Journal of Chiropractic Education最新文献

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.

Objective: To describe student loan debt and income of doctors of chiropractic (DC) who sought private student loan counseling.

Methods: A descriptive analysis of de-identified client records from a student debt consulting firm (Student Loan Planner®) was conducted. Data regarding chiropractic programs, cumulative student loan amounts, and current incomes at the time of consultation were abstracted. Descriptive statistics were reported.

Results: Consultations (n = 448) were completed with DCs between March 2017 and August 2023. Nearly half (44.2%) reported student loan indebtedness between $150,000 and $249,999 with another 35.7% indicating between $250,000 and $349,999. The mean student loan debt was $249,149 (SD: $82,892) with a median of $240,000 (interquartile range [IQR]: $199,507-$295,390). The mean income for DCs in this sample was $81,305 (SD: $47,495) with a median income of $75,000 (IQR: $50,000-$100,000). The mean debt-to-income ratio was 4.11 (SD: 2.93) with a median of 3.38 (IQR: 2.21-5.16). Sixteen consultees possessed a debt-to-income ratio below 1.00, whereas more than a quarter (26.3%) of consultees reported a debt-to-income ratio greater than 5.00.

Conclusion: DCs seeking debt guidance commonly carry substantial student loan debt that far exceeds their income. Our findings highlight that the student loan debt crisis includes DCs.

Objective: Evidence-based radiographic guidelines are used to justify the need for radiographs and prevent their overuse. This study aimed to assess whether 4th-year chiropractic interns at the International Medical University plan to use x-ray imaging in their future private practice in line with the principles taught throughout their chiropractic program and the evidence-based imaging guidelines.

Methods: A survey questionnaire was distributed to 74 final year chiropractic interns, with 62 completed responses. The questionnaire consisted of 8 case scenarios representing potential chiropractic patients. The interns were asked to decide whether to x-ray the patient or not, and which x-ray views to request if they chose to x-ray the patient.

Results: Results were compared with the gold standard using percentage agreement. The findings revealed that the chiropractic students adhered to the gold standard answers for 6 out of 8 cases. However, they did not perform well in selecting the correct x-ray views for the 3 cases where radiography was indicated by the gold standard.

Conclusion: Results suggest that while the interns have a good understanding of when radiography is necessary, they may need additional training in selecting the appropriate x-ray views for each case.

Objective: Higher stress levels may be associated with decreased academic success and physical and psychological well-being in chiropractic students. This study aimed to determine the perceived stress and burnout of chiropractic students at the University of Johannesburg during the COVID-19 pandemic.

Methods: This was a quantitative, exploratory study utilizing a self-administered online questionnaire distributed to chiropractic students (n = 246) at the university. The questionnaire consisted of 3 main components: demographics, the Perceived Stress Scale (PSS-10), and the Maslach Burnout Inventory-Student Survey (MBI-SS). Data were analyzed utilizing exploratory factor analysis, Cronbach alpha for reliabilities, and descriptive statistics for mean scores being interpreted using subscales pertaining to the 2 survey tools.

Results: The response rate was 63.82% (n = 157) with the PSS-10 indicating participants obtained a total mean score of 25.08 (average stress). For the MBI-SS categories, participants scored 18.96 out of 30 for exhaustion, 10.31 out of 30 for cynicism, and 22.46 out of 36 for professional efficiency; higher scores of exhaustion and cynicism and lower scores of professional efficiency are indicative of higher degrees of burnout. Statistically significant differences for both tools were noted in relation to age and academic year with higher values indicated with increased age and progression in the program.

Conclusion: The results indicate that chiropractic students experienced moderate levels of stress but higher burnout than other health sciences student populations when compared to current literature. Age and progression in the program appear to have a negative influence on both these factors.

This conference was convened by the Association of Chiropractic Colleges in San Diego, CA from March 21-23, 2024. The theme for this Association of Chiropractic Colleges Educational Conference and Research Agenda Conference (ACC-RAC) program was The Healthcare Evolution. This proceedings document includes the names of the Peer Review Committee members and all platform and poster abstracts presented at the 2024 ACC-RAC.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 2, 2023. This conference took a closer look at what chiropractic programs are doing to identify burnout and build student, faculty, and staff resilience in the psychosocial domain. During the meeting, presenters and panelists took an in-depth look at research related to how chiropractic programs are addressing issues in mental health of students, faculty, and staff as this relates to burnout and resilience in the chiropractic program and practice.