About the Program:
The A.T. Still Research Institute offers a novel, series of courses entitled, “Advancing Skills in
Osteopathy (ASO)” that gives participants the most scientifically advanced training in palpation
worldwide. This program uses 21st Century objective scientific methods for feedback so
participants can refine and standardize their fundamental palpation skills. Leading researchers
and educators within the Still Research Institute and the ATSU-Kirksville College of Osteopathic
Medicine’s Department of Osteopathic Manipulative Medicine will give up-to-date evidence-based
presentations on the neurobiology of palpation and the art of osteopathic practice. The ASO team,
which includes experienced research assistants and coordinators, oversees extensive hands-on
training during this program. A unique feature to this training program is its historical component.
Led by staff from ATSU’s Museum of Osteopathic Medicine(SM), this feature gives participants an
intimate experience of the history of osteopathic medicine upon the grounds of the American
School of Osteopathy, where Andrew Taylor Still began a revolution in medicine that continues
today. By incorporating living history with modern advanced technologies, the ASO program is an
unprecedented and irreproducible program.
The goal of the ASO program is to provide motivated and skilled students with objective feedback,
using state-of-the-art instrumentation, in osteopathic principles and practices
The goal of the ASO program is to provide objective feedback using state-of-the-art
instrumentation to assist motivated and skilled students in osteopathic principles and practices
refine and standardize their skillset and give them a personal, motivational experience of the
osteopathic legacy.
Application Guidelines:
Applications must be submitted by April 15, 2014, to be selected for the 2014 Summer
Advancing Skills in Osteopathy Program (July 7-11, 2014).
The ASO program is geared toward research experiences equivalent to 40 hours.
To be considered for this program, prior research experience is not required. However, applicants
must possess or meet the following criteria to be eligible:
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Undergraduate Fellow within an osteopathic Fellowship program in Osteopathic Manipulative
Medicine or a student motivated to incorporate osteopathic manipulative skills in their
specialty.
Strong interest in a career as a clinician focused on whole-body healthcare and based on
attention to the mind, body and spirit of their future patients.
Strong interest in a career that directly contributes to clinical research or educational activities.
Excellent communication skills (oral, written, and technological).
Strong interest in science and the scientific method as a basis for critical thinking.
Strong academic record.
Admirable interpersonal skills.
Evidence of leadership potential and/or community involvement.
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Advancing Skills in Osteopathy Program
OMM Fellows and Medical Students
Application Process:
To apply for the Advancing Skills in Osteopathy program, applicants must submit the following
materials:
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Completed application (attached to this document).
Letter of intent that addresses the following:
 Reasons for interest in gaining experience through this program;
 Academic/professional goals;
 Personal interest in clinical and/or biomedical research and/or education.
Up-to-Date Resume.
A letter of recommendation and completed evaluation form (pg 7) from the Chair of the
OMM/OPP department of the applicant’s training institution.
Up-to-date Transcript from an osteopathic medical program.
Course Location:
The Advancing Skills in Osteopathy program will be held at the A.T. Still Research Institute facility
located on the ATSU-Kirksville Campus at 800 W. Jefferson Street, Kirksville, MO 63501.
Specifically, the laboratory for the Still Research Institute is located in the bottom floor of the
Gutensohn Building.
Course Date:
The Advancing Skills in Osteopathy program is scheduled to be held July 7-11, 2014.
Course Fee:
Course tuition is $1,250 per student.
Scholarships:
Scholarships may be available. If interested in learning more about these scholarships, please
place a checkmark in the following box.
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Name
____________
____________________
Last
First
Middle
Current Address ________
Street Address
Current Telephone (
)
City
-
State
Zip Code
Email Address
Permanent Address
Street Address
Cell Phone (
Gender
)
-
Male
City
Other Phone (
Female
)
State
-
home
Zip Code
work
other
Birth Date __ __ / __ __ / __ __ __ __ (Month/Date/Year)
Cumulative University Grade Point Average
Yes, I am interested in receiving information about the scholarships that are available
U.S. Citizen Yes
No
Permanent U.S. Resident? Yes
No
Were you ever the recipient of any action for unacceptable academic performance (including but not
limited to academic probation or academic warning)?
Yes
No
If yes, please explain:
Were you ever the recipient of any action for conduct violations by any college or school?
Yes
No
If yes, please explain:
Are there any disciplinary charges pending or expected to be brought against you?
Yes
No
If yes, please explain:
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Community Service & Leadership Activities (Positions held, and length of time)
Research/Lab Related Activities & Experiences (Positions held, and length of time)
Employment Experience (Positions held, and length of time)
Why are you applying to the ATSU Still Research Institute ASO program?
Applicant Signature
Date
Notice of Nondiscrimination
A.T. Still University of Health Sciences (ATSU) does not discriminate on the basis of race, color, religion,
national origin, sex, gender, sexual preference, age or disability in admission or access to, or treatment or
employment in its programs and activities. Any person with questions concerning ATSU’s nondiscrimination
policies is directed to contact the Vice President of Student and Alumni Affairs at 660-626-2236 or the
Director of Human Resources at 660-626-2790
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Deadline for Applications
 April 15, 2014, for Summer Advancing Skills in Osteopathy program
Attach the following documents to Application
 Letter of intent
 Current CV
 Academic transcript,
 Evaluation information form
Mail complete application by the above deadline to the following address:
Brian Degenhardt, D.O.
Director, Still Research Institute
c/o Charity Thomann, Research, Grants, and Information Systems
800 W. Jefferson St.
Kirksville, MO 63501
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Evaluation Information
To be completed by student and submitted with application
Evaluation I
Chair of the OMM/OPP department from the Applicant’s training institution
Name
Title
Relationship
_______________________________________________________________________
Address
Street
City
Telephone
(
State
)
-
Email
Zip Code
_____________________________________________
Deadlines for Applications
April 15, 2014, for Summer Advancing Skills in Osteopathy program
Please ask evaluators to mail completed evaluation forms by above deadline to:
Brian Degenhardt, D.O.
Director, Still Research Institute
c/o Charity Thomann, Research, Grants, and Information Systems
800 W. Jefferson St.
Kirksville, MO 63501
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Evaluation
To be completed by the Chair of the OMM/OPP department of the Applicant’s training institution. Please also
attach a letter on official letterhead.
I.
APPLICANT INFORMATION (to be completed by applicant)
Legal Name of Applicant
Last
First
Middle
Social Security Number
Permanent Address
Telephone
(
)
-
Email
_____________________________________________
Please Either Sign Box #1 or #2:
1. I voluntarily waive and relinquish my right of access to
this evaluation.
2.
Applicant’s Signature
Applicant’s Signature
Date
II.
I retain my right of access to this evaluation.
Date
EVALUATOR INFORMATION (to be completed by evaluator)
Name
Rank or Title
Address
City
Telephone
State
Zip
Evaluator Signature
III.
EVALUATOR COMMENTS (to be completed by evaluator)
State nature, duration, and extent of your association with the applicant
Has applicant ever been placed on disciplinary or academic probation?
Yes
No
Are you familiar with how the applicant reacts in a stressful or crisis situation?
Yes
No
If yes, explain:
What unique strengths and/or potential for clinical research does this applicant possess?
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Please describe this applicant’s work ethic.
Please describe any weaknesses of this applicant.
Please give your overall impression of this applicant.
Please check how you would rate this applicant on the following characteristics:
CHARACTERISTIC
Cooperation
Communication Skills
Initiative
Study Habits
Intellectual Curiosity
Intellectual Ability
Judgment
Expression
Maturity
Personality
Reliability
Leadership
Personal Hygiene
Emotional Stability
Ethical Standards
Self-Understanding
Attitude Toward
Associates
Ability to Inspire
Confidence
OUTSTANDING
ABOVE
AVERAGE
AVERAGE
BELOW
AVERAGE
Do you recommend this applicant to the Advancing Skills in Osteopathy program? Yes
No
UNABLE TO
JUDGE
Undecided
Why or why not?
Deadlines for Applications

April 15, 2014, for Summer Advancing Skills in Osteopathy program
Please mail completed evaluation by above deadline to:
Brian Degenhardt, D.O.
Director, Still Research Institute
c/o Charity Thomann, Research, Grants, and Information Systems
800 W. Jefferson St.
Kirksville, MO 63501
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