Journal of Chiropractic Education最新文献

Objective: The main objective of this study was to evaluate the validity of grade point average (GPA) for predicting the National Board of Chiropractic Examiners (NBCE) Part I exam scores using chiropractic GPA.

Methods: Data were collected during the January 2019 computer-based testing administration of the NBCE's Part I exam. The sample size was n = 2278 of test takers from 18 domestic and 4 international chiropractic educational institutions. Six regression models were developed and tested to predict the Part I domain scores from chiropractic GPA while controlling for self-reported demographic variables. Residuals from the models were disaggregated by pre-chiropractic GPA.

Results: Chiropractic GPA revealed a positive, statistically significant correlation with sex. The chiropractic GPA was found to be a significant predictor of the Part I domain scores. A different perspective was obtained when residuals (observed minus predicted) were collected and split by the pre-chiropractic GPA. Very good students tended to be underpredicted, while other students were overpredicted.

Conclusion: This study builds on the cascading evidence from educational literature by providing additional results suggesting that undergraduate (prechiropractic) GPA as well as the GPA obtained in doctor of chiropractic programs are related to the future performance on the NBCE Part I exam. The results provide a first glance at the connection between the standardized test scores, which are often used for instructors' and institutional evaluation and the GPA obtained in a doctor of chiropractic program.

Objective: To investigate coping strategies adopted by chiropractic college students and how these strategies affect student-perceived stress levels.

Methods: Four hundred seven (407) 1st-quarter students were recruited during 2014 and 2015. The validated Brief COPE inventory was used to assess coping strategies during the 1st week of classes. Perceived Chiropractic College Stress (PCCS) was assessed via a modification of Vitaliano Perceived Medical School Stress survey instrument. The modified coping instrument was administered during the 1st quarter (PCCS1) and 6 months later during the 3rd quarter (PCCS2).

Results: Mean perceived stress levels were greater after 6 months. Although perceived stress increased more for females than for males over that period, it was not statistically significant. Male and female coping strategies differed only in the preferential use of emotional support by females. Students generally adopted active coping strategies (eg, active coping and planning) rather than avoidant strategies (eg, substance abuse). Regression analysis revealed a moderate positive relationship between avoidant-emotion coping and PCCS1 with a weaker positive correlation between problem-focused coping, sex, and PCCS1. Avoidant-emotion coping also demonstrated a moderate positive correlation with PCCS2. Neither sex nor the 3 coping strategies were predictors of PCCS change (PCCS2 - PCCS1).

Conclusion: This study is a starting point for exploring the relationship between perceived stress and coping behaviors in a chiropractic training institution. Students generally used healthy adaptive coping strategies with minimal sex differences. Avoidant-emotion coping appears to be a reliable predictor of PCCS, with sex being a poor predictor.

Objective: To determine if an existing course in genetics should be revised to refocus on the topic of genomics and its impact on health and primary care, a survey of chiropractors was conducted regarding genomics and patient care.

Methods: A short survey was designed to ascertain chiropractors' knowledge and use of genomics in their practices, particularly regarding direct to consumer genetic testing. Nine closed-ended questions and 2 open-ended questions were included. Pearson correlation was used to evaluate relationships between close-ended responses. Content analysis was conducted on the final open-ended question that queried respondents for further comments.

Results: There were 181 completed surveys returned. Patients do ask chiropractors about their own direct to consumer genetic testing results-42% indicated that they are approached by patients 1-3 times per month to discuss genetics/genomics. Knowledge of genomics varies among chiropractors, yet 51% feel that teaching genomics is moderately (31%) or extremely (20%) important.

Conclusion: An introductory course in clinical genomics is necessary to prepare a chiropractor for patient care.

Objective: Impostor phenomenon is expressed by feelings of self-doubt and the belief that one is unintelligent. The purpose of this research was to describe the prevalence of impostor phenomenon among students enrolled in a doctor of chiropractic program and to evaluate for any differences in the rates of impostor phenomenon between males and females.

Methods: We performed an anonymous cross-sectional, online survey of all students enrolled in the doctor of chiropractic program at 2 campuses of 1 chiropractic college. We reported the point prevalence of impostor phenomenon and used χ2 to evaluate the differences in impostor phenomenon among males and females. We also evaluated for between-group differences for 4 other demographic factors believed to influence impostor phenomenon.

Results: We received 406 survey responses (34% response rate). Impostor phenomenon was reported in 39% of students responding to our survey. Approximately 46% of all females and 32% of all males met the criteria for impostor phenomenon, and females had significantly higher rates of impostor phenomenon (p = .005). The following variables were not associated with impostor phenomenon: year in which students were enrolled; marital status; whether chiropractic was their first career; and type of clinical experience the student encountered.

Conclusion: Our findings demonstrate that over a third of students enrolled in a doctor of chiropractic program met the criteria for impostor phenomenon, and females were significantly more likely to experience impostor phenomenon. The results from this survey are similar to those reported in other healthcare educational settings.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 5, 2020. This meeting provided a forum for the presentation of scholarly works in chiropractic education theory and practice. This conference specifically focused on research related to chiropractic education during the COVID-19 pandemic. During the December 2020 CERF meeting, presenters and panelists took an in depth look at how programs worked to meet program objectives, graduation requirements, accreditation, and other activities during the COVID-19 pandemic.

Objective: Case-based online modules can be created to integrate basic science and clinical science knowledge. An integrated module was designed, implemented, and evaluated for student performance and perception.

Methods: Five faculty members from both basic science and clinical education departments developed an integrative, online, case-based learning module. The case involved a patient with facial asymmetry, and the student was led to a diagnosis of Bell's palsy. Material on Bell's palsy was presented in an integrated module in addition to traditional lecture for a fall cohort of students and was presented only in traditional lecture format to a winter cohort of students. Both cohorts were given the same 5 multiple-choice questions on Bell's palsy as part of a midterm exam, and the scores of these test questions were compared between cohorts. A 13-question, mixed-methods survey was given to the fall cohort to determine their perceptions of the module and their learning.

Results: Multiple-choice test question performance was equivalent between cohorts for the Bell's palsy questions (fall 2018: mean = 3.68, SD = 0.99; winter 2019: mean = 3.51, SD = 0.92). Perception survey responses indicated that students felt positively about the integrated module and that it was applicable and helpful with improving, reinforcing, and integrating basic science and clinical knowledge.

Conclusion: This study provides evidence that case-based integrated modules are perceived favorably by students and result in similar exam question performance. They can be a useful tool to help students connect information throughout the chiropractic curriculum.

Objective: To explore the self-perceived preparedness and clinical proficiency in headache diagnosis and management of Australian chiropractic students in senior years of study.

Methods: Australian chiropractic students in the 4th (n = 134) and 5th year (n = 122) of 2 chiropractic university programs were invited to participate in an online cross-sectional survey. Descriptive analyses were conducted for all variables. Post hoc analyses were performed using simple linear regression to evaluate the relationship between self-perceived preparedness and correctness of headache diagnosis and management scores.

Results: Australian chiropractic students in senior years demonstrated moderate overall levels of self-perceived preparedness and proficiency in their ability to diagnose and manage headache disorders. Final-year students had a slightly higher self-perceived preparedness and proficiency in headache diagnosis and management compared to those students in the 4th year of study. There was no relationship between self-perceived preparedness and correctness of headache diagnosis and management for either 4th- or 5th-year chiropractic students.

Conclusion: Our findings suggest that there may be gaps in graduate chiropractic student confidence and proficiency in headache diagnosis and management. These findings call for further research to explore graduate chiropractic student preparedness and proficiency in the diagnosis and management of headache disorders.

Objective: This is a report of the results of 4 facilitated workshops aimed at developing a standardized chiropractic technique curriculum.

Methods: Workshops were held at research conferences during 2014, 2016, 2018, and 2019. Participants were tasked with developing recommendations for diagnostic and therapeutic procedures appropriate for chiropractic technique programs.

Results: For diagnostic procedures, there was general agreement among participants that chiropractic programs should include diagnostic imaging, postural assessment, gait analysis, palpation (static, motion, and joint play/springing), global range of motion, and evidence-based orthopedic/neurological tests. No consensus could be reached with respect to chiropractic x-ray line marking (spinography) nor heat sensing instruments, and there was only partial consensus on leg length assessment. For therapeutic procedures, all participants agreed that the following should be included: high-velocity, low amplitude spinal and extremity manipulation, adjustments assisted by hand-held instruments, drop tables, flexion-distraction tables, and pelvic blocks. There was unanimous support for teaching mobilization of the spine and peripheral joints, as well as for manual and instrument-assisted soft tissue therapies. There were some overarching issues: participants strongly preferred assessment methods known to be reliable and valid and therapeutic procedures known to be safe and effective. Where evidence was lacking, they insisted that diagnostic and therapeutic methods at minimum have face validity and biological plausibility. However, they cautioned against applying aspects of evidence-based care too rigidly.

Conclusions: Despite differing views on chiropractic terminology, philosophy, and scope of practice, participants' opinions were similar regarding diagnostic and therapeutic procedures that ought to be included in chiropractic technique programs.

Objective: Team-based learning (TBL) is an active learning method in which student teams participate in individual work, teamwork, and the application of learned concepts to problem solving. It has been widely adopted in the education of health professions. The aim of this study was to assess whether TBL in tutorials would be beneficial to students' assessed knowledge and subjective sense of satisfaction as compared to traditional modes of teaching.

Methods: In 2018, TBL was introduced into the tutorials of a clinically oriented undergraduate course of neuroanatomy, and its benefits in improving student grades and satisfaction were assessed. The Welch 2 sample t test was used for group differences in continuous variables, and Pearson's χ2 test with Yates' continuity correction was used for group differences in dichotomous variables. Linear modeling was used to look for group differences while adjusting for significant baseline characteristics.

Results: Our study found that in comparison to more traditionally delivered teaching, TBL did not improve grades or alter overall satisfaction. A post hoc pairwise comparison of satisfaction among lectures, tutorials, and practical classes showed that students appeared to be most dissatisfied with the TBL.

Conclusion: Analysis of our methods, results, student comments, and the literature indicate that the length of the tutorials, at 1 hour, was too short to conduct TBL to the standards required. In addition, there is an imperative to persist in preparing students for a different knowledge-transfer paradigm, and it takes a few iterations to improve the approach and application of this method of teaching.

Objective: Chiropractic trainees require exposure to a diverse patient base, including patients with multiple medical conditions. The Veterans Affairs (VA) Chiropractic Residency Program aims for its doctor of chiropractic (DC) residents to gain experience managing a range of multimorbid cases, yet to our knowledge there are no published data on the comorbidity characteristics of patients seen by VA DC residents. We tested 2 approaches to obtaining Charlson Comorbidity Index (CCI) scores and compared CCI scores of resident patients with those of staff DCs at 1 VA medical center.

Methods: Two processes of data collection to calculate CCI scores were developed. Time differences and agreement between methods were assessed. Comparison of CCI distribution between resident DC and staff DCs was done using 100 Monte Carlo simulation iterations of Fisher's exact test.

Results: Both methods were able to calculate CCI scores (n = 22). The automated method was faster than the manual (13 vs 78 seconds per patient). CCI scores agreement between methods was good (κ = 0.67). We failed to find a significant difference in the distribution of resident DC and staff DC patients (mean p = .377; 95% CI, .375-.379).

Conclusion: CCI scores of a VA chiropractic resident's patients are measurable with both manual and automated methods, although automated may be preferred for its time efficiency. At the facility studied, the resident and staff DCs did not see patients with significantly different distributions of CCI scores. Applying CCI may give better insight into the characteristics of DC trainee patient populations.