Chiropractic College Research Articles

Library as a Therapeutic Landscape Promoting Health and Well-Being to Chiropractic Students: A Descriptive Report

ObjectiveThe purpose of this paper is to describe a bibliotherapy-based wellness initiative that was developed at the health science library at Canadian Memorial Chiropractic College. MethodsA comprehensive literature review and consultations with stakeholders were completed. A bibliotherapy program, which included the practice of using books and reading to promote mental health, well-being, and resilience for chiropractic students, was developed and launched in January 2020. The program included shared reading, reflection, and a guided group discussion. Short readings of various genres (i.e., poetry, fiction, nonfiction) were tailored specifically to address psychological, emotional, and social challenges facing students. ResultsThe program participant feedback showed that shared reading helped students cope with anxiety, worries, and loneliness and isolation caused by the pandemic, as consistent with bibliotherapy research. ConclusionThe bibliotherapy program at this 1 location seemed to be well-received by chiropractic students. The program was recognized by faculty and college administrators as a valuable addition to other mental health and wellness support services available on campus. These findings suggest future research to evaluate the potential efficacy of bibliotherapy for the mental health, well-being, and resilience of chiropractic students.

Depression, anxiety, and sleep attributes: A cross-sectional study of chiropractic college students.

To measure degree of depression, anxiety, and hours of sleep of chiropractic college students through an anonymous paper survey. A convenience sample of 164 chiropractic college students completed a Major Depression Inventory (MDI) survey, a 2-item Generalized Anxiety Disorder (GAD-2) survey, and were asked the number of hours of sleep they had per night and demographic questions. The survey was distributed to trimester 1-6 students 4 weeks into their 15-week semester. Chiropractic students had an average MDI score of 18.1 ± 10.6 (mean ± SD), indicating the average chiropractic college student did not display depression. However, subset analysis revealed 18.9% of students had MDI scores over 30, which is associated with possible severe depression. Of students who demonstrated possible severe depression, 80.6% were female. Body mass index demonstrated no correlation with the number of respondents at risk for severe depression. Average GAD-2 score was 3.0 ± 1.9; male students scored 2.4 ± 1.8 and female 3.6 ± 1.8, indicating female students expressed anxiety more. Last, survey respondents reported they averaged 6.3 ± 1.1 hours of sleep per night with females reporting approximately 30 minutes less sleep per night than males. Chiropractic students, on average, did not display depression. However, a subset of female students near the age of 26 were at an increased risk of severe depression. Chiropractic students displayed a rate of anxiety greater than that of undergraduate college students based on existing data sets and reported approximately 6 hours of sleep per night.

Improving diversity, equity, and inclusion in chiropractic education and profession: Report from three 2020-2021 summit meetings.

Racial and ethnic minority groups are underrepresented in chiropractic education and the profession, and are less likely than individuals identifying as White to have access to or use chiropractic care. Stakeholders with leadership positions in USA-based chiropractic colleges and organizations participated in 3 online diversity, equity, and inclusion (DEI) summit meetings to foster a deeper understanding of DEI, identify DEI objectives, and develop action steps and drive change. Summit I (51 attendees) comprised 3 presentations that provided background about DEI in chiropractic education and practice. Summit II (32 attendees), comprised 4 breakout sessions addressing organizational issues in DEI. Summit III (65 attendees) comprised 5 collaborative sessions focused on implementation of DEI objectives. We use aggregate data and qualitative summaries to provide a descriptive narrative. Data sources include pre/post-summit quantitative surveys, items from open-ended questionnaires, and a spreadsheet of recommendations for increasing organizational DEI. Before attending Summit I, 48% rated their understanding of DEI issues as "moderately" or "very" high, compared with 74% afterward. Summit II participants suggested actions that should be taken by their institutions and the profession. Summit III participants stressed the need for DEI-supportive data, policies, and resources. They identified > 150 action steps to address DEI objectives. A listserv was established to facilitate ongoing institutional collaboration. Summit participants recognized the importance of developing a diverse, culturally aware chiropractic workforce. The summits provided structure and support for stakeholders to effectively plan for and implement DEI in their organizations and institutions.

Classroom recordings: Utilization and influence on course performance.

Providing video recordings of lecture material may enhance student flexibility, but does it alter attendance or influence their grade? This project assessed the extent and purpose of video usage by students and evaluated their impact on course performance within first-year basic science courses in a chiropractic curriculum. All first-year students enrolled at a chiropractic college based in the United States were invited to complete a retrospective survey regarding video usage, attendance, and study behaviors for basic science courses they were enrolled during the previous term. Grades were third-party obtained for each consenting student. Statistical analysis included descriptive statistics and independent t tests for each course. Effect size using Cohen's d was calculated for all statistically significant courses (p < .05). Overall, 260 students completed the questionnaire assessing 18 courses in total. The perceived helpfulness of video recordings was associated with heavier usage, primarily to study for exams. Shorter summary videos were preferred by 78% of students over full lecture recordings. Use of videos to replace lectures increased from 21.9% to 53.2% in first through third trimester, respectively. Video use in Neuroanatomy I, Neuroanatomy II, Gross Anatomy II, Organ Histology, and Endocrinology were associated with lower exam scores and overall grades (p < .05), yielding moderate to large effect sizes. Videos were used < 1 hour per week, primarily to study for exams. When used as a study tool, video use decreased course performance. Rewatching videos to prepare for exams may be mistaken for mastery of material.

Association of Chiropractic Colleges Educational Conference and Research Agenda Conference 2024: The Healthcare Evolution.

This conference was convened by the Association of Chiropractic Colleges in San Diego, CA from March 21-23, 2024. The theme for this Association of Chiropractic Colleges Educational Conference and Research Agenda Conference (ACC-RAC) program was The Healthcare Evolution. This proceedings document includes the names of the Peer Review Committee members and all platform and poster abstracts presented at the 2024 ACC-RAC.

Attitudes, beliefs, and recommendations for persistent low back pain patients: cross-sectional surveys of students and faculty at a chiropractic college

BackgroundWhile the use of chiropractic care for persistent low back pain (PLBP) is prevalent, chiropractors’ attitudes and beliefs related to PLBP patients are not fully understood. The purpose of this study was to assess the attitudes, beliefs and activity/work recommendations of students and faculty at a chiropractic college regarding PLBP patients.MethodsThe Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) and clinical vignettes were requested to be completed by chiropractic students and faculty at Parker University in April 2018. Higher HC-PAIRS scores indicate stronger beliefs that PLBP justifies disability and limitation of activities. Activity and work recommendations from clinical vignettes were rated as “adequate”, “neutral”, or “inadequate”, as defined in previous literature. Descriptive statistics, independent t-tests, and logistic regression were used to analyze results.ResultsStudent and faculty response rates were 63.6% and 25.9%, respectively. Faculty mean HC-PAIRS scores (3.66 [SD:0.88]) were significantly lower than students’ (4.41 [SD:0.71]). The percentage of faculty providing “adequate” activity (62.1%) and work (41.0%) recommendations was significantly greater than the percentage of students (activity: 33.9%, work: 21.2%) (p < 0.05). Higher HC-PAIRS scores in students were associated with decreased odds of providing “adequate” activity and work recommendations.ConclusionsStudent and faculty attitudes and beliefs, and students’ activity/work recommendations were found to be dissimilar to those from similar studies and less congruent with CPG recommendations. Lower HC-PAIRS scores increased the odds of students providing “adequate” activity and work recommendations to patients with PLBP. Results from this study may help guide future research and training opportunities.

Frequency and indication of non-musculoskeletal examinations: a cross-sectional survey of Quebec chiropractors

BackgroundApproximately 1% of low back pain is estimated to be caused by serious systemic diseases, including cancer, infection, or abdominal aortic dissection. This study aimed to determine the frequency of execution of non-MSK physical examination procedures among Quebec chiropractors and to identify the clinical context that prompts them to use these physical examination procedures.MethodsCross-sectional survey containing 44 questions administered to a random sample of Quebec chiropractors using a succession of online, postal and phone questionnaires. The 4-part survey questionnaire contained six demographic questions, 28 single-choice questions to determine the frequency of execution of non-MSK physical examination procedures, seven short clinical vignettes for which the respondents had to select the non-MSK examinations that would be required, and two questions inquiring about the proportion of new patients for which participants’ felt non-MSK examinations were necessary and whether appropriate assessments were performed. The questionnaire was pilot tested, and feedback received integrated prior to administration. We conducted descriptive statistics, Pearson correlations, and an ANOVA.ResultsThe survey was completed by 182 chiropractors (response rate: 36.4%). The most commonly non-musculoskeletal examination performed daily were blood pressure (12.1%) and cranial nerves (4.9%). The most common tests never performed were oxygen saturation (68.7%), cardiac auscultation (69.2%), tibio-brachial index (71.4%), breast (86.8%), rectal (96.7%), testicular (95.6%), and vaginal (99.9%) exams. Female chiropractors and Quebec University in Trois-Rivières graduates reported that a significantly higher proportion of their new patients required a non-musculoskeletal physical examination compared to male participants (37.2% vs 28.3%) or Canadian Memorial Chiropractic College graduates (33.9% vs 19.9%). Reason for not performing a physical examination included the belief that another healthcare professional was better positioned to perform and/or interpret the related tests (76.4%).ConclusionsVital signs and cranial nerve examinations were the most frequency performed non-musculoskeletal examinations reported by chiropractors. Apart from the genitourinary exam almost never performed, most participants chose non-musculoskeletal examinations deemed appropriate for the patient’s presentation.

Resilient responses to stressful events among chiropractic students: A cross-sectional survey.

Resilient students may better navigate the challenges of chiropractic training. This study explored the relationships between response to stressful experiences, perceived stress, and quality of life among students at 1 US chiropractic college campus. A cross-sectional survey was conducted with 873 students. The anonymous online questionnaire included demographics, quality of life, perceived stress, and the Response to Stressful Events Scale (RSES). Hierarchical multiple regression analyses assessed for significant relationships among variables. A sample of 221 students (60% female) completed the survey (25% response rate). Male respondents reported greater psychological health. Participants reporting high quality of life exhibited higher resiliency on the RSES flat score and many RSES domains. Respondents who rated greater psychological health and social relationships exhibited greater spiritual resiliency. Respondents reporting higher psychological health and lower levels of perceived stress exhibited higher self-efficacy resilience. Psychological health was the most important predictor for RSES flat score and domains, except for spiritual resilience, for which social relationships were most important. Male gender was predictive of 3 RSES domains: meaning making, active coping, and cognitive flexibility. More resilient responses to stressful events were reported by male chiropractic students and those who reported greater psychological health, higher quality of life, or lower perceived stress. Female students and those experiencing psychological challenges or lower quality of life might consider resilience training to increase the use of protective coping strategies. These findings may permit academic institutions to identify students at highest risk and employ interventions to prevent program withdrawal.

"It's the most important work we will ever do": Chiropractic students, servicelearning experiences at a day laborer center in California.

From 2009 to 2019, staff, students, and faculty volunteers from a chiropractic college started Mission Trip America, later re-named Service Trip America (STA), providing monthly free chiropractic services at a hiring hall for day laborers in San Francisco until the 2020 COVID-19 hiatus. We report on volunteers' service-learning experiences. Mixed-methods analysis comprising document review, descriptive report of site visit records, and thematic analysis of semi-structured interviews with 12 student and faculty volunteers. STA conducted 104 visits (8-11 per year) including 2272 patient encounters. Document review revealed an average of 22 patients per visit, with 60% to 85% return patients. On average, 3 student interns and 2 student assistants attended each visit, supervised by a doctor of chiropractic faculty member and the program director. Most commonly, interns treated 8 patients during the 4- to 5-hour visits. Patient concerns included musculoskeletal problems and other health conditions commonly seen at chiropractic offices and teaching clinics. Interns also regularly saw chronic health problems exacerbated by poor living conditions, violence, limited access to health care, low educational attainment, chronic stress, and the extreme biomechanical loading resulting from heavy labor. Interview results yielded 4 themes: learning, attitudes, challenges, and program strengths. Interviewees described opportunities to learn while working with a marginalized population and discussed long-term effects on their postgraduation practice as chiropractors. Patients' physical, mental health, and psychosocial issues illustrated unique circumstances and profound needs of the underserved population being cared for by STA volunteers. Our findings may provide guidance for other community-based chiropractic service-learning programs in marginalized and underserved communities.

Assessment of professionalism in a chiropractic college: A design and implementation of a rubric.

To describe the design, implementation, and revision of a rubric used in assessing professionalism that was in alignment with Council on Chiropractic Education meta-competency 5 (professional ethics and jurisprudence, curricular objective C: Expected professional conduct). The rubric was designed using a grading scale from 0 to 5 by which students needed to meet all criteria to earn full points for each defined dimension of professionalism. A comments section allowed for explanation of deductions and/or comments on exceptional behavior. Comments on professionalism were collected in a log during the trimester and used to populate the rubric. After initial use, the rubric was revised to incorporate criteria that had not initially been included and to allow for greater point deductions for multiple/repeat infractions or egregious behavior. Feedback from other faculty members was also gathered during in-service presentations of the rubric and taken into consideration. Professionalism score was 10% of the course grade. From 2016 to 2020, the average professionalism grade changed from 95.6% to 98.9%. A review of the frequency distributions of average professionalism grades in a calendar year showed that some students were earning grades between 70% and 79%. Only achieving 70% to 75% of the professionalism grade affected the final course grade by 2.5% to 3.0%. In training chiropractic students on expected behaviors related to professionalism, a rubric assessment of professionalism guided communications between the clinical educator and students to discuss professionalism and remediate unprofessional behaviors. A rubric defining expected classroom behaviors aligns with educational best practices to use assessment methods to develop professionalism in health care students.

Peer review chair report: Association of Chiropractic Colleges Educational Conference and Research Agenda Conference 2023 peer review process.

The purpose of this report is to provide a summary of the methods used and feedback from reviewers about the peer review process for the 2023 Association of Chiropractic Colleges Educational Conference and Research Agenda Conference (ACC-RAC). After the peer review process was complete, the 2023 ACC-RAC peer review committee members were invited to provide feedback through an anonymous electronic form. The survey included a Likert scale to rate items about the peer review process and an option for open-ended comments. Of the 166 peer reviewers, 77 (46%) completed the survey. The reviewers represented 9 countries, with the greatest number from North America. The majority (95%) of respondents rated the process of peer review in topic groups as good to excellent, and the majority (92%) of respondents rated the overall 2023 peer review process as good to excellent. The critical comments that were submitted are addressed in this report. Overall, peer reviewer satisfaction with the process used for the 2023 ACC-RAC was high. We will include information from this report as part of the continuous quality improvement of peer review process, an important part of improving chiropractic education, research, and scholarly activities.

Bibliometric Analysis of Research Trends on Manual Therapy for Low Back Pain Over Past 2 Decades.

Low back pain (LBP) is a prevalent musculoskeletal disorder, and manual therapy (MT) is frequently employed as a non-pharmacological treatment for LBP. This study aims to explore the research hotspots and trends in MT for LBP. MT has gained widespread acceptance in clinical practice due to its proven safety and effectiveness. The study aims to analyze the developments in the field of MT for LBP over the past 23 years, including leading countries, institutions, authoritative authors, journals, keywords, and references. It endeavors to provide a comprehensive summary of the existing research foundation and to analyze the current cutting-edge research trends. Relevant articles between 2000 and 2023 were retrieved from the Web of Science Core Collection (WOSCC) database. We used the software VOSviewer and CiteSpace to perform the analysis and summarize current research hotspots and emerging trends. Through screening, we included 1643 papers from 2000 to 2023. In general, the number of articles published each year showed an upward trend. The United States had the highest number of publications and citations. Canadian Memorial Chiropractic College was the most published research institution. The University of Pittsburgh in the United States had the most collaboration with other research institutions. Long, Cynthia R. was the active author. Journal of Manipulative and Physiological Therapeutics was the most prolific journal with 234 publications. This study provides an overview of the current status and trends of clinical studies on MT for LBP in the past 23 years using the visualization software, which may help researchers identify potential collaborators and collaborating institutions, hot topics, and new perspectives in research frontiers, while providing new clinical practice ideas for the treatment of LBP.

Differences in history-taking skills between male and female chiropractic student interns.

The purpose of this study was to determine if there was a difference in history-taking skills between male and female chiropractic student interns. This study included 2040 patient histories collected by student interns over a 3-year period. Students were assessed by chiropractic college clinicians on reasoning (ability to derive clinically relevant information using a mnemonic for taking a history), communication, and professionalism using a modified Dreyfus model scoring system on a 1-4 scale (1 = novice, 4 = proficient). Ordinal dependent variables were scores for reasoning, communication, and professionalism. The categorical independent variable was sex of the student intern (male or female). A Mann-Whitney U test was used to compare for differences in nonparametric dependent variables by the sex of the students. The Mann-Whitney U test revealed that communication scores were greater for female chiropractic interns compared with male chiropractic interns (p < .001, with a small effect size (r = -.08). There was no statistically significant effect for sex on reasoning (p = .263) or professionalism (p = .098). Female chiropractic student interns scored higher than male interns on communication skills during a history-taking patient encounter. This supports the trend seen among female medical school students and physicians that women score higher than men on communication-related assessments.

The one-week prevalence of neck pain and low back pain in post-secondary students at two Canadian institutions

BackgroundLow back and neck pain are common in the general population, but the prevalence among Canadian post-secondary students is not well known. We aimed to determine the one-week prevalence of neck pain (NP) and low back pain (LBP) among postsecondary students in Canada.MethodsWe conducted a cross-sectional study of students enrolled in the Faculty of Health Sciences and Faculty of Education at Ontario Tech University, and the Canadian Memorial Chiropractic College (CMCC) in the Fall of 2017. Neck and low back pain intensity in the past week were measured with the 11-point numerical rating scale. We report the cumulative, gender- and institution-specific one-week prevalence (95% CI) of any pain (1–10/10) and moderate to severe pain (≥ 3/10).ResultsThe one-week prevalence of any neck pain ranged from 45.4% (95% CI: 38.4, 52.4) in the Faculty of Education to 76.9% (95% CI: 72.9, 80.4) at CMCC. The one-week prevalence of neck pain ≥3/10 ranged from 44.4% (95% CI: 37.5, 51.4) in the Faculty of Education to 58.4% (95% CI: 54.0, 62.7) at CMCC. The one-week prevalence of any low back pain ranged from 60.9% (95% CI: 53.8, 67.5) in the Faculty of Education to 69.0% (95% CI: 64.8, 73.0) at CMCC, and the one-week prevalence of low back pain ≥ 3/10 ranged from 47.8% (95% CI: 43.4, 52.2) at CMCC to 55.1% (95% CI: 51.2, 58.9) in the Faculty of Health Sciences. The prevalence of any back or neck pain and pain ≥ 3/10 was consistently higher in females than males, with the largest difference seen for neck pain at CMCC.ConclusionMost post-secondary students in our samples experienced LBP and NP in the past week. Overall, the one-week prevalence of NP and LBP was higher among chiropractic students and among females. This study should draw attention to school administrators about the burden of NP and LBP in post-secondary students.

A cross-sectional study of the association between sleep quality and anxiety in postsecondary students in Ontario

Postsecondary students frequently report high rates of anxiety and poor sleep quality. The association between poor sleep quality and anxiety is poorly understood in this population. We conducted a cross-sectional study of students enrolled in two faculties at Ontario Tech University (OTU) - Faculty of Health Sciences (FHS) and Faculty of Education (FEd), and students attending the Canadian Memorial Chiropractic College (CMCC) during the fall of 2017 to determine the prevalence of poor sleep quality and moderate to extremely severe anxiety, as well as the association between them. Participants completed self-report questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]), anxiety (Depression, Anxiety, and Stress Scale – 21 Items [DASS-21]), socio-demographic, lifestyle and health-related variables. Multivariable logistic regression was used to measure the association between poor sleep quality and moderate to extremely severe anxiety, as well as to control for covariates. A significant correlation between PSQI scores and DASS-21 anxiety scores was found in both populations: students who reported poor sleep quality were more likely to report moderate to extremely severe anxiety. This association decreased but still remained high even after controlling for important covariates (i.e., biological sex, stress, and depression).

From student to doctor: An analysis of chiropractic oaths as an allegory of the transition from academic integrity to ethical professionalism.

This article examined current chiropractic oaths, particularly topics related to aspects of integrity, ethics, and professional behavior. The oaths were then compared for their individual inclusion and emphasis of these components. Data were obtained from 1988 and 2019 papers describing components of the oaths used at each existing chiropractic college as well as those used in the past by colleges that are no longer operational. Additionally, colleges founded after 2019 were contacted to obtain their oaths. Nine oath components related to ethics and professional conduct were selected from 26 topics originally studied. Each oath was evaluated for the presence of and specific wording used to describe those components. The oaths were compared for their inclusion and emphasis of these components. Some topics, such as "keeping a patient's confidence" and "refrain from wrongdoing," demonstrated a high rate of occurrence. Others, including "serving humanity" and "respecting teachers," were less frequent. The oath of 1 program contained 8 of the topics, 4 program's oaths used 7 topics, 11 schools had 6 topics in their oath, and the oaths of 5 schools included 2 topics. There is wide variation in the occurrence and emphasis of themes relating to ethics, integrity, and professionalism in the different chiropractic oaths. This study provides information for institutions to consider with regard to the content of the oath they administer. It is hoped that this article may encourage the creation of a universally accepted chiropractic oath that will help each graduate commit to a fulsome, all-encompassing pledge to become an ethical professional who optimally represents chiropractic.

Transforming the delivery of chiropractic education through the strategic integration of educational technology in a chiropractic college program.

Chiropractic institutions face the challenging quandary of how to prepare future doctors for entry into a society completely transformed by technology. At an increasing rate, the incoming student profile is representative of a digital generation with a high affinity for technology use. The aim of this study was 2-fold: (1) outline the basic elements of a technology integration program at our institution and (2) determine if a potential relationship exists between ongoing training and acceptance of such a programmatic shift among faculty and students. At each phase of technology integration, electronic survey instruments were deployed to participating students and faculty members. Survey instruments included question items assessed through Likert-type scales and open-ended questions to provide students and faculty members with a vehicle for providing specific feedback. To ensure anonymity of student and faculty survey respondents, the response collection source was a different department than the deployment of the survey emails. Participants were encouraged, but not required, to complete the surveys. Analysis of survey responses generally found increases in overall participant satisfaction and acceptance of the technology integration with the provision of ongoing support systems. As suggested in similar scholarship in the field, the results of this study underscored the value of support systems for faculty members and students in an academic community. The systems that provided ongoing training and other support mechanisms seemed more accepted when tailored to myriad skill levels. Creating a culture in which faculty members and students felt adequately supported fostered the acceptance necessary for forward momentum of a campus initiative of significant change.

Association of Chiropractic Colleges Educational Conference and Research Agenda Conference 2023: Leadership in Education.

This conference was convened by the Association of Chiropractic Colleges in New Orleans, Louisiana from March 23-25, 2023. The theme for this Association of Chiropractic Colleges Educational Conference and Research Agenda Conference (ACC-RAC) program was Leadership in Education. This proceedings document includes the names of the Peer Review Committee members and all platform and poster abstracts presented at the 2023 ACC-RAC.

The Australian Chiropractic College Library

The ACC is the fruition of the vision of a group of passionate Adelaide chiropractors. They weren't just passionate about their own careers within chiropractic, they were passionate about the field as a whole; and that includes education. Not only were there no chiropractic courses offered locally, but even those located interstate were all offered within the broader context of universities. This group of people had a vision of a local institution that was dedicated solely to chiropractic education.

11th World Federation of Chiropractic Colleges/Association of Chiropractic Colleges Global Education Conference: Leveling Up: Creating Consistency in Chiropractic Education, November 2-5, 2022.

This conference was convened by the World Federation of Chiropractic and the Association of Chiropractic Colleges from November 2 to 5, 2022. The title for the program was Leveling Up: Creating Consistency in Chiropractic Education. The 2022 program focused on the delivery of consistent global chiropractic education. Scholarly works were presented in a variety of formats, including platform presentations, posters, innovations panels, and workshops.