Journal of Chiropractic Education最新文献

Objective: To examine peer-reviewed literature involving undergraduate interprofessional education (IPE) focusing on musculoskeletal (MSK) healthcare professions.

Methods: Methodological searches were conducted on electronic databases PubMed, Scopus, ERIC, and ProQuest. No date restrictions were applied. English sources (qualitative and quantitative methodological studies, conference papers and proceedings, systematic reviews, grey literature, unpublished materials, theses, and dissertations) were included. A researcher, independent reviewer, and research librarian completed the search and data extraction from June to October 2023. Disagreements were resolved by discussion. ATLAS.ti was used to analyze data by generating codes linked to the text. Findings were reported in a narrative format and by using tables.

Results: Initially, 2894 articles were retrieved and screened for relevance. After rigorous screening procedures, 18 articles from various countries were deemed eligible for inclusion. The included studies were conducted within the date range of 2010 to 2024. The included studies employed mixed methods (n = 9), quantitative (n = 5), and qualitative (n = 4) approaches. Combined medical and physiotherapy student cohorts were prominently featured in 67% (n = 12) of the reviewed studies. All 18 studies incorporated the implementation and/or evaluation of an IPE intervention. Thematic analysis revealed 5 overarching themes, encompassing the benefits, barriers, interventions, strategies, evaluation, and general findings related to IPE.

Conclusion: The reviewed literature emphasizes a significant gap in IPE initiatives concerning various MSK health providers, including chiropractors, podiatrists, biokineticists, and osteopaths. This paucity accentuates the need for further exploration and evaluation of IPE within MSK-specific contexts, crucial for addressing and mitigating the escalating global burden of MSK diseases.

Objective: To evaluate the possible association between student final exam scores and student-reported measures of study time, sleep duration, perception of course difficulty, and grade satisfaction.

Methods: A 4-item questionnaire was administered to 354 3rd-quarter students during finals week. Students were asked to report their study time, sleep duration the night prior to the exam, and perception of course difficulty as well as grade satisfaction using a 5-point Likert scale response prior to taking the exam. The relationship between exam scores from the immunology and endocrinology courses and those 4 items were analyzed.

Results: We found the grade satisfaction and total scores before the final exam and sleep duration had a positive relationship with final exam scores (immunology: r = .29, r = .56, and r = .22, p < .01; endocrinology: r = .41, r = .42, and r = .26, p < .01). In contrast, a negative relationship between the perceptions of course difficulty and the final exam score was found (immunology: p < .01, r = -.15; endocrinology: p < .01, r = -.32). Surprisingly, study time did have a significant correlation with final exam scores (p > .05).

Conclusion: Adequate sleep the night prior to an examination was positively associated with the exam scores. Study time for the final exam did not correlate with final exam scores. There may be a need for schools to consider the potential impact student sleep habits have on academic performance and to distribute this information to students.

Objective: Although the force-time characteristics of spinal manipulative therapy (SMT) have been extensively studied, evidence on the maturation of SMT delivered to the cervicothoracic junction is scarce. The aim of this study is to compare the force-time characteristics of a cervicothoracic SMT technique between experienced chiropractors and chiropractic interns. .

Methods: Participants performed a total of 18 posterior-to-anterior cervicothoracic SMT on a human-shaped manikin, fixed to an instrumented treatment table. Participants were instructed to execute the technique, contacting either the right or the left side of the manikin, at 3 different levels of force: low, typical, and high. Three-level analysis of variance was used to assess the effect of group (experienced chiropractors or interns), force level, and contact side on force-time characteristics. Variability of these characteristics among participants was also evaluated.

Results: No statistically significant differences were observed in any of the force-time characteristics between chiropractic interns (n = 15) and experienced chiropractors (n = 10), nor on the contact side used to perform the SMT (p > .05). Significant effects on force level were noted for all force-time characteristics (p < .05), except for impulse duration (p > .05). The interns displayed more variability than experienced chiropractors for the force at thrust initiation only (p = .02). .

Conclusion: This study shows that both chiropractic interns and experienced clinicians deliver SMT to the cervicothoracic junction with similar force-time characteristics. However, final-year students exhibited greater variability in controlling their force just before initiating the thrust, indicating that some aspects of their motor skill may still be developing.

Objective: To measure degree of depression, anxiety, and hours of sleep of chiropractic college students through an anonymous paper survey.

Methods: A convenience sample of 164 chiropractic college students completed a Major Depression Inventory (MDI) survey, a 2-item Generalized Anxiety Disorder (GAD-2) survey, and were asked the number of hours of sleep they had per night and demographic questions. The survey was distributed to trimester 1-6 students 4 weeks into their 15-week semester.

Results: Chiropractic students had an average MDI score of 18.1 ± 10.6 (mean ± SD), indicating the average chiropractic college student did not display depression. However, subset analysis revealed 18.9% of students had MDI scores over 30, which is associated with possible severe depression. Of students who demonstrated possible severe depression, 80.6% were female. Body mass index demonstrated no correlation with the number of respondents at risk for severe depression. Average GAD-2 score was 3.0 ± 1.9; male students scored 2.4 ± 1.8 and female 3.6 ± 1.8, indicating female students expressed anxiety more. Last, survey respondents reported they averaged 6.3 ± 1.1 hours of sleep per night with females reporting approximately 30 minutes less sleep per night than males.

Conclusion: Chiropractic students, on average, did not display depression. However, a subset of female students near the age of 26 were at an increased risk of severe depression. Chiropractic students displayed a rate of anxiety greater than that of undergraduate college students based on existing data sets and reported approximately 6 hours of sleep per night.

Objective: To compare previously recorded quality of life scores of students at the New Zealand College of Chiropractic using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to those after New Zealand (NZ) COVID lockdowns.

Methods: Previously recorded students' SF-36 questionnaires were collected before (2019) and after (2022) the lockdowns. Student populations were independent at each time point (pre- and post-lockdown) and were compared between 2019 and 2022 using unpaired Wilcoxon tests and to similarly aged and NZ normative data.

Results: Two hundred seventy-six pre-COVID (51.1% female) and 120 post-COVID (60.8% female) data sets were returned. All pre-COVID years and scores were significantly higher or comparable with reference data (p ≤ .050). Post-COVID scores dropped below pre-COVID and reference data-with the largest drops seen in emotional wellbeing, emotional role limitations, social, and fatigue domains (p < .05 - p < .001). Only post-COVID physical functioning was comparable with pre-COVID or reference data (p > .050).

Conclusion: This study suggests that before COVID New Zealand College of Chiropractic perceived their quality of life as the same or better than the average New Zealander or similarly aged person. After COVID, most quality of life scores dropped substantially with emotional, social, and fatigue-related domains showing the greatest decline.

Objective: Since 1963 the Canadian Chiropractic Examining Board has conducted competency examinations for individuals seeking licensure to practice chiropractic in Canada. To maintain currency with changes in practice, examination content and methodology have been regularly updated since that time. This paper describes the process used by the Canadian Chiropractic Examining Board to restructure the examination to ensure it was current and to align it with the 2018 Federation of Canadian Chiropractic's Canadian Chiropractic Entry-to-Practice Competency Profile.

Methods: A subject-matter-expert committee developed proposed candidate outcomes (indicators) for a new examination, derived from the competency profile. A national survey of practice was undertaken to determine the importance and frequency-of-use of the profile's enabling competencies. Survey results, together with other practice-based data and further subject-matter-expert input, were used to validate indicators and to create a new structure for the examination.

Results: The new examination is a combination of single-focus and case-based multiple-choice questions, and OSCE (objective, structured, clinical examination) methodology. Content mapping and item weighting were determined by a blueprinting committee and are provided.

Conclusion: Administration of the new examination commenced in early 2024.

Objective: The objective was to compare the average number of mistakes made on multiple-choice (MCQ) and fill-in-the-blank (FIB) questions in anatomy lab exams.

Methods: The study was conducted retrospectively; every exam had both MCQs and FIBs. The study cohorts were divided into 3 tiers based on the number and percentage of mistakes in answering sheets: low (21-32, >40%), middle (11-20, 40%-20%), and high (1-9, <20%) tiers. The study used an independent 2-sample t test to compare the number of mistakes between MCQs and FIBs overall and per tier and a 1-way analysis of variance to compare the number of mistakes in both formats across the 3 tiers.

Results: The results show that there was a significant difference in the number of mistakes between the 2 formats overall with more mistakes found on FIBs (p < .001). The number of mistakes made in the high and middle tiers had a statistical difference, being higher on MCQs (p < .001). There was no significant difference in the number of mistakes made in the low tier between formats (p > .05). Furthermore, the study found significant differences in the number of mistakes made on MCQs and FIBs across the 3 tiers, being highest in the low-tier group (p < .001).

Conclusion: There were fewer mistakes on the MCQ than the FIB format in exams. It also suggests that, in the low tier answering sheets, both formats could be used to identify students at academic risk who need more attention.

Objective: This study sought to determine whether chiropractic faculty were extrinsically, introjectedly, or intrinsically motivated to pursue scholarship; if satisfaction of a faculty member's work-related needs of autonomy, competence, and relatedness correlated with intrinsic motivation to pursue scholarly activities; and to identify barriers to faculty participation in scholarship.

Methods: An anonymous online survey was administered to full-time faculty at 2 chiropractic institutions in the United States. Survey items assessed whether faculty perceived their work-related needs as met, which motivation type they displayed, and perceived barriers to performing scholarly work. Pearson correlation was used to measure the relationships between satisfaction of the work-related needs and intrinsic motivation. Content analysis was used to analyze faculty responses regarding perceived barriers.

Results: On average, survey items indicating extrinsic motivation received 52.2% of positive responses, those indicating intrinsic motivation received 47.8% of positive responses, and those indicating introjected motivation received 26.7%. Intrinsic motivation was positively correlated with each of the work-related needs (autonomy: r = .34, p = .067; competence: r = .52, p = .004; relatedness: r = 0.34, p = .063). Four categories of barriers were reported: time constraints, lack of knowledge, lack of support, and lack of interest.

Conclusion: In this sample, chiropractic faculty most frequently identified with survey items indicating extrinsic motivation. Satisfaction of each of the 3 work-related needs was positively correlated with intrinsic motivation; however, competence showed a significant correlation indicating as competence is satisfied faculty are more likely to be intrinsically motivated to pursue scholarship. Perceived lack of time, knowledge, and support were reported barriers to the pursuit of scholarship.

Objective: To examine chiropractic students' attitudes regarding knowledge of pain neuroscience, chronic pain, and patient-centered care before and after educational interventions. Secondarily, this study aimed to compare measures of these skills between cohorts at different timepoints throughout training programs.

Methods: Using stratified randomization, 281 Year 3 chiropractic students at 2 institutions were allocated into 1 of 3 educational interventions and served as active-control comparison groups: pain neuroscience education, chronic pain education, or patient-centered care. Participants completed validated surveys regarding their experience with the education interventions immediately pre- and post-lecture and 12 weeks after completion. For further comparison, surveys were also completed by 160 Year 1 students and 118 Year 2 students at 1 of the institutions. Independent sample t tests and 1-way analysis of variance were used for data analysis.

Results: All Year 3 lecture groups showed immediate improvements (pain neuroscience education: 3.99 + 3.09/100, p = .18 [95% CI: 10.10 to -1.77]; chronic pain education: 0.42 + 0.74/7, p = .02 [95% CI: 0.72 to 0.07]; patient-centered care: 0.25 + 0.12/6, p = .05 [95% CI: 0.12-0.51]), but these were not sustained at the 12-week follow-up (pain neuroscience education: -6.25 + 4.36/100, p = .15 [95% CI: 14.93 to -2.42]; chronic pain education: 0.33 + 0.16/7, p = .19 [95% CI, 0.66 to 0.01]; patient-centered care: 0.13 + 0.13/6, p = .30 [95% CI: 0.41 to -0.13]). Compared to active controls, only the patient-centered care group showed an immediate statistically significant difference.

Conclusions: While this study found that immediate improvement in targeted competencies is possible with focused interventions, they were not sustained long term.

The Chiropractic Educators Research Forum convened a conference on June 22, 2024. During this meeting, attendees shared what chiropractic programs are doing, specifically focusing on education research related to technology. Presenters and panelists discussed what technology chiropractic programs should be using to educate chiropractors for the future.