Journal of Chiropractic Education最新文献

Objective: Force-sensing treatment tables are becoming more commonly used by chiropractic educational institutions. However, when a table-embedded force platform is the sole measurement method, there is little information available about what force-time values instructors and students should expect for side-posture spinal manipulative thrusts. The purpose of this report is to provide force-time values recorded with such a system during side-posture manipulation with human recipients.

Methods: Student volunteers were examined by and received lumbar or pelvic side-posture manipulation from experienced chiropractors who were diplomates of the Gonstead Clinical Studies Society. Forces were recorded using proprietary software of a Bertec force platform; force and time data were analyzed with a custom-programmed software tool in Excel.

Results: Seven doctors of chiropractic performed 24 thrusts on 23 student recipients. Preload forces, averaging 69.7 N, and thrust loading duration, averaging 167 milliseconds, were similar to previous studies of side-posture manipulation. Peak loads were higher than previous studies, averaging 1010.9 N. Other variables included prethrust liftoff force, times from thrust onset to peak force and peak load to resolution of thrust, and average rates of force loading and unloading.

Conclusion: The values we found will be used for reference at our institution and may be useful to instructors at other chiropractic educational institutions, in the teaching of lumbar side-posture manipulation. A caveat is that the values of this study reflect multiple sources of applied force, not solely the force applied directly to the spine.

Objectives: The Objective Structured Clinical Examination (OSCE) is a commonly used assessment of clinical skill, and ensuring the quality and reliability in OSCEs is a complex, and on-going process. This paper discusses scoring schemas and reviews checklists and global rating scales (GRS) for marking. Also detailed are post-examination quality assurance metrics tailored to smaller cohorts, with an illustrative dataset.

Methods: A deidentified OSCE dataset, from stations with both a checklist and GRS, of 24 examinees from a 2021 cohort was assessed using the following metrics: Cut-scores or pass-rates, number-of-failures, R2, inter-grade discrimination, and between-group-variation. The results were used to inform a set of implementable recommendations to improve future OSCEs.

Results: For most stations the calculated cut-score calculated was higher than the traditional pass of 50% (58.9.8-68.4%). Number-of-failures were low for traditional pass rates and cuts-scores (0.00-16.7%), excepting Lab Analysis where number-of-failures was 50.0%. R2 values ranged from 0.67-0.97, but proportion of total variance was high (67.3-95.9). These data suggest there were potential missed teaching concepts, that station marking was open to examiner interpretation, and there were inconsistencies in examiner marking.Recommendations included increasing checklist detail and using a weighted marking scale, separating some stations into dichotomous and key-feature checklists, using GRSs specific to each station, and reviewing all future OSCEs with the metrics described to guide refinements.

Conclusions: The analysis used revealed several potential issues with the OSCE assessment. These findings informed recommendations to improve the quality of future examinations.

Objective: The purpose of this study was to assess chiropractic interns' knowledge and adherence to radiographic clinical practice guidelines (CPGs) and compare their clinical decisions to previous surveys of established practitioners in Canada and Australia.

Methods: A clinical decision-making survey was administered to 88 interns. The survey contained clinical scenarios and vignettes with inquiries regarding indications for radiographic referral, the likelihood of referral, and the application of CPGs.

Results: Forty-four percent (43.75%) of the interns were aware of CPGs, 38.75% were unsure, and 17.5% were not aware. When asked specific questions about the appropriateness of diagnostic imaging, the interns' responses were similar to those of practitioners in Canada and Australia. When interns evaluated a clinical vignette, there was lower compliance with CPGs.

Conclusion: The interns' clinical decisions regarding the use of diagnostic radiography did not significantly differ from those of practitioners who were surveyed in other related studies. Interns were inconsistent in applying their decision making in clinical cases. Notwithstanding the similarities with practitioners, some deviation from the guidelines indicates the need for further intern education to improve the implementation of CPGs for optimal cost-effective and clinically appropriate care.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 3, 2022. This meeting provided a forum for the presentation of scholarly works in education theory and practice. This conference specifically focused on research related to education research and building faculty scholarship and research capacity. During the December 2022 CERF meeting, presenters and panelists took an in-depth look at education research and how chiropractic programs work to enhance research and scholarship capacity.

Objective: To explore Australian chiropractors' and final year students' readiness to identify and support patient's experiencing intimate partner violence (IPV).

Methods: This cross-sectional study used the Chiro-PREMIS, an adaptation of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) to explore chiropractors' and final year students' readiness. Survey responses were analyzed through a lens of Miller's framework for developing clinical competence and chiropractic graduate competencies.

Results: One hundred forty participants completed the online survey (n = 99 chiropractors and n = 41 students). Reports of practice over the 4 weeks prior to completing the survey showed 21% of chiropractors and 20% of students consulted with patients who had disclosed they were involved in IPV. Thirty-three percent of chiropractors and 27% of students suspected a patient was involved, but that patient did not disclose. Participants report meager training in IPV. Many are unclear about appropriate questioning techniques, documentation, referrals, identifying available resources, and legal literacy. Overall, participants do not "know" about IPV, they do not "know how" to and may not be able to "show how" or "do" when it comes to managing IPV-related clinical scenarios. Further studies are needed to confirm if chiropractors have the appropriate clinical capabilities.

Conclusion: With proper preparation, chiropractors have an opportunity to make a positive contribution to this social problem. We anticipate chiropractic-specific discourse surrounding these escalating growing social concerns will highlight the intent of the chiropractic profession to make a substantial contribution to the health care of the Australian public. More studies are needed.

Objective: The global COVID-19 pandemic required the teaching of basic science instructional laboratories be done in a remote, online format termed emergency remote teaching (ERT). The aims of this study were to: (1) share strategies for ERT of basic science instructional laboratories and (2) assess student perceptions of the experience of virtual demonstrations that were recorded from the first-person perspective of the professor.

Methods: Laboratories for courses in gross anatomy, neuroanatomy, and clinical microbiology were adapted to ERT by creating videos that allowed the students to view the laboratory activities through the eyes and hands of the faculty. A unique 5-question survey instrument was created to collect students' perceptions of gross anatomy, neuroanatomy, and clinical microbiology virtual lab experiences. Percentage of responses were calculated for 4 close-ended questions. Qualitative content analysis was conducted on the single open-ended question. Two additional close-ended questions were used for assessing perception of gross anatomy labs only.

Results: Videos of gross anatomy, neuroanatomy, and clinical microbiology laboratory activities mimicked the student experience through the camera lens as labs were performed by faculty members engaged in either dissection, viewing structures or doing experiments, respectively. In all 3 basic science courses, over 70% of students strongly agreed or agreed that the videos created a sense of being in the laboratory.

Conclusion: Use of video technology allowed faculty to mimic the student experience of being in basic science laboratories, and, importantly, allowed the student to virtually participate in the learning experience.

Objective: We developed a Research Readiness Survey (RRS) to identify students' information literacy needs prior to instruction by a team of faculty members and librarians in our doctor of chiropractic program clinical research literacy courses. In addition to describing students' responses to our RRS, we explored associations between (1) students' overall performance on the RRS and their prior earned degrees and (2) their self-reported ability and performance on questions pertaining to evaluating information quality (standard 3 of the Association of College and Research Libraries [ACRL] Information Literacy Competency Standards for Higher Education).

Methods: The RRS is composed of 50 questions, of which 22 pertain to information literacy knowledge assessment per ACRL standards. We calculated means and standard deviations for summary scores on 4 ACRL standards and for a total RRS score. We used analysis of variance to assess whether standard 3 scores differed by students' self-reported ability to judge health information quality and whether there was an association between total RRS scores and students' previously earned degrees.

Results: In 2017-2018, 245 students (70% of matriculates) completed the RRS. Students performed best on standard 3 (average score 67%) and worst on standard 2, the ability to access information (average score = 59%). Students who reported an average ability to judge information quality had higher standard 3 scores than students who reported poor ability (p = .003). Students with bachelor's degrees had higher total RRS scores than students with associate's degrees (p = .004).

Conclusion: Matriculating students had the most difficulty with accessing information, supporting the need to include librarians on the teaching team.

Objective: Test anxiety is a debilitating disorder that can impair cognitive performance and affect academic success. Aromatherapy is commonly used for relaxation therapy. The primary aim of the study was to determine if nasal inhaler aromatherapy, utilizing a blend of rosemary and lavender essential oils, could be a useful strategy to reduce testing anxiety in students.

Methods: This study recruited first trimester chiropractic students enrolled in both Neuroanatomy I and Biochemistry I. A randomized crossover design was utilized over 2 study days during final exams, with a 2-day wash-out period. Participants were randomly assigned into groups based on results of test anxiety analysis. On each day, students were given a nasal inhaler with either an aromatherapy blend of lavender and rosemary essential oils or distilled water as the control. Students completed pretest surveys and posttest surveys to rate their anxiety levels. Paired sample t-tests were performed to determine group differences in test anxiety. Both intention-to-treat and per-protocol analyses were conducted.

Results: Forty-five students were randomly assigned into the study, whereas only 38 completed per-protocol. Between group comparisons showed no statistically significant difference between change in anxiety scores between aromatherapy and control for both intention-to-treat (p =.10) and per-protocol (p =.07).

Conclusion: Use of personal inhalers and aromatherapy diffusers were not shown to reduce test anxiety in a chiropractic population under high-stakes examination. Other options should be explored for future research.

Objective: The purpose of this study was to determine the knowledge and attitudes toward COVID-19 and perceived behavioral modification of South African chiropractic students returning to clinical training during the COVID-19 pandemic.

Methods: An online survey was administered to students registered for clinical training in South African chiropractic programs. The survey consisted of questions related to knowledge and attitudes toward COVID-19 and perceptions on behavioral modification in the form of personal protective equipment (PPE) use to prevent transmission.

Results: Out of 129 participants, there was a 69% response rate (n = 89), with a mean age of 25 (±2.39) years and 75% were females. They had an acceptable level of knowledge (67.9%). There was a favorable perception score about COVID-19 (98.8%) but a poor perception of the role of PPE. They expressed concern about returning to clinical training (62.9%) but were prepared to return to serve their patients during the pandemic (72%).

Conclusion: Chiropractic students within South Africa demonstrated good attitudes, knowledge, and perception toward the measures required to return safely to the clinical environment during the COVID-19 pandemic. There was a level of stress associated with potential infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mostly for onward transmission to family members.

Objective: Health professional students' mental health and lifestyle behaviors may impact their personal health as well as their clinical practice. The objective of our retrospective study was to see if there were changes in students' mental health and lifestyle behaviors during their doctor of chiropractic program (DCP).

Methods: In 2019, we identified health center files for 198 students who graduated from our DCP between 2015 and 2016, of which 69% (n = 137) contained Health Insurance Portability and Accountability Act (HIPAA) consent forms granting permission for file review. From each of these files, we extracted mental health and lifestyle behavior data that students self-reported at the beginning and end of their DCP. Data were analyzed with descriptive statistics, paired t test, sign test, and McNemar's chi-square test.

Results: The majority of our students reported drinking alcohol, engaging in regular exercise, and not smoking at the beginning and end of our DCP. Comparing pre and post data, there was a statistically significant increase in water, fruit, and vegetable consumption along with an increased proportion of students reporting eating junk food and drinking 1 or more servings of caffeine (p ≤ .002). The proportion of students reporting anxiety or depression decreased between the beginning and end of our DCP (p = .002).

Conclusion: This study provided information about student mental health and lifestyle behaviors at 1 DCP. We recommend future studies use validated questionnaires across multiple DCPs. There also may be a need for intervention research to decrease DCP student alcohol use.