Journal of Chiropractic Education最新文献

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.

This conference was convened by the World Federation of Chiropractic from October 30 to November 2, 2024, in Kuala Lumpur, Malaysia. The 2024 program focused on the delivery of technology in chiropractic education.

Objective: The purpose of this review was to identify assessment instruments and their measurement properties for assessing evidence-based practice (EBP) knowledge, skills, attitudes, and behavior among students of manual therapy education programs.

Methods: 7 electronic databases were systematically searched from inception to May 19, 2023. (MEDLINE, EMBASE, CINAHL, ERIC, EBSCO Discovery, LISA, Google Scholar.) Search terms were subject headings specific to each database (MeSH in MEDLINE) and relevant to evidence-based practice, assessment tools/instruments, and manual therapy healthcare professions. Eligible studies included students of manual therapy education programs (chiropractic, physiotherapy, occupational therapy, osteopathy) and provided evidence supporting instrument measurement properties (reliability, validity). Titles and abstracts were screened by 2 reviewers. Data on each instrument and its properties were extracted and tabulated by 2 reviewers. Instruments were compared using the Classification Rubric for EBP Assessment Tools in Education (CREATE) framework including the 5 steps in the EBP model. Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist were followed.

Results: 5 studies were identified, (3 physiotherapy, 2 chiropractic) Two studies used a physiotherapy-focused modification of the Fresno test. One study presented the Knowledge of Research Evidence Competencies instrument. Two studies presented original instruments. Instruments focused on the knowledge domain and did not assess all 5 EBP model steps.

Conclusion: The current literature does not address all 5 steps of the EBP model. The identified instruments have the potential to ensure chiropractic institutions are graduating chiropractors who are highly skilled in evidence-based practice.

Objective: Racial and ethnic minority groups are underrepresented in chiropractic education and the profession, and are less likely than individuals identifying as White to have access to or use chiropractic care. Stakeholders with leadership positions in USA-based chiropractic colleges and organizations participated in 3 online diversity, equity, and inclusion (DEI) summit meetings to foster a deeper understanding of DEI, identify DEI objectives, and develop action steps and drive change. Summit I (51 attendees) comprised 3 presentations that provided background about DEI in chiropractic education and practice. Summit II (32 attendees), comprised 4 breakout sessions addressing organizational issues in DEI. Summit III (65 attendees) comprised 5 collaborative sessions focused on implementation of DEI objectives.

Methods: We use aggregate data and qualitative summaries to provide a descriptive narrative. Data sources include pre/post-summit quantitative surveys, items from open-ended questionnaires, and a spreadsheet of recommendations for increasing organizational DEI.

Results: Before attending Summit I, 48% rated their understanding of DEI issues as "moderately" or "very" high, compared with 74% afterward. Summit II participants suggested actions that should be taken by their institutions and the profession. Summit III participants stressed the need for DEI-supportive data, policies, and resources. They identified > 150 action steps to address DEI objectives. A listserv was established to facilitate ongoing institutional collaboration.

Conclusion: Summit participants recognized the importance of developing a diverse, culturally aware chiropractic workforce. The summits provided structure and support for stakeholders to effectively plan for and implement DEI in their organizations and institutions.

Objective: This study investigated patient satisfaction with care provided by chiropractic students under supervision vs supervisors in a Danish hospital setting.

Methods: A cross-sectional observational study of patient satisfaction was conducted at the Spine Center of Southern Denmark, where chiropractic students from the University of Southern Denmark complete an 8-week internship in their final year of pregraduate training. Patients were assigned to students or supervisors based on administrative convenience (ie, natural allocation). Blinded from the aim of the study, all patients seen by a chiropractor (with or without a student) were invited to answer a questionnaire rating satisfaction with the clinical encounter. Results were analyzed using ordinal logistic regression with group allocation blinded by the investigators.

Results: Results from 438 participants (response rate = 88%) showed no significant difference in patient satisfaction between the student and supervisor groups. Although a small difference favored the supervisor group, the student group had a higher proportion of high and very high satisfaction combined.

Conclusion: Satisfaction differed minimally whether patient care was administered by students under the supervision of a licensed chiropractor or by licensed chiropractors alone. Our findings suggest that patients do not negatively view student involvement in clinical consultations at a Danish hospital.

Objective: To compare unproctored and proctored online exams among chiropractic students.

Methods: Pre-existing data of 234 students across 4 consecutive endocrinology classes were analyzed for this study. The course was comprised of 3 lectures (50 minutes per lecture) each week. Student performance was evaluated by midterm exam and summative exam (S1). The students from 3 classes were asked to take a voluntary second summative exam (S2) approximately 7 months after the S1. Since this study was partially conducted during the COVID pandemic, some classes took the midterm and the S1 proctored in the classroom while others took them unproctored from a remote location.

Results: The mean midterm exam (p < .001) and S1 scores (p = .01) for the unproctored group (93.6 ± 7.0 and 88.8 ± 8.2) were significantly higher than the proctored group (88.1 ± 8.2 and 83.9 ± 11.2). The mean time taken by students was much greater for the unproctored exams than for the proctored exams (midterm: 40.7 ± 10.2 versus 16.7 ± 7.0, p < .001; S1: 47.0 ± 8.7 versus 21.5 ± 9.0, p < .001). By contrast, the mean unproctored S2 scores were lower than the proctored group (60.2 ± 14.7 versus 88.1 ± 8.2, p < .001). A linear regression test showed that the final exam was a statistically significant predictor of the recall exam (p < .01, R2 = 28.3%).

Conclusion: The findings suggest that student performance is significantly altered by test format.