Abstract
BackgroundPsychological factors, such as intolerance of uncertainty (IU), have been shown to impact on the quality of medical care. However, this psychological measure has not been studied in the chiropractic profession. Our objective was to investigate if higher levels of IU in chiropractic students were related to poor choices of management in specific clinical scenarios. Also, we sought to investigate if levels of IU were related to students’ intentions to adopt a prescriptive chiropractic technique system and evaluate their levels of self-belief.MethodBetween October and November of 2016, students from two Australian chiropractic programs (N = 444) answered a questionnaire on measures of IU levels, patient case scenarios for neck and low back pain, and questions about self-ratings of their future chiropractic abilities and perceived need for the adoption of a chiropractic technique system. Associations were tested by the IU score and the therapeutic choices relating to a) a neck pain case scenario, b) a low back pain scenario, c) various technique systems, and d) the self-rated competence level treating the IU score both as a continuous and a categorical variable.ResultsThere was an overall response rate of 53%. Those students who were high in levels of IU were significantly more likely to make incorrect clinical decisions than those with normal or low levels of IU for the neck pain case scenario. No differences were found on the low back pain scenario, on preferences to use a technique system in the future, or on predicted self-rating of competence after graduation.ConclusionsPsychological factors, such as IU, may have an impact on chiropractic students’ clinical decisions. However, it does not impact on all aspects of practice. This finding has implications for chiropractic educators, especially when dealing with neck pain. However, it may be relevant to continue the search for specific personality profiles in relation to various favourable and unfavourable practice patterns, as it is unknown whether these dynamics are important for other aspects of chiropractic education.
Highlights
Psychological factors, such as intolerance of uncertainty (IU), have been shown to impact on the quality of medical care
There was an overall response rate of 53%. Those students who were high in levels of IU were significantly more likely to make incorrect clinical decisions than those with normal or low levels of IU for the neck pain case scenario
It may be relevant to continue the search for specific personality profiles in relation to various favourable and unfavourable practice patterns, as it is unknown whether these dynamics are important for other aspects of chiropractic education
Summary
Psychological factors, such as intolerance of uncertainty (IU), have been shown to impact on the quality of medical care. This psychological measure has not been studied in the chiropractic profession. The educational institutions have a responsibility to select and educate students to this end Failure in this task may have undesirable consequences for chiropractors, patients, and public health. IU has been found to be associated with behavioural performance [6] With such an influence on behaviours, it is not surprising that past research has shown this factor to impact on the decisionmaking of primary care medical / general practitioners [7]
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