Perceptions and attitudes of University of Johannesburg chiropractic students toward a blended learning approach and a shift to an e-learning approach necessitated by the COVID-19 pandemic

ABSTRACT Objective This study aimed to explore and compare the perceptions and attitudes of chiropractic students on a blended learning offering in 2019 and a subsequent shift to an e-learning approach in 2020 owing to the COVID-19 pandemic. Methods This was an exploratory descriptive study of 4th-year BHSc chiropractic students enrolled in the Clinical and Applied Biomechanics IV module in 2019 (n = 31) and 2020 (n = 33). The survey used close-ended Likert scale questions collected from 29 July to 14 August 2020. Data were analyzed using frequencies and descriptions, exploratory factor analysis, and reliability. Trends and interrelationships of and between student attitude, satisfaction, social influences, ease of use, accessibility, and effectivity were investigated for each year and compared between successive years' cohorts. Results Students were mostly female (76.6%), aged 20 to 24 years (84.4%). Although both cohorts showed similar positive attitudes, accessibility, and satisfaction levels, the e-learning group showed increased effectivity (p = .016) and ease of use (p = .038) compared with the blended learning cohort. Face-to-face time with the lecturer was shown to be more important to the blended learning cohort (p = .006). Strong correlations were demonstrated in both cohorts between accessibility and satisfaction with attitude, effectivity, and ease of use. Conclusion Findings suggest that students were more receptive to an e-learning approach than they may have been in the past. This may be as a direct consequence of the response to COVID-19, and the adapted offerings of the curriculum.

Examining the validity of chiropractic grade point averages for predicting National Board of Chiropractic Examiners Part I exam scores

ABSTRACT Objective The main objective of this study was to evaluate the validity of grade point average (GPA) for predicting the National Board of Chiropractic Examiners (NBCE) Part I exam scores using chiropractic GPA. Methods Data were collected during the January 2019 computer-based testing administration of the NBCE's Part I exam. The sample size was n = 2278 of test takers from 18 domestic and 4 international chiropractic educational institutions. Six regression models were developed and tested to predict the Part I domain scores from chiropractic GPA while controlling for self-reported demographic variables. Residuals from the models were disaggregated by pre–chiropractic GPA. Results Chiropractic GPA revealed a positive, statistically significant correlation with sex. The chiropractic GPA was found to be a significant predictor of the Part I domain scores. A different perspective was obtained when residuals (observed minus predicted) were collected and split by the pre–chiropractic GPA. Very good students tended to be underpredicted, while other students were overpredicted. Conclusion This study builds on the cascading evidence from educational literature by providing additional results suggesting that undergraduate (prechiropractic) GPA as well as the GPA obtained in doctor of chiropractic programs are related to the future performance on the NBCE Part I exam. The results provide a first glance at the connection between the standardized test scores, which are often used for instructors' and institutional evaluation and the GPA obtained in a doctor of chiropractic program.

Going Beyond Grades: Online Learning Assessment: Chiropractic Educators Research Forum (CERF), June 26, 2021

This conference was convened by the Chiropractic Educators Research Forum (CERF) on June 26, 2021. This meeting provided a forum for the presentation of scholarly works in education theory and practice. The conference specifically focused on research related to education and learning assessment. During the June 2021 CERF meeting, presenters and panelists took an in depth look at how programs assess learning, including both summative and formative assessments, either live or asynchronously through technology or the internet.

Assessing attitudes of patient-centered care among chiropractic students at a South African university

Objective Patient-centered care (PCC) is acknowledged globally as a foundation of quality patient care and key to doctor–patient rapport. Student attitudes toward PCC have been assessed in some health professions and some international chiropractic institutions but is lacking in the South African chiropractic student context. This study explores this concept and compares these attitudes to other student groups. Methods A cross-sectional survey was conducted on chiropractic students (years 1, 3, 5, and 6) at a South African institution. The 18-item Patient–Practitioner Orientation Scale (PPOS), with scoring 1–6 on a Likert scale, was used to evaluate the attitude toward PCC by students. Higher scores were representative of more patient-centeredness. Variables were analyzed to assess for associations between variables. Mean PPOS scores were calculated, and reliability and validity were tested using Cronbach α and factor analysis. Results There were 100 respondents (68% response rate). The PPOS showed unsatisfactory reliability in our sample. The mean scores for the overall PPOS were 3.64 (SD = 0.46), the sharing subscale was 2.99 (SD = 0.61), and the caring subscale was 4.29 (SD = 0.58). There were small but suggestive trends noticed in PPOS scores based on age, sex, and year of study. Conclusions Chiropractic students from our university showed a general positive tendency toward PCC with no association between age and year of study. Sex showed some suggestive descriptive trends contrary to findings in other studies. The PPOS showed poor reliability in this study, warranting consideration with its use in similar contexts.

Looking back at the lawsuit that transformed the chiropractic profession: Overview

The purpose of this paper is to provide a brief overview of Looking Back at the Lawsuit That Transformed the Chiropractic Profession, which is a series of 8 research papers that explore the historical events surrounding the Wilk v American Medical Association lawsuit and how these events may have had an influence on the chiropractic profession.

Looking back at the lawsuit that transformed the chiropractic profession part 2: Rise of the American Medical Association

Objective This paper is the second in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated anti-trust law by restraining chiropractors' business practices. The purpose of this paper is to provide a brief review of the history of how the AMA rose to dominate health care in the United States, and within this social context, how the chiropractic profession fought to survive in the first half of the 20th century. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the second of the series that explores the growth of medicine and the chiropractic profession. Results The AMA's code of ethics established in 1847 continued to direct organized medicine's actions to exclude other health professions. During the early 1900s, the AMA established itself as “regular medicine.” They labeled other types of medicine and health care professions, such as chiropractic, as “irregulars” claiming that they were cultists and quacks. In addition to the rise in power of the AMA, a report written by Abraham Flexner helped to solidify the AMA's control over health care. Chiropractic as a profession was emerging and developing in practice, education, and science. The few resources available to chiropractors were used to defend their profession against attacks from organized medicine and to secure legislation to legalize the practice of chiropractic. After years of struggle, the last state in the US legalized chiropractic 79 years after the birth of the profession. Conclusion In the first part of the 20th century, the AMA was amassing power as chiropractic was just emerging as a profession. Events such as publication of Flexner's report and development of the medical basic science laws helped to entrench the AMA's monopoly on health care. The health care environment shaped how chiropractic grew as a profession. Chiropractic practice, education, and science were challenged by trying to develop outside of the medical establishment. These events added to the tensions between the professions that ultimately resulted in the Wilk v AMA lawsuit.

Looking back at the lawsuit that transformed the chiropractic profession part 8: Judgment impact

Objective This paper is the eighth in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to discuss the possible impact that the final decision in favor of the plaintiffs may have had on the chiropractic profession. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the eighth of the series that discusses how the trial decision may have influenced the chiropractic that we know today in the United States. Results Chiropractic practice, education, and research have changed since before the lawsuit was filed. There are several areas in which we propose that the trial decision may have had an impact on the chiropractic profession. Conclusion The lawsuit removed the barriers that were implemented by organized medicine against the chiropractic profession. The quality of chiropractic practice, education, and research continues to improve and the profession continues to meet its most fundamental mission: to improve the lives of patients. Chiropractors practicing in the United States today are allowed to collaborate freely with other health professionals. Today, patients have the option to access chiropractic care because of the dedicated efforts of many people to reduce the previous barriers. It is up to the present-day members of the medical and chiropractic professions to look back and to remember what happened. By recalling the events surrounding the lawsuit, we may have a better understanding about our professions today. This information may help to facilitate interactions between medicine and chiropractic and to develop more respectful partnerships focused on creating a better future for the health of the public. The future of the chiropractic profession rests in the heads, hearts, and hands of its current members to do what is right.

Looking back at the lawsuit that transformed the chiropractic profession part 5: Evidence exposed

Objective This is the fifth article in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this article is to provide a brief review of events surrounding the eventual end of the AMA's Committee on Quackery and the exposure of evidence of the AMA's efforts to boycott the chiropractic profession. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 articles following a successive timeline. This article, the fifth of the series, explores the exposure of what the AMA had been doing, which provided evidence that was eventually used in the Wilk v AMA antitrust lawsuit. Results The prime mission of the AMA's Committee on Quackery was “first, the containment of chiropractic and, ultimately, the elimination of chiropractic.” However, the committee did not complete its mission and quietly disbanded in 1974. This was the same year that the chiropractic profession finally gained licensure in all 50 of the United States; received recognition from the US Commissioner of Education, Department of Health, Education and Welfare; and was successfully included in Medicare. In 1975, documents reportedly obtained by the Church of Scientology covert operatives under Operation AMA Doom revealed the extent to which the AMA and its Committee on Quackery had been working to contain and eliminate the chiropractic profession. The AMA actions included influencing mainstream media, decisions made by the Joint Commission on Accreditation of Hospitals, and the Department of Health, Education, and Welfare. Other actions included publishing propaganda against chiropractic and implementing an anti-chiropractic program aimed at medical students, medical societies, and the American public. Conclusion After more than a decade of overt and covert actions, the AMA chose to end its Committee on Quackery. The following year, documents exposed the extent of AMA's efforts to enact its boycott of chiropractic.

Looking back at the lawsuit that transformed the chiropractic profession part 6: Preparing for the lawsuit

Objective This is the sixth article in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this article is to provide a brief review of the plaintiffs, lead lawyer, and the events immediately before the lawsuit was filed. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 articles following a successive timeline. This article, the sixth of the series, explores the plaintiffs' stories. Results Because of the AMA's boycott on chiropractic, chiropractors were not able to collaborate with medical physicians or refer patients to medical facilities, which resulted in restricted trade and potential harm to patients' well-being. The plaintiffs, Patricia Arthur, James Bryden, Michael Pedigo, and Chester Wilk, came from different regions of the United States. Each had unique experiences and were compelled to seek justice. The lead lawyer, Mr George McAndrews, was the son of a chiropractor and had witnessed the effect that the AMA's attacks on chiropractic had on his father. It took several years to gather enough resources to file the suit, which was submitted in 1976. Conclusion The conflicts that the plaintiffs experienced stimulated them to pursue a lawsuit against the AMA and other organized political medicine groups.