Chiropractic student diagnosis and management of headache disorders: A survey examining self-perceived preparedness and clinical proficiency

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.

Characteristics of chiropractic patients treated at the University of Johannesburg chiropractic student clinic and relevance to the educational process

Objective This study aimed to analyze the demographic and descriptive information of new patients presenting to an educational institution–based chiropractic student clinic in South Africa that could then be used to draw comparisons to other international chiropractic student clinics and local practices. Methods We conducted a retrospective descriptive study of all new patient files from January 1, 2016, to July 31, 2016. The variables extracted were age, health profiles, number of musculoskeletal complaints, treatment protocol, and number of treatments that patients received for the initial complaint. Data were analyzed using cross-tabulations and multidimensional χ2 tests. Results There were 865 files reviewed. Most patients were aged between 20 and 24 years. Lumbar and pelvic complaints were most common (42.2%), followed by the cervical spine (28%). Lumbar (18.8%) and cervical (16.8%) biomechanical conditions, followed by lumbar myofascial pain syndrome (7.6%), were the most common problems. Musculoskeletal conditions were reported in 99% of cases. The majority (80%) of patients received 9 or fewer treatments for their initial complaint. Manipulation was used in 93.9% of cases, followed by mobilization (8.8%), interferential current (23.5%), and dry needling (19.1%). Conclusions Data gathered suggest that there are some general similarities with international training institutions. There are also differences between the study sample and international institutions and South African private chiropractic practice. The dissimilarities were a younger patient population, a lower number of treatment visits, and low exposure to nonmusculoskeletal conditions. These differences may affect the breadth of student education and require further investigation.

Provider–Patient Interaction: Exploring Elderspeak in Simulated Preclinical Chiropractic Student Encounters

Objective: The purpose of this study was to identify whether or not elderspeak was evident in simulated provider–patient encounters in a chiropractic education program. This study was designed to answer the following three research questions (RQs): RQ 1: Is elderspeak present in simulated patient encounters in a chiropractic education program? RQ 2: If elderspeak is present, which categorization of elderspeak is most frequently used during simulated patient encounters? RQ 3: If elderspeak is present, is gender an influencing variable? Method: The presence of elderspeak in simulated chiropractic encounters was studied using a cross-sectional mixed methods observational research design. Results: A total of 331 occurrences of elderspeak were identified in 60 digitized recordings. The most common form of elderspeak was collective pronoun usage. Conclusion: Results indicated that the chiropractic industry is susceptible to elderspeak. Understanding elderspeak is important to prevent future ageist behaviors from affecting older adult patients and to improve their health outcomes.

A mixed-method study of chiropractic student clinical immersion placements in nonmetropolitan Western Australia: Influence on student experience, professional attributes, and practice destination

Objective: To explore the influence of nonmetropolitan clinical immersion placements (CIPs) on undergraduate chiropractic student experience, professional attributes, and practice destination. Methods: Students enrolled in an Australian undergraduate chiropractic program were invited to complete a service experience questionnaire and an open-ended reflective feedback form following a nonmetropolitan CIP (Part A). Online searches were performed to gather data on graduate practice location (Part B). Results: Sixty-four students participated in Part A. All agreed that the placement was educational and should be retained in the program. Students agreed that the placement enhanced respect for individuals and awareness of others in need, highlighted the importance of respect for all people, improved empathy for the disadvantaged, and provided an opportunity to improve communication skills. Most indicated that they were more likely to practice in a country setting as a result of their placement, with those participating in a country placement more likely to practice in nonmetropolitan regions after graduation. Conclusion: Many chiropractic programs around the world are adopting CIPs. This study is the 1st to investigate the possible influence of nonmetropolitan CIPs on the development of desirable attributes in Australian chiropractic students. It also discusses the potential influence of nonmetropolitan CIPs on future practice location decisions. These results support the utility of CIPs to help meet the educational objectives of chiropractic programs and possibly address the maldistribution of the chiropractic workforce in Australia.

Engagement as predictors of performance in a single cohort of undergraduate chiropractic students

Objective: To investigate the potential association of novel academic and nonacademic factors with chiropractic student academic performance. Methods: Students enrolled into year 1 of a chiropractic master's degree (MChiro) at our college were selected for this study. Data collected included demographics, attendance, virtual learning environment use, additional learning needs, previous degree qualifications, and summative marks. Differences between students who had to take an examination more than once (resit) and nonresit students were explored using t test and χ2 analysis. Relationships between attendance and end-of-year marks were explored using regression analysis. Results: Male students outperformed female students in four of the six units and as the total year average. Students who attended <80% of classes were more likely to have a resit in one or more units (relative risk [RR] = 2.6; 95% confidence interval [CI], 1.4–4.9). Students who performed poorly (<70%) in the semester 1 unit of a course on human structure and failed the semester 1 practical assessment of a course on clinical management were significantly more likely to have one or more resit assessments in semester 2 units (RR = 3.5 [95% CI, 2.2–5.7]; RR = 3.2 [95% CI, 2.0–4.9]). Attendance and unit 105 were independent predictors of one or more resits at the end-of-year (R2 = 0.86, p < .001). Conclusion: Attendance and first semester summative marks were associated with end-of-year performance. As such, these markers of performance may be used to flag struggling students in the program.

Chiropractic student attitudes toward team-based learning

Objective: The purpose of this study was to measure chiropractic student attitudes toward team-based learning (TBL) to determine if they are similar to those of medical students and to help clarify existing evidence regarding student perceptions of TBL. Method: Two consecutive cohorts of chiropractic students enrolled in a course that used weekly TBL activities completed an adaptation of the value of teams survey at the end of the term. Chi square analysis was used to assess for differences in scores between the beginning and end of the term. Results: The students did value the TBL process (χ2 = 75.21, p < .001). Students had a neutral opinion regarding TBL at the start of the term (χ2 = 30.41, p < .001), but their opinion of TBL improved by the end of the term (χ2 = 51.66, p < .001). Conclusion: These results were similar to those found in medical education studies. Students tended to value TBL, but they were more receptive to it over time.

Prevalence of nonmusculoskeletal versus musculoskeletal cases in a chiropractic student clinic

Objective We sought to identify the percentage of nonmusculoskeletal and musculoskeletal conditions treated by interns in the National University of Health Sciences (NUHS) Student Clinic compared to chiropractic and allopathic health care professionals. Methods The information gathered was taken from the charts of patients treated in the fall trimester, dated September 12, 2011 through December 9, 2011. The data collected included ICD-9 codes for the conditions treated, the number of patient visits, age, and gender, and was evaluated using Microsoft Excel. Results Over half of the 113 eligible patients were women with a mean patient age of 28 years, an average of three treated diagnoses, and a mean of seven treatments. Those treated only for musculoskeletal conditions totaled 52% of the patients; 48% of the patients were treated for nonmusculoskeletal conditions, or musculoskeletal plus nonmusculoskeletal conditions. Conclusion The NUHS Student Clinic interns are treating a greater percentage of nonmusculoskeletal conditions and a lesser percentage of musculoskeletal conditions than practicing chiropractic physicians. The student interns also treat a lesser percentage of nonmusculoskeletal and a greater percentage of musculoskeletal conditions than allopathic practitioners. This comparison would suggest that NUHS is nearing its institutional goal of training its student interns as primary care practitioners.