Abstract
BackgroundSpine related disorders entail biological (somatic), psychological, and social factors. Though biological factors are often emphasized, psychosocial considerations may not be receiving proper attention in the chiropractic field. Chiropractors treat spine complaints and therefore should be trained in the full spectrum of the biopsychosocial model. This study examines the use of psychosocial related terminology in United States doctor of chiropractic program (DCP) curricula, the Council on Chiropractic Education (CCE) standards, and the National Board of Chiropractic Examiners (NBCE) test plans.MethodsNineteen academic course catalogs, CCE curricular standards and meta-competencies, and NBCE test plans were studied. Terms containing “psycho”, “soci”, “mental”, “econom”, “cultur”, “emotion”, “determinant”, “public”, “communit”, “neighbor”, “behav”, or “cognitive” were identified in each document. Frequency of use, context of use, thematic categorization, and percentage of use compared to overall content were calculated and described.Results‘Public’ is the most commonly used psychosocial related term in DCP curricula. ‘Determinant’ was used in 1 DCP curriculum. The number of courses with psychosocial related terminology in course titles and course descriptions ranged from 1 to 5 and 3 to 12, respectively. Most terms are found in clinical skills, special populations, and other miscellaneous courses, with fewer terms found in psychology and public health courses. Terminology use in course titles and descriptions compared to overall content ranges from 3.40 to 14.86%. CCE uses terminology 17 times across 5 (out of 8) total meta-competencies. NBCE includes terminology in test plans I and II, but not III or IV.ConclusionsDespite evidence suggesting the influential role of psychosocial factors in determinants of health and healthcare delivery, these factors are poorly reflected in United States DCP curricula. This underappreciation is further evidenced by the lack of representation of psychosocial terminology in NBCE parts III and IV test plans. The reasons for this are theoretical; lack of clarity or enforcement of CCE meta-competencies may contribute.
Highlights
IntroductionSpine related disorders entail biological (somatic), psychological, and social factors
Spine related disorders entail biological, psychological, and social factors
We describe the usage of psychosocial terminology by the Chiropractic Education (CCE) as it relates to their established curricular metacompetencies, and by the National Board of Chiropractic Examiners (NBCE) within their testing content
Summary
Spine related disorders entail biological (somatic), psychological, and social factors. Chiropractors are recognized by the public as clinicians who care for spine related disorders (SRDs) [1, 2]. The biopsychosocial (BPS) model explains this multidimensional nature of SRDs. Biological factors are often emphasized in the clinical evaluation and management of SRDs. current best practices incorporate the BPS model, requiring that clinicians identify and address broader modifiers of patients’ health, conventionally termed “psychosocial factors” [5]. Current best practices incorporate the BPS model, requiring that clinicians identify and address broader modifiers of patients’ health, conventionally termed “psychosocial factors” [5] Despite these guidelines, adoption of the BPS model in chiropractic care settings is arguably incomplete [6, 7]. Students across various healthcare disciplines, including chiropractic, have a poor awareness of these psychosocial factors [8]
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