scholarly journals A perspective on Councils on Chiropractic Education accreditation standards and processes from the inside: a narrative description of expert opinion, part 2: Analyses of particular responses to research findings

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Stanley I. Innes ◽  
Vicki Cope ◽  
Charlotte Leboeuf-Yde ◽  
Bruce F. Walker
Keyword(s):  
Historical Context ◽  
Evidence Based ◽  
Structured Interviews ◽  
Extensive Experience ◽  
Accreditation Standards ◽  
Expert Opinions ◽  
Chiropractic Education ◽  
Chiropractic Practice ◽  
Mainstream Healthcare ◽  
Assessment Of Student Learning

Abstract Background This is the second article reporting on a study that sought the views of people with extensive experience in Councils on Chiropractic Education (CCEs) on research that has raised concerns about variability in accreditation standards and processes for chiropractic programs (CPs) and chiropractic practice in general. Methods This qualitative study employed in-depth semi-structured interviews that consisted of open-ended questions asking experts about their thoughts and views on a range of issues surrounding accreditation, graduate competency standards and processes. The interviews were audio-recorded, and transcribed verbatim in June and July of 2018. The transcripts were reviewed to develop codes and themes. The study followed the COREQ guidelines for qualitative studies. Results The interviews revealed that these CCE experts were able to discern positive and negative elements of the accreditation standards and processes. They were, in general, satisfied with CCEs accreditation standards, graduating competencies, and site inspection processes. Most respondents believed that it was not possible to implement an identical set of international accreditation standards because of cultural and jurisdictional differences. This was thought more likely to be achieved if based on the notion of equivalence. Also, they expressed positive views toward an evidence-based CP curriculum and an outcomes-based assessment of student learning. However, they expressed concerns that an evidence-based approach may result in the overlooking of the clinician’s experience. Diverse views were found on the presence of vitalism in CPs. These ranged from thinking vitalism should only be taught in an historical context, it was only a minority who held this view and therefore an insignificant issue. Finally, that CCEs should not regulate these personal beliefs, as this was potentially censorship. The notable absence was that the participants omitted any mention of the implications for patient safety, values and outcomes. Conclusions Expert opinions lead us to conclude that CCEs should embrace and pursue the widely accepted mainstream healthcare standards of an evidence-based approach and place the interests of the patient above that of the profession. Recommendations are made to this end with the intent of improving CCE standards and processes of accreditation.

scholarly journals A perspective on Chiropractic Councils on Education accreditation standards and processes from the inside: a narrative description of expert opinion, part 1: Themes

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Stanley I. Innes ◽  
Vicki Cope ◽  
Charlotte Leboeuf-Yde ◽  
Bruce F. Walker
Keyword(s):  
Interest Groups ◽  
Structured Interviews ◽  
The Public ◽  
Accreditation Standards ◽  
Chiropractic Education ◽  
Chiropractic Practice ◽  
The Family ◽  
Key Informant ◽  
Research Findings ◽  
Use Of Expertise

Abstract Background The aim of this study was to report on key informant opinions of Councils on Chiropractic Education (CCE) regarding recent research findings reporting on improving accreditation standards and processes for chiropractic programs (CPs). Methods This qualitative study employed in-depth semi-structured interviews with key experienced personnel from the five CCEs in June and July of 2018. The interviews consisted of open-ended questions on a range of issues surrounding accreditation, graduate competency standards and processes. All interviews were audio-recorded, and transcribed verbatim. The transcripts were analysed to develop codes and themes using thematic analysis techniques assisted by NVivo coding software. The study followed the COREQ guidelines for qualitative studies. Results Six themes were isolated from the interview transcripts; they were: professional differences; keep it in the family; to focus on outcomes or be prescriptive?; more resources please; inter-profession integration; and CPs making ends meet. Most respondents saw a need for CCEs standards and processes to improve interdisciplinarity while at the same time preserving the ‘uniqueness’ of chiropractic. Additionally, informants viewed CCEs as carrying out their functions with limited resources while simultaneously dealing with vocal disparate interest groups. Diverse views were observed on how CCEs should go about their business of assessing chiropractic programs for accreditation and re-accreditation. Conclusions An overarching confounder for positive changes in CCE accreditation standards and processes is the inability to clearly define basic and fundamental terms such as ‘chiropractic’ and its resultant scope of practice. This is said to be because of vocal, diverse and disparate interest groups within the chiropractic profession. Silence or nebulous definitions negotiated in order to allow a diversity of chiropractic practice to co-exist, appears to have complicated and hindered the activities of CCEs. Recommendations are made including an adoption of an evidence-based approach to accreditation standards and processes and the use of expertise from other health professions. Further, the focus of attention should be moved away from professional interests and toward that of protection of the public and the patient.

scholarly journals A failed review of CCE site inspection standards and processes

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Stanley I. Innes ◽  
Charlotte Leboeuf-Yde ◽  
Bruce F. Walker
Keyword(s):  
Educational Research ◽  
Quality Standards ◽  
Educational Programs ◽  
Quality Improvements ◽  
High Quality ◽  
Accreditation Standards ◽  
Chiropractic Education ◽  
Chiropractic Practice ◽  
Similarities And Differences

Abstract Background Accreditation of educational programs involves an independent agency assessing quality against a set of defined standards. Site inspection teams are appointed by an accrediting agency and compile a report with the intention of identifying deficiencies and making recommendations for their rectification and continued improvement. For chiropractic programs accreditation is carried out by Councils on Chiropractic Education (CCEs). However, the reliability of their site inspection teams remains unknown. Recent research has suggested that variability in chiropractic practice may be partially traced back to the education provider. This raises the possibility of deficient accreditation procedures that may include unsatisfactory site inspection standards or processes or the accreditation standards by which they work to. We sought to compare the various CCEs documented standards and processes for site inspection teams for similarities and differences with the intent of making recommendations to create uniform and high quality standards. Further, we sought to compare a sample of CCEs site inspection team surveys / reports for commonly identified recommendations and quality improvements and determine if they are adequately described in their accreditation standards. Method In December of 2018 invitation emails were sent to 4 CCEs through their website portals outlining a proposed study investigating site inspection teams’ standards and processes. Access was requested to all appropriately redacted documentation relating to site inspection teams and their chiropractic program reports. Follow up emails were sent several weeks later. Results Only one of four of the CCEs responded by providing the requested information. Conclusion and recommendations Three CCEs did not cooperate with this educational research. The possible reasons for the non-engagement is discussed.

scholarly journals Perceptions, beliefs, and needs of Japanese people with knee osteoarthritis during conservative care: A qualitative study

2021 ◽  
Author(s):  
Daisuke Uritani ◽  
Akane Ikeda ◽  
Toru Shironoki ◽  
Kentaro Matsubata ◽  
Yuto Mutsura ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Japanese Patients ◽  
Interview Data ◽  
Evidence Based ◽  
Theory Approach ◽  
Structured Interviews ◽  
Japanese People ◽  
Extensive Experience ◽  
Conservative Care ◽  
Knee Oa

Abstract Background Patients’ perceptions and beliefs of disease could be influenced by their lifestyle and culture. Although it is important to understand their perceptions and beliefs toward disease to prevent and manage osteoarthritis (OA) through conservative care, this topic has not been investigated in Japanese people with knee OA. Therefore, this qualitative study aims to clarify how Japanese patients with knee OA experience and perceive their symptoms and disabilities, and how they face them during conservative care.Methods Participants were recruited by purposive sampling. Face-to-face, semi-structured interviews were conducted with nine patients (2 men and 7 women, mean age, 74.3±5.5 years) with knee OA until data saturation was reached. Interview data comprised participants’ accounts of particular personal experiences of living with knee OA, including their perceptions and attitudes toward knee OA-related symptoms and disabilities. Two physiotherapists (one with extensive experience conducting qualitative studies) and four physiotherapy students conducted the interviews. Recorded interview data were transcribed verbatim in Japanese. Data analysis, including developing a coding scheme, was conducted based on a grounded theory approach. Results Six categories were extracted from the data: “self-analysis on the cause of knee OA,” “difficulties in daily life due to knee symptoms,” “psychological barrier,” “how to deal with knee pain and difficulty in moving,” “importance of connecting with others,” and “information considered useful to cope with knee OA.” Japanese patients with knee OA desired evidence-based information and to connect with other people in the same situation to solve problems related to their condition. Conclusions To address patients’ concerns, medical professionals should carry out careful interviews and obtain information regarding patients’ past experiences, and understand their experiences related to knee OA. Symptoms and difficulties experienced by patients with knee OA should be managed by evidence-based information integrating their perceptions and beliefs toward knee OA.

scholarly journals In memoriam of Alan H. Adams, DC, MS, MSEd:

2021 ◽  
Author(s):  
Claire D. Johnson ◽  
Bart N. Green ◽  
Ian D. Coulter ◽  
Scott Haldeman DC ◽  
Eric L. Hurwitz ◽  
...  
Keyword(s):  
Education Research ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Early Adopter ◽  
Collaborative Relationships ◽  
Scientific Careers ◽  
Chiropractic Education ◽  
Chiropractic Practice ◽  
In Memoriam ◽  
Based Medicine

In this paper we pay homage to Dr Alan H. Adams, who was born on November 3, 1945, and passed away on December 26, 2020. An early adopter of problem-based learning and evidence-based medicine, he contributed substantially to improving chiropractic education, research, and developing an evidence-based practice mindset for chiropractic practice. People who knew Al best recall that he was a fluent instigator of collaborative relationships, and he inspired and advanced many people in their academic and scientific careers. His curiosity, expertise, and mentorship were appreciated by many people and developed numerous interprofessional collaborations.

Contextualizing Discrimination of Religious and Linguistic Minorities in South Thailand

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Christopher Mark Joll
Keyword(s):  
High Tide ◽  
Historical Context ◽  
Historical Analysis ◽  
Second World War ◽  
Evidence Based ◽  
Relative Importance ◽  
World War ◽  
Intractable Conflict ◽  
Comparative Historical Analysis ◽  
Second World

Abstract This article explores how scholarship can be put to work by specialists penning evidence-based policies seeking peaceful resolutions to long-standing, complex, and so-far intractable conflict in the Malay-Muslim dominated provinces of South Thailand. I contend that more is required than mere empirical data, and that the existing analysis of this conflict often lacks theoretical ballast and overlooks the wider historical context in which Bangkok pursued policies impacting its ethnolinguistically, and ethnoreligiously diverse citizens. I demonstrate the utility of both interacting with what social theorists have written about what “religion” and language do—and do not—have in common, and the relative importance of both in sub-national conflicts, and comparative historical analysis. The case studies that this article critically introduces compare chapters of ethnolinguistic and ethnoreligious chauvinism against a range of minorities, including Malay-Muslim citizens concentrated in the southern provinces of Pattani, Yala, and Narathiwat. These include Buddhist ethnolinguistic minorities in Thailand’s Northeast, and Catholic communities during the second world war widely referred to as the high tide of Thai ethno-nationalism. I argue that these revealing aspects of the southern Malay experience need to be contextualized—even de-exceptionalized.

scholarly journals Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christine W. Hartmann ◽  
Ryann L. Engle ◽  
Camilla B. Pimentel ◽  
Whitney L. Mills ◽  
Valerie A. Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Evidence Based ◽  
National Program ◽  
Extensive Experience ◽  
Evidence Based Practices ◽  
Team Members ◽  
Virtual Experience ◽  
Key Points ◽  
Program Content

Abstract Background Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program. Model and recommendations Success in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program. Summary These principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

scholarly journals Anxiety in autistic individuals who speak few or no words: A qualitative study of parental experience and anxiety management

Autism ◽  
2020 ◽  
pp. 136236132096236
Author(s):  
Joanne Tarver ◽  
Effie Pearson ◽  
Georgina Edwards ◽  
Aryana Shirazi ◽  
Liana Potter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Language Use ◽  
Management Strategies ◽  
Assessment Tools ◽  
Evidence Based ◽  
Structured Interviews ◽  
Verbal Language ◽  
Parental Recognition

Anxiety is a common co-occurring condition in autism and impacts quality of life of autistic individuals and their families; autistic individuals who speak few or no words represent an under-researched group. This qualitative study aimed to understand more about parental recognition and management of anxiety in autistic individuals who speak few or no words. Semi-structured interviews were conducted with parents/carers of 17 autistic individuals (mage = 14.29) recruited from an existing participant database and social media adverts. Using thematic analysis, 15 themes were placed under three a-priori grand themes: parental recognition of anxiety; parental management of anxiety; and anxiety impact on the autistic individual and their family. Due to reduced verbal language use and overlap with other behaviours, parents described difficulties recognising anxiety in their child. However, they also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. The findings of this study can help to inform the development of targeted intervention and assessment measures for anxiety in autistic individuals who speak few or no words. Lay abstract Anxiety is a common condition in autistic individuals, including those who also have an intellectual disability. Despite this, autistic individuals who have severe to profound intellectual disability, or use few or no words, are often excluded from autism research. There are also very few assessment tools and interventions with known effectiveness for autistic individuals with intellectual disability. In this study, we aimed to learn more about parent/carers experiences of recognising and managing anxiety in autistic individuals who use few or no words. We conducted semi-structured interviews with parents and carers to address three research questions: (1) what techniques and management strategies do parents describe for anxiety-related behaviour in their child; (2) how do communication difficulties impact parental understanding and management of anxiety provoking situations and behaviours; (3) what is the impact of anxiety-related behaviours on the quality of life of autistic individuals and their families? During the interviews, parents described difficulties recognising anxiety in their child, mostly due to reduced verbal language use and anxiety behaviours overlapping with other behaviours (e.g. autism characteristics). However, parents also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. We will use the findings of this study to inform future research to develop assessment tools and interventions for anxiety in autistic individuals who use few or no words.

scholarly journals Educator Perceptions of the Evidence-Based Teaching Model in Undergraduate Athletic Training Education

2011 ◽  
Vol 6 (2) ◽  
pp. 76-87 ◽  
Author(s):  
Sarah A. Manspeaker ◽  
Bonnie L. Van Lunen ◽  
Paula S. Turocy ◽  
Shana Pribesh ◽  
Dorice Hankemeier
Keyword(s):  
Athletic Training ◽  
Direct Interaction ◽  
Time Frame ◽  
Teaching Model ◽  
Evidence Based ◽  
Structured Interviews ◽  
Therapeutic Modalities ◽  
Academic Courses ◽  
Patient Health ◽  
New Perspective

Context: While research recommends that health professions expand the instruction and use of evidence-based practice (EBP) due to the individualized approach to patient health care, few examples of the incorporation of EBP into academic courses exist in athletic training. Objective: To evaluate educators' perceptions of the Evidence-Based Teaching Model (EBTM) as a strategy to introduce EBP concepts to athletic training (AT) students. Design: Qualitative program evaluation including semi-structured interviews. Setting: Institutions that sponsor CAATE-accredited professional undergraduate programs. Participants: Stratified purposeful sampling of 9 experienced educators (2 males, 7 females; average years teaching 8 ± 5 years) teaching therapeutic modalities or rehabilitation were trained in the EBTM and interviewed regarding their experience. Measures: Educators' experiences regarding implementation of the EBTM. Coded categories were triangulated via member checks and peer review to establish trustworthiness of the findings. Results: Educators valued the EBTM as a method to implement evidence-based concepts within a short time frame in their course, and perceived it as a user-friendly and effective teaching tool. Assignments requiring direct interaction between students and clinical instructors were considered most favorable. Training materials provided educators with a new perspective of how to implement EBP at the professional level. Conclusions: Implementation of the EBTM helped educators attain their goals of expanding evidence-based concepts within professional undergraduate curricula and increasing student and clinical instructor interaction. Overall, the EBTM provided a mechanism to begin incorporation of EBP concepts in athletic training curricula.

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