive to understand themselves provide better care than those who do not. (10) 0.75 0.00 -0.02 0.51 1.40
Physicians who model a balanced lifestyle (i.e., Attending to their own health, social, family and spiritual needs, as well as interests beyond medicine) generate improved patient satisfaction. (4) 0.68 -0.02 0.04 0.49 1.25
A strong relationship between patient and physician is an extremely valuable therapeutic intervention that leads to improved outcomes. (6) 0.65 0.08 0.02 0.54 1.44
Psychosocial factors are as important as biomedical factor in health and illness. (11) 0.54 0.09 0.04 0.47 1.25
Instilling hope in patients is a physician’s duty. (7) 0.42 -0.11 0.13 0.31 1.02
Medical problems need specific medical and surgical interventions, thus, holistic approaches to medical problems cannot be as beneficial as targeted biomedical treatment. (12) 0.05 0.67 -0.05 0.48 1.56
Touch and tactile approaches may not serve a significant purpose in patient care. (13) 0.08 0.62 0.03 0.54 1.55
Osteopathic Manipulation often makes patients “feel” better temporarily but does not lead to objective improvement in long-term outcomes for patients. (5) -0.12 0.52 0.32 0.54 1.67
Information about the relative effectiveness of treatments that is obtained by research methods other than randomized controlled trials has little value to physicians. (9) -0.02 0.48 -0.03 0.32 1.15
Therapeutic touch has been completely discredited as a healing modality. (3) -0.01 0.46 -0.05 0.29 1.09
Osteopathic manipulative therapy is a valuable method for resolving a wide variety of musculoskeletal problems (beyond back pain). (8) 0.07 0.06 0.71 0.61 1.72
The osteopathic philosophy of holistic care greatly influenced my decision to attend an osteopathic school. (1) 0.05 0.00 0.66 0.51 1.42
Patients whose physicians are knowledgeable of multiple medical systems and complementary and alternative practices, in addition to conventional medicine, do better than those whose physicians are only familiar with conventional medicine. (2) 0.18 -0.06 0.54 0.49 1.45
Eigenvalue 4.41 1.59 1.04    

(a) Based on the content of items with high factor loadings, Factor 1: was entitled “Perspectives on Osteopathic Medicine”, Factor 2: “Osteopathic Diagnosis and Treatment”, and Factor 3: “Holistic-Integrative Care”.   Items are sorted by descending order of factor loadings within each factor. Number in parentheses refer to the appearance of the items in the ATOMS.

(b) Correlations between scores on each item and the ATOMS total score by excluding the corresponding item from the total score, all were statistically significant (p< 0.01).

(c) Effect size estimate (Cohen’s d statistic) of the discrimination index was calculated by subtracting the item mean score of the ATOMS high scorers (top 33%) from the item mean score of the ATOMS low scorers (bottom 33%), divided by the pooled standard deviation of the corresponding item.

 Int J Med Educ. 2021; 12:222-232; doi: 10.5116/ijme.615c.2cfa