Coping strategies and chiropractic student perceived stress

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.

Experiences and perspectives of chiropractic students graduating from an alternate admission track plan

Objective This study explored self-reported experiences of alternate admission track plan (AATP) students who completed a chiropractic training program at a US chiropractic college. Methods Our institution conducted semistructured exit interviews with 16 graduating AATP students. Our consensus-drafted open-ended interview questions probed in-depth for these students' experience throughout the training program, with national board exams, their personal characteristics, their satisfaction with the training program generally, and with the AATP program specifically. We employed a content analysis to identify themes and patterns of responses across the blinded deidentified interview transcripts. We used a combination of deductive coding based on our interview guides, and inductive coding to identify newly emerging subthemes. Results Perceived facilitators of student success were strong commitment to chiropractic, cooperative, and supportive environment (eg, student study groups and a highly committed faculty), work ethic, and time management skills. Although many recommended that AATP entrants without science backgrounds take prerequisite courses in biology and chemistry, they also observed that a capable student could dedicate the time and effort to obtain the needed information via available college resources. Conclusion Graduating AATP students were positive about the AATP program overall, and their preparation for national board exams and for clinical practice. They greatly valued the opportunity to accelerate their entrance into chiropractic college. A major limitation of this study is that the perspectives of AATP students who did not complete the doctor of chiropractic program are not represented in these interviews of graduating students.

A survey of chiropractic students' perceived business preparedness at graduation

Objective The objective of this study was to assess chiropractic college graduates' business experience, education, and need for further education at the time of graduation. Methods We conducted an anonymous survey of graduating chiropractic students in 2015 and 2016 regarding their prior business experience, business courses taken before and during chiropractic education, business abilities and needs, and practice plans. Results Eighty-one responded out of 114 surveyed (71% response rate). Less than half had taken college-level business courses or had business experience prior to entering chiropractic college. Almost 90% of respondents took 1 or more of 3 elective courses in business skills during their chiropractic education. Sixty-eight percent planned to work as an associate doctor and to be in private practice after 5 years. The respondents indicated that they were more prepared in the business abilities of ethics/risk management/jurisprudence, employee management, strategic planning, and marketing/advertising, and least prepared in business operations, accounting, and billing/reimbursement. In the areas of economics, finance, business taxes, and starting a practice, the respondents indicated a need for further education or experience. It was statistically significant (p < .001) that students who had prior business experience and/or college business education were more confident in operating a health care practice. Conclusion Chiropractic business education provides students with some of the practice management skills essential for operating a health care practice. Students with prior business experience and/or education reported more confidence in their ability to run a chiropractic practice immediately after graduation.

Educator's Learning Alignment Instrument (ELAI): A tool to assess aligned learning concepts within college courses

Objective To report the development and initial testing of a questionnaire designed to assess the concept of learning alignment within chiropractic college courses. Methods A 36-item questionnaire, Educator's Learning Alignment Instrument (ELAI), was created to evaluate how learning goals, course activities, and assessments align within a college course. Questionnaire development was informed by learning theories and tested using a 2-phased electronic survey mechanism among a chiropractic college faculty. Phase 1 included completing the ELAI for a currently implemented course. Phase 2 included questions about confidential reports generated from ELAI data. Results Thirty-one of 46 (67%) respondents completed an ELAI. Twelve (38%) participated in phase 2. Twenty-one (68%) courses demonstrated consistent learning focus across goals, activities, and assessments. Aggregate data from early, middle, and late chiropractic program courses revealed progressive shifts toward higher-level learning. Eighty-seven percent of courses contained 1 or more individual learning areas with potentially misaligned goals, activities, or assessment. Ninety-seven percent of respondents completed ELAI questions within 20 minutes. Most (87%) phase 2 respondents noted the report accurately reflected the course. Sixty-seven percent of phase 2 respondents agreed that confidential reports provided useful information to inform course design. Conclusion The ELAI is a nonburdensome instrument that can facilitate faculty reflection on how aligned learning concepts are applied in a course and provide novel data to assess general learning focus within college courses and within programs. Results indicate ELAI questions can be revised to improve clarity. Additional research comparing ELAI responses from experts, peer educators, and students is recommended.

Can formative quizzes predict or improve summative exam performance?*

Objective Despite wide use, the value of formative exams remains unclear. We evaluated the possible benefits of formative assessments in a physical examination course at our chiropractic college. Methods Three hypotheses were examined: (1) Receiving formative quizzes (FQs) will increase summative exam (SX) scores, (2) writing FQ questions will further increase SE scores, and (3) FQs can predict SX scores. Hypotheses were tested across three separate iterations of the class. Results The SX scores for the control group (Class 3) were significantly less than those of Classes 1 and 2, but writing quiz questions and taking FQs (Class 1) did not produce significantly higher SX scores than only taking FQs (Class 2). The FQ scores were significant predictors of SX scores, accounting for 52% of the SX score. Sex, age, academic degrees, and ethnicity were not significant copredictors. Conclusion Our results support the assertion that FQs can improve written SX performance, but students producing quiz questions didn't further increase SX scores. We concluded that nonthreatening FQs may be used to enhance student learning and suggest that they also may serve to identify students who, without additional remediation, will perform poorly on subsequent summative written exams.

Correlation between academic performance and NBCE part I scores at a chiropractic college

Objective This study investigates the association between pre-National Board assessments and National Board Part 1 scores (NBCE) at a chiropractic college. Methods A convenience sample of 24 students enrolled in the doctor of chiropractic degree program was recruited for the study. These were 6th and 7th quarter students who had registered to take NBCE in March 2011. Each student's class scores were computed and average numeric means score derived. Subject clusters that make up testable subject categories in NBCE also were computed to obtain a single numeric mean score. Pretests were administered in all areas tested in NBCE. Results were compared to the student's scores in NBCE using correlation and multiple linear regression for 14 predictors and one response variable (NBCE). Results Among the 14 correlations for 19 students (due to missing data when running the correlation matrix), six were moderate-to-strong and statistically significant. Two predictors qualified for multiple linear regression (where n = 22): mean anatomy and mean chemistry, both of which revealed similar regression coefficients. Conclusion Mean anatomy and mean chemistry scores were shown to be the best predictors of NBCE Part 1 results in this sample.