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Meyer KW, Al-Ryati OY, Cupler ZA, Bonavito-Larragoite GM, Daniels CJ. Integrated clinical opportunities for training offered through US doctor of chiropractic programs. THE JOURNAL OF CHIROPRACTIC EDUCATION 2023; 37:90-97. [PMID: 37246958 PMCID: PMC11095651 DOI: 10.7899/jce-22-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/05/2022] [Accepted: 11/28/2022] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The primary objective of this study was to assess, summarize, and compare the current integrated clinical learning opportunities offered for students who matriculated in US doctor of chiropractic programs (DCPs). METHODS Two authors independently searched all accredited DCP handbooks and websites for clinical training opportunities within integrated settings. The 2 data sets were compared with any discrepancies resolved through discussion. We extracted data for preceptorships, clerkships, and/or rotations within the Department of Defense, Federally Qualified Health Centers, multi-/inter-/transdisciplinary clinics, private/public hospitals, and the Veterans Health Administration. Following data extraction, officials from each DCP were contacted with a request to verify the collected data. RESULTS Of the 17 DCPs reviewed, all but 3 offered at least 1 integrated clinical experience, while 41 integrated clinical opportunities were the most offered by a single DCP. There was an average of 9.8 (median 4.0) opportunities per school and an average of 2.5 (median 2.0) clinical setting types. Over half (56%) of all integrated clinical opportunities were within the Veterans Health Administration, followed by multidisciplinary clinic sites (25%). CONCLUSION This work presents preliminary descriptive information of the integrated clinical training opportunities available through DCPs.
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Glucina TT, Krägeloh CU, Spencer K, Holt K. Defining chiropractic professional identity: A concept analysis. J Bodyw Mov Ther 2023; 35:75-83. [PMID: 37330807 DOI: 10.1016/j.jbmt.2023.04.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/12/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The concept of professional identity within chiropractic is often discussed and debated, however in the field to date, there is no formal definition of chiropractic professional identity (CPI). This article aims to create a coherent definition of CPI and to formalise the conceptual domains that may encompass it. METHODS Using the Walker and Avant (2005) process, a concept analysis methodology was employed to clarify the diffuse concept of CPI. This method initially involved selecting the concept (CPI), determining the aims and purpose of the analysis, identifying concept uses, and defining attributes. This was achieved from a critical literature review of professional identity across health disciplines. Chiropractic-related model, borderline and contrary cases were used to exemplify characteristics of CPI. The antecedents required to inform CPI, consequences of having, and ways to measure the concept of CPI were evaluated. RESULTS From the concept analysis data, CPI was found to encompass six broad attributes or domains: knowledge and understanding of professional ethics and standards of practice, chiropractic history, practice philosophy and motivations, the roles and expertise of a chiropractor, professional pride and attitude, and professional engagement and interaction behaviours. These domains were not mutually exclusive and may overlap. CONCLUSION A conceptual definition of CPI may bring together members and groups within the profession and promote intra-professional understanding across other disciplines. The CPI definition derived from this concept analysis is: 'A chiropractor's self-perception and ownership of their practice philosophies, roles and functions, and their pride, engagement, and knowledge of their profession'.
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Affiliation(s)
- Tanja T Glucina
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand.
| | - Christian U Krägeloh
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Kirsten Spencer
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Kelly Holt
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
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Innes S, Goncalves G, Leboeuf-Yde C. Who are the chiropractic students favouring a limitless scope of practice? Exploring the relationship with personality, magical thinking, and academic achievement. Chiropr Man Therap 2022; 30:30. [PMID: 35879769 PMCID: PMC9310675 DOI: 10.1186/s12998-022-00440-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/28/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Some chiropractors seem to have an inflated belief in the powers of spinal manipulation (SMT), for example aiming at preventing future spinal degeneration and health problems, activities that are without supporting evidence. Non-evidenced health beliefs have been shown to be associated with a tendency toward magical thinking. Holding such beliefs about SMT is associated with a limitless scope of practice (LLSoP). Recent studies have shown that “chiropractic conservatism” (ChiroCon) is also associated with such approaches. We wanted to understand ChiroCon and these attitudes toward SMT by exploring three different factors: intolerance to uncertainty, academic achievement, and tendency toward magical thinking and how they relate to ChiroCon and LLSoP.
Method A cross-sectional survey of 243 chiropractic students from an Australian chiropractic program was conducted in May 2020. Students answered a questionnaire involving a patient case-scenario for LLSoP, levels of ChiroCon, validated questionnaires on (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. LLSoP was defined as wanting to treat with SMT a 5-year-old asymptomatic child for future (i) Musculoskeletal (MSK) problems and/or (ii) Non-musculoskeletal diseases. Logistic regression models were used to confirm if there was an association between ChiroCon and LLSoP and to explore associations between LLSoP and (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. We repeated the same analyses using ChiroCon as the outcome variable. Results We confirmed that chiropractic students in the more extreme ChiroCon group were more likely to want to prevent future spinal disorders in an asymptomatic 5-year-old child as compared to those with lower levels (OR = 3.9, (95%CI 1.97–7.72). This was also the case for the prevention of future diseases in the same child (OR = 6.9, (95%CI 3.11–15.06). Of the three predictor variables, magical belief was positively associated with both ChiroCon and LLSoP. Conclusion Not surprisingly, ChiroCon is closely related to LLSoP and both were linked to magical thinking. Therefore, the questionnaire ‘Magical Health Beliefs’ could be a useful instrument to screen future chiropractic students to prevent a mismatch between student and institution. Depending on the outlook of the school, some schools would welcome these students, whereas other institutions would want to avoid them in their education program. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00440-6.
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Affiliation(s)
- Stanley Innes
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia. .,Faculty of Allied Health & Wellbeing, University of Central Lancashire (UClan), Preston, UK.
| | - Guillaume Goncalves
- Institut Franco Européen de Chiropraxie, 24 Boulevard Paul Vaillant Couturier, 94200, Ivry-Sur-Seine, France.,Faculty of Allied Health & Wellbeing, University of Central Lancashire (UClan), Preston, UK
| | - Charlotte Leboeuf-Yde
- Department of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 5000, Odense, Denmark
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Axén I, Bergström C, Bronson M, Côté P, Nim CG, Goncalves G, Hébert JJ, Hertel JA, Innes S, Larsen OK, Meyer AL, O'Neill S, Perle SM, Weber KA, Young KJ, Leboeuf-Yde C. Misinformation, chiropractic, and the COVID-19 pandemic. Chiropr Man Therap 2020; 28:65. [PMID: 33208144 PMCID: PMC7672412 DOI: 10.1186/s12998-020-00353-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 11/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including 'stay-at-home' orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. MAIN TEXT During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. CONCLUSIONS Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.
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Affiliation(s)
- Iben Axén
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Intervention and Implementation Research for worker health, Stockholm, Sweden. .,The Norwegian Chiropractic Research Foundation "Et liv I Bevegelse", ELIB, Oslo, Norway.
| | - Cecilia Bergström
- Umeå University, Department of Clinical Sciences, Unit of Obstetrics and Gynecology, Umeå, Sweden
| | - Marc Bronson
- Evidence Based Chiropractic Network, Private practice, Kirkland Lake, Ontario, Canada
| | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Ontario, Canada
| | - Casper Glissmann Nim
- Spinecentre of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Jeffrey J Hébert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada.,Discipline of Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Perth, Australia
| | | | - Stanley Innes
- Discipline of Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Perth, Australia
| | | | | | - Søren O'Neill
- Spinecentre of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Stephen M Perle
- College of Health Sciences, School of Chiropractic, University of Bridgeport, Bridgeport, CT, USA
| | - Kenneth A Weber
- Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Systems Neuroscience and Pain Lab, Palo Alto, California, USA
| | - Kenneth J Young
- University of Central Lancashire, School of Sport and Health Sciences, Preston, UK
| | - Charlotte Leboeuf-Yde
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Emary PC, Oremus M, Houweling TAW, Wangler M, Akhtar-Danesh N. Attitudes, beliefs, and practices regarding medication prescribing for musculoskeletal conditions: a protocol for a national Q-methodology study of Swiss chiropractors. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2020; 64:119-130. [PMID: 33012811 PMCID: PMC7500235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Since 1995, chiropractors in Switzerland have been licensed to prescribe medications for treating musculoskeletal conditions. However, controversy remains over whether or not medication prescribing should be pursued within the chiropractic profession internationally. OBJECTIVE To assess Swiss chiropractors' attitudes, beliefs, and practices regarding their existing medication prescription privileges. METHODS A Q-methodology approach will be used to collect data for the assessment. In addition, scope expansion and frequency of prescribing by Swiss chiropractors will be queried using a 13-item questionnaire. Recruitment will be conducted by e-mail and all members of the Swiss Chiropractic Association will be eligible to participate. Data will be analyzed using by-person factor analysis and descriptive statistics. DISCUSSION This will be the first national update on attitudes toward prescribing medications among Swiss chiropractors since 2003, and the first using Q-methodology. The results of this study are important as they will inform future directions and research regarding chiropractic prescription rights.
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Affiliation(s)
- Peter C Emary
- PhD Student, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Adjunct Assistant Professor, Chiropractic Department, D'Youville College, Buffalo, NY, USA
- Private Practice, Cambridge, ON, Canada
| | - Mark Oremus
- School of Public Health and Health Systems, University of Waterloo
- Department of Health Research Methods, Evidence and Impact, McMaster University
| | | | | | - Noori Akhtar-Danesh
- School of Nursing, McMaster University
- Department of Health Research Methods, Evidence and Impact, McMaster University
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Innes SI, Leboeuf-Yde C, Walker BF. The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary. Chiropr Man Therap 2020; 28:40. [PMID: 32693804 PMCID: PMC7374969 DOI: 10.1186/s12998-020-00329-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Chiropractors see themselves as well positioned to provide safe, effective and economical care for the on-going financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world’s accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research. Main text We reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs’ educational standards and processes. Areas included a lack of definitions for key terms such as, ‘chiropractic’, ‘diagnosis’, and ‘competency’, without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a “big tent” approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is “unique”, highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to ‘traditional’ thinking. This has implications for public safety and patient quality of care. Conclusion If chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.
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Affiliation(s)
- Stanley I Innes
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.
| | - Charlotte Leboeuf-Yde
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.,Institute for Regional Health Research, University of Southern Denmark, DK-5000, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
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Emary PC, Lamont H, Taylor JA. Attitudes Toward Medication Prescription Rights: A Survey of Chiropractic Students and Faculty at D'Youville College. J Chiropr Med 2019; 18:286-298. [PMID: 32952474 PMCID: PMC7486473 DOI: 10.1016/j.jcm.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/22/2018] [Accepted: 01/16/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The purpose of this study was to ascertain the general attitudes of students and faculty in the chiropractic department of D'Youville College, Buffalo, New York, toward the inclusion of medication prescription rights in the chiropractic scope of practice. METHODS A 15-item questionnaire was adapted from a previous instrument used in assessing chiropractors' opinions toward medication prescription rights. Invitations were sent by e-mail to all 123 chiropractic students and faculty at D'Youville College in September 2018. Data were collected and analyzed using descriptive and inferential statistics. RESULTS A total of 113 questionnaires were completed for a 92% response rate. Ninety percent of respondents agreed that chiropractors should be authorized to prescribe medications such as over-the-counter and prescription-based analgesics, anti-inflammatories, and muscle relaxants. Respondents were less in favor of chiropractors prescribing opioids or having full prescribing rights. Over half indicated that their knowledge of musculoskeletal medications was high, whereas a similar number indicated that their knowledge of nonmusculoskeletal medications was low. Most respondents indicated that further education in pharmacology should be necessary for those in the profession wishing to prescribe medications. CONCLUSION Chiropractic students and faculty at D'Youville College endorsed expanding the chiropractic scope of practice to include limited medication prescription. Surveys and qualitative studies of students and faculty from other chiropractic educational institutions are warranted.
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Affiliation(s)
- Peter C. Emary
- Private Practice, Cambridge, Ontario, Canada
- Chiropractic Department, D'Youville College, Buffalo, New York
| | | | - John A. Taylor
- Chiropractic Department, D'Youville College, Buffalo, New York
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Goncalves G, Demortier M, Leboeuf-Yde C, Wedderkopp N. Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students. Chiropr Man Therap 2019; 27:3. [PMID: 30820316 PMCID: PMC6379950 DOI: 10.1186/s12998-018-0227-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 12/14/2018] [Indexed: 12/16/2022] Open
Abstract
Background While there is a broad spectrum of practice within chiropractic two sub-types can be identified, those who focus on musculoskeletal problems and those who treat also non-musculoskeletal problems. The latter group may adhere to the old conservative 'subluxation' model. The main goal of this study is to determine if chiropractic students with such conservative opinions are likely to have a different approach to determine contra-indications, non-indications and indications to chiropractic treatment versus those without such opinions. Method An anonymous and voluntary survey on 3rd to 6th year French chiropractic students was conducted between November 2017 and January 2018. Level of chiropractic conservatism (10 items) and the ability to determine contra-indications (2 cases), non-indications (4 cases) and indications (3 cases) were evaluated through a questionnaire. Answers to these cases were dichotomized into 'appropriate' and 'inappropriate' answers, as defined by previous research teams and the present team. The level of conservatism was classified into four groups, 'group 4' corresponding to the highest score. Descriptive data are provided, and bi- and multivariate analyses were performed through logistic regression to test the associations between the level of conservatism and the ability to determine the suitability of chiropractic treatment. Results In all, 359 of 536 (67%) students responded to the questionnaire. They generally recognized a number of contra-indications and indications to treatment. However, they found it more difficult to identify non-indications. The more conservative students were more likely to intend to treat their patients, even if this was irrelevant (non-indications). For example, those who were most conservative (group 4) were much more willing than those in group 1 to treat 'chiropractically' a 5-year-old child with no history of back pain or disease to prevent future back pain (OR = 14.7) and also to prevent non-musculoskeletal disease (OR = 22). Conclusion It is concerning that students who adhere to the subluxation model are prepared to 'operationalize' their conservative opinions in their future scope of practice; apparently willing to treat asymptomatic people with chiropractic adjustments. The determinants of this phenomenon need to be understood.
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Affiliation(s)
- Guillaume Goncalves
- CIAMS, University of Paris-Sud, University of Paris-Saclay, F- 91405 Orsay Cedex, France
- CIAMS, University of Orléans, F-, 45067 Orléans, France
- Institut Franco Européen de Chiropraxie, 24 boulevard Paul Vaillant Couturier, F- 94200, Ivry sur Seine, France
| | - Marine Demortier
- CIAMS, University of Paris-Sud, University of Paris-Saclay, F- 91405 Orsay Cedex, France
- CIAMS, University of Orléans, F-, 45067 Orléans, France
- Institut Franco Européen de Chiropraxie, 24 boulevard Paul Vaillant Couturier, F- 94200, Ivry sur Seine, France
| | - Charlotte Leboeuf-Yde
- CIAMS, University of Paris-Sud, University of Paris-Saclay, F- 91405 Orsay Cedex, France
- CIAMS, University of Orléans, F-, 45067 Orléans, France
- Institut Franco Européen de Chiropraxie, 24 boulevard Paul Vaillant Couturier, F- 94200, Ivry sur Seine, France
- Institute for Regional Health Research, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Niels Wedderkopp
- Institute for Regional Health Research, University of Southern Denmark, DK-5000 Odense, Denmark
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de Luca KE, Gliedt JA, Fernandez M, Kawchuk G, Swain MS. The identity, role, setting, and future of chiropractic practice: a survey of Australian and New Zealand chiropractic students. THE JOURNAL OF CHIROPRACTIC EDUCATION 2018; 32:115-125. [PMID: 29509506 PMCID: PMC6192485 DOI: 10.7899/jce-17-24] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE: To evaluate Australian and New Zealand chiropractic students' opinions regarding the identity, role setting, and future of chiropractic practice. METHODS: An online, cross-sectional survey was administered to chiropractic students in all chiropractic programs in Australia and New Zealand. The survey explored student viewpoints about the identity, role/scope, setting, and future of chiropractic practice as it relates to chiropractic education and health promotion. Associations between the number of years in the program, highest degree preceding chiropractic education, institution, and opinion summary scores were evaluated by multivariate analysis of variance tests. RESULTS: A total of 347 chiropractic students participated in the study. For identity, most students (51.3%) hold strongly to the traditional chiropractic theory but also agree (94.5%) it is important that chiropractors are educated in evidence-based practice. The main predictor of student viewpoints was a student's chiropractic institution (Pillai's trace =.638, F[16, 1368] = 16.237, p < .001). Chiropractic institution explained over 50% of the variance around student opinions about role/scope of practice and approximately 25% for identity and future practice. CONCLUSIONS: Chiropractic students in Australia and New Zealand seem to hold both traditional and mainstream viewpoints toward chiropractic practice. However, students from different chiropractic institutions have divergent opinions about the identity, role, setting, and future of chiropractic practice, which is most strongly predicted by the institution. Chiropractic education may be a potential determinant of chiropractic professional identity, raising concerns about heterogeneity between chiropractic schools.
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Innes SI, Leboeuf-Yde C, Walker BF. How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years. Chiropr Man Therap 2018; 26:8. [PMID: 29568484 PMCID: PMC5853152 DOI: 10.1186/s12998-018-0178-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 01/31/2018] [Indexed: 12/20/2022] Open
Abstract
Background Evidence suggests that a students’ beliefs already prior to entering a program may be important as a determinant in sustaining unsuitable health care beliefs. Our objectives were to investigate the proportion of Australian chiropractic students who hold non-evidence-based beliefs in the first year of study and the extent to which they may be involved in non-musculoskeletal health conditions. Finally, to see if this proportion varies over the course of the chiropractic program. Method In 2016, students from two Australian chiropractic programs answered a questionnaire on how often they would give advice on five common health conditions in their future practices as well as their opinion on whether chiropractic spinal adjustments could prevent or help seven health-related conditions. Results From a possible 831 students, 444 responded (53%). Students were highly likely to offer advice (often/quite often) on a range of non-musculoskeletal conditions. The proportions were lowest in first year and highest the final year. Also, high numbers of students held non-evidence-based beliefs about ‘chiropractic spinal adjustments’ which tended to occur in gradually decreasing in numbers in sequential years, except for fifth year when a reversal of the pattern occurred. Conclusions New strategies are required for chiropractic educators if they are to produce graduates who understand and deliver evidence-based health care and able to be part of the mainstream health care system. Electronic supplementary material The online version of this article (10.1186/s12998-018-0178-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stanley I Innes
- 1School of Health Professions, Murdoch University, Murdoch, Australia
| | - Charlotte Leboeuf-Yde
- 1School of Health Professions, Murdoch University, Murdoch, Australia.,Institut Franco-Européen de Chiropraxie, 94200 Ivry sur Seine, France.,3CIAMS, University Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France.,4CIAMS, Université d'Orléans, 45067 Orléans, France.,5Institute for Regional Health Research, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Bruce F Walker
- 1School of Health Professions, Murdoch University, Murdoch, Australia
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Innes SI, Leboeuf-Yde C, Walker BF. Chiropractic student choices in relation to indications, non-indications and contra-indications of continued care. Chiropr Man Therap 2018; 26:3. [PMID: 29387341 PMCID: PMC5778768 DOI: 10.1186/s12998-017-0170-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 12/20/2017] [Indexed: 01/11/2023] Open
Abstract
Background The quality of health care provider clinical decisions has long been recognized as variable. Research has focused on clinical decision making with the aim of improving patient outcomes. No studies have looked at chiropractic students´ abilities in this regard. Method In 2016, advanced students from two Australian chiropractic programs (N = 444) answered a questionnaire on patient case scenarios for neck and low back pain (LBP). We selected 7 scenarios representing the three categories; continuing care, non-indicated care, and contraindicated care. This represented a total of 21 tested scores. Comparisons of correct answers were made a) for program years 3, 4 and 5, and b) between the three categories of care. Results In almost 1/3 of scenarios, correct scores were 70% or greater. Best results were for two neck pain cases (simple and with spinal cord involvement). Continued care showed most improvements with study year. However, the scenarios that reflected non-indication for continued care had much worse results and did not improve in higher years. For the obvious contraindicated neck scenario, the results were good from the beginning and progressively improved and for a contraindicated LBP scenario the results started poorly in year 3 but improved over the program years. Conclusions Although student responses were generally good, there is still room for improvement, especially for non-indicated care. The quality of students’ clinical decisions can be measured and thus has the potential to be used by chiropractic educators and regulatory bodies to identify student’s in need of assistance as well as to monitor chiropractic programs in relation to student competence. Trial registration Not applicable. Electronic supplementary material The online version of this article (10.1186/s12998-017-0170-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stanley I Innes
- 1School of Health Professions, Murdoch University, Murdoch, Australia
| | - Charlotte Leboeuf-Yde
- 1School of Health Professions, Murdoch University, Murdoch, Australia.,Institut Franco-Européen de Chiropraxie, Ivry sur Seine, France.,3CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France.,4CIAMS, Université d'Orléans, 45067 Orléans, France.,5Institute for Regional Health Research, University of Southern Denmark, DK-5000 Odense C, Denmark
| | - Bruce F Walker
- 1School of Health Professions, Murdoch University, Murdoch, Australia
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Tollefson M, Wisneski L, Sayre N, Helton J, Matuszewicz E, Jensen C. Integrative Healthcare: An Exploration of Students Who Choose This Undergraduate Major. J Altern Complement Med 2015; 22:166-70. [PMID: 26595170 DOI: 10.1089/acm.2015.0219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Given the dearth of literature on this topic, the aim of this study was to understand who chooses to study integrative healthcare at an academic institution and why they choose to do so, the demographic characteristics of the student population, their background, and postgraduate plans. DESIGN A cross-sectional survey design. SETTING Data were collected at a large, urban, public university with a well-established undergraduate bachelor of science program in integrative healthcare. PARTICIPANTS A total of 105 declared integrative health undergraduate majors. MEASUREMENTS Online research software collected anonymous survey responses during a 2-month period. RESULTS Survey participants were more likely to be white and full-time students compared with the general undergraduate population. Many respondents discovered the integrative health major and then decided to enroll at the university. Most had used complementary and alternative medicine modalities, such as massage, yoga, and meditation. More than half of the survey participants were dissatisfied with conventional/Western medicine and its providers. Most respondents had a personal interest in complementary and alternative medicine and holistic health that influenced their decision to declare the major. Additionally, more than half of the respondents want to become a complementary and alternative medicine provider. Most survey participants plan to pursue postgraduate training/education in an integrative healthcare-related field. CONCLUSION Students who choose to study integrative healthcare in an undergraduate academic institution may mirror the patient population of complementary and alternative medicine practitioners. Their profile, rationale, exposures, intentions, and directions may be helpful to universities considering adding this type of program or postgraduate education programs in attracting new students to integrative health fields. It also informs existing integrative healthcare programs regarding program enhancement. A larger sample involving more integrative health academic institutions would be useful for a future study.
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Affiliation(s)
- Michelle Tollefson
- 1 Department of Health Professions, Metropolitan State University of Denver , Denver, CO
| | | | - Nancy Sayre
- 1 Department of Health Professions, Metropolitan State University of Denver , Denver, CO
| | - Jeffrey Helton
- 1 Department of Health Professions, Metropolitan State University of Denver , Denver, CO
| | - Emily Matuszewicz
- 1 Department of Health Professions, Metropolitan State University of Denver , Denver, CO
| | - Carol Jensen
- 1 Department of Health Professions, Metropolitan State University of Denver , Denver, CO
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Gliedt JA, Hawk C, Anderson M, Ahmad K, Bunn D, Cambron J, Gleberzon B, Hart J, Kizhakkeveettil A, Perle SM, Ramcharan M, Sullivan S, Zhang L. Chiropractic identity, role and future: a survey of North American chiropractic students. Chiropr Man Therap 2015; 23:4. [PMID: 25646145 PMCID: PMC4313466 DOI: 10.1186/s12998-014-0048-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 12/20/2014] [Indexed: 11/23/2022] Open
Abstract
Background The literature pertaining to chiropractic students’ opinions with respect to the desired future status of the chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single chiropractic college. This current study is an expansion of this pilot project to collect data from chiropractic students enrolled in colleges throughout North America. Objective The purpose of this study is to investigate North American chiropractic students’ opinions concerning professional identity, role and future. Methods A 23-item cross-sectional electronic questionnaire was developed. A total of 7,455 chiropractic students from 12 North American English-speaking chiropractic colleges were invited to complete the survey. Survey items encompassed demographics, evidence-based practice, chiropractic identity and setting, and scope of practice. Data were collected and descriptive statistical analysis was performed. Results A total of 1,247 (16.7% response rate) questionnaires were electronically submitted. Most respondents agreed (34.8%) or strongly agreed (52.2%) that it is important for chiropractors to be educated in evidence-based practice. A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes. A large number of respondents (55.2%) were not in favor of expanding the scope of the chiropractic profession to include prescribing medications with appropriate advanced training. Most respondents estimated that chiropractors should be considered mainstream health care practitioners (69.1%). Several respondents (46.8%) think that chiropractic research should focus on the physiological mechanisms of chiropractic adjustments. Conclusion The chiropractic students in this study showed a preference for participating in mainstream health care, report an exposure to evidence-based practice, and desire to hold to traditional chiropractic theories and practices. The majority of students would like to see an emphasis on correction of vertebral subluxation, while a larger percent found it is important to learn about evidence-based practice. These two key points may seem contradictory, suggesting cognitive dissonance. Or perhaps some students want to hold on to traditional theory (e.g., subluxation-centered practice) while recognizing the need for further research to fully explore these theories. Further research on this topic is needed. Electronic supplementary material The online version of this article (doi:10.1186/s12998-014-0048-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jordan A Gliedt
- Private Practice, 725 S. Dobson Rd, Suite 100, Chandler, AZ 85224 USA ; Logan University College of Chiropractic, 1851 Schoettler Rd, Chesterfield, MO 63017 USA
| | - Cheryl Hawk
- Logan University College of Chiropractic, 1851 Schoettler Rd, Chesterfield, MO 63017 USA
| | - Michelle Anderson
- Logan University College of Chiropractic, 1851 Schoettler Rd, Chesterfield, MO 63017 USA
| | - Kashif Ahmad
- Northwestern University of Health Sciences, 2501 W. 84th St, Bloomington, MN 55431 USA
| | - Dinah Bunn
- Northwestern University of Health Sciences, 2501 W. 84th St, Bloomington, MN 55431 USA
| | - Jerrilyn Cambron
- National University of Health Sciences, 200 E. Roosevelt Rd, Lombard, IL 60148 USA
| | - Brian Gleberzon
- Canadian Memorial College of Chiropractic, 6100 Leslie St, Toronto, Ontario Canada
| | - John Hart
- Sherman College of Chiropractic, 2020 Springfield Rd, Boiling Springs, SC 29316 USA
| | - Anupama Kizhakkeveettil
- Southern California University of Health Sciences, 16200 E. Amber Valley Dr., Whittier, CA 90604 USA
| | | | - Michael Ramcharan
- Texas Chiropractic College, 5912 Spencer Highway, Pasadena, TX 77505 USA
| | | | - Liang Zhang
- Palmer College of Chiropractic - Florida, 4777 City Center Parkway, Port Orange, FL 32129 USA
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Lorence J, Lawrence DJ, Salsbury SA, Goertz CM. Financial attitudes, knowledge, and habits of chiropractic students: A descriptive survey. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2014; 58:58-65. [PMID: 24587498 PMCID: PMC3924501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Our purpose was to describe the financial knowledge, habits and attitudes of chiropractic students. METHODS We designed a cross-sectional survey to measure basic financial knowledge, current financial habits, risk tolerance, and beliefs about future income among 250 students enrolled in business courses at one US chiropractic college. Descriptive statistical analyses were performed. RESULTS We received 57 questionnaires (23% response rate). Most respondents would accumulate over $125,000 in student loan debt by graduation. Financial knowledge was low (mean 77%). Most respondents (72%) scored as average financial risk takers. Chiropractic students reported recommended short-term habits such as having checking accounts (90%) and health insurance (63%) or paying monthly bills (88%) and credit cards (60%). Few saved money for unplanned expenses (39%) or long-term goals (26%), kept written budgets (32%), or had retirement accounts (19%). CONCLUSION These chiropractic students demonstrated inadequate financial literacy and did not engage in many recommended financial habits.
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Affiliation(s)
- Julie Lorence
- Doctoral student, Kinesiology and Community Health, University of Illinois, Huff Hall, 1206 S. Fourth Street, Champaign, IL 61820
| | - Dana J. Lawrence
- Senior Director, Center for Teaching and Learning, Interim Senior Director for Continuing Education and Events, Palmer College of Chiropractic, 1000 Brady Street, Davenport, IA 52803
| | - Stacie A. Salsbury
- Clinical Project Manager, Palmer Center for Chiropractic Research, Palmer College of Chiropractic. 741 Brady Street, Davenport, IA 52803
| | - Christine M. Goertz
- Vice Chancellor for Research and Health Policy, Palmer Center for Chiropractic Research, Palmer College of Chiropractic. 741 Brady Street, Davenport, IA 52803,
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Zhang N, Henderson CNR. Test anxiety and academic performance in chiropractic students. THE JOURNAL OF CHIROPRACTIC EDUCATION 2014; 28:2-8. [PMID: 24350946 PMCID: PMC3967645 DOI: 10.7899/jce-13-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Objective : We assessed the level of students' test anxiety, and the relationship between test anxiety and academic performance. Methods : We recruited 166 third-quarter students. The Test Anxiety Inventory (TAI) was administered to all participants. Total scores from written examinations and objective structured clinical examinations (OSCEs) were used as response variables. Results : Multiple regression analysis shows that there was a modest, but statistically significant negative correlation between TAI scores and written exam scores, but not OSCE scores. Worry and emotionality were the best predictive models for written exam scores. Mean total anxiety and emotionality scores for females were significantly higher than those for males, but not worry scores. Conclusion : Moderate-to-high test anxiety was observed in 85% of the chiropractic students examined. However, total test anxiety, as measured by the TAI score, was a very weak predictive model for written exam performance. Multiple regression analysis demonstrated that replacing total anxiety (TAI) with worry and emotionality (TAI subscales) produces a much more effective predictive model of written exam performance. Sex, age, highest current academic degree, and ethnicity contributed little additional predictive power in either regression model. Moreover, TAI scores were not found to be statistically significant predictors of physical exam skill performance, as measured by OSCEs.
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