Chiropractic Education Research Articles

Technology in Education: Riding the Wave of the Future. Chiropractic Educators Research Forum (CERF), June 22, 2024

Technology in Education: Riding the Wave of the Future. Chiropractic Educators Research Forum (CERF), June 22, 2024

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.

Global status of chiropractic education research: a scoping review protocol.

The objective of this scoping review is to map the volume and nature (topics, study designs, regions) of chiropractic education research relating to chiropractic learners and programs worldwide. Education of the health workforce is critical to reach population health goals. Chiropractic educational programs are expanding globally; however, the state of chiropractic education research is not known. A better understanding of the volume and nature of chiropractic education research will inform education research priorities and development of chiropractic programs, and assist with preparing a stronger chiropractic workforce to address world health goals. This scoping review will consider articles that study students, faculty, administration, staff, graduates, and programs in any chiropractic education setting, including graduate, clinical, postgraduate, and specialty training, in any country. Articles on non-educational topics or clinical research will be excluded. This review will follow the JBI scoping review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases to be searched include PubMed, Scopus, CINAHL, Index to Chiropractic Literature, Biblioteca Virtual em Saúde, and Educational Resources Information Center, from their inception. All languages will be considered. Two reviewers will independently screen records using predefined eligibility criteria and extract data using tables. Data extracted from eligible articles will include study design, participants, region, and topics. The results will be presented in a narrative summary, with data presented in tabular and diagrammatic formats. Open Science Framework https://osf.io/9b3ap.

Development of Preliminary Integrated Health Care Clinical Competencies for United States Doctor of Chiropractic Programs: A Modified Delphi Consensus Process.

There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training. The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education. A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies. Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration. We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment.

Battling Burnout: Raising Resilience in Education. Chiropractic Educators Research Forum (CERF), December 2, 2023.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 2, 2023. This conference took a closer look at what chiropractic programs are doing to identify burnout and build student, faculty, and staff resilience in the psychosocial domain. During the meeting, presenters and panelists took an in-depth look at research related to how chiropractic programs are addressing issues in mental health of students, faculty, and staff as this relates to burnout and resilience in the chiropractic program and practice.

Postgraduate training opportunities for chiropractors: A description of United States programs.

The objective of this study was to describe and compare the current postgraduate training opportunities (PTOs) in the United States (US) for which doctors of chiropractic are eligible, namely, residencies, fellowships, and board certifications. An internet search of publicly available English-language websites on Google.com was executed using a cache-cleared private browser and key search phrases. Following webpage data extraction, e-mail and telephone follow-up were completed with officials from institutions offering doctor of chiropractic programs possessing accreditation by the Council on Chiropractic Education (CCE) in the US. Additional programs identified were annotated and incorporated into the data set if they met the inclusion criteria. Descriptive statistics were generated following data aggregation. Three-hundred internet search results were screened, 70 of which were assessed for eligibility and 47 included for descriptive analysis. Among the 16 CCE-accredited institutions solicited, 13 returned correspondence (81.3% response rate), resulting in the addition of 2 programs to the data set ascertained by the initial web search. There were 49 PTOs for chiropractors. Of programs available, residencies represented 49.0% (24/49) of programs, and fellowships represented 12.2% (6/49) of programs. There were 19 board specialty diplomate programs, constituting 38.8% of PTOs. This work details preliminary descriptive information on the current state of US-based PTOs for chiropractors.

Twelfth World Federation of Chiropractic Global Education Conference: "Technology and Innovation: Shaping the Future of Chiropractic Education".

This conference was convened by the World Federation of Chiropractic from October 30 to November 2, 2024, in Kuala Lumpur, Malaysia. The 2024 program focused on the delivery of technology in chiropractic education.

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.

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.

Keeping It Real: Practice Relevant Education. Chiropractic Educators Research Forum (CERF), June 24, 2023.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on June 24, 2023. This meeting provided a forum for the presentation of scholarly works in education theory and practice. This conference specifically focused on research related to developing competency in practice-relevant skills, knowledge, and attitudes. As educators, we help our students develop their cognitive, psychomotor, and affective abilities. Throughout this process, we must keep in mind what we are producing: health care providers. Our graduates must demonstrate competency in relevant knowledge, skills, and attitudes to practicing health care in a professional and evidence-based manner (ie, intersection of best evidence, clinical expertise, and patient values). Therefore, integrating practice-relevant skills, knowledge, and attitudes is essential throughout our programs. During the June 2023 CERF meeting, presenters and panelists took an in-depth look at education research and how chiropractic programs work to deliver practice-relevant education.

The Effect of Chiropractic Education Seminar on Physiotherapy Students' Knowledge Levels and Attitudes About Chiropractic

Kayropraktik mesleğinin ülkemizde henüz yaygınlaşmaması önemli bir halk sağlığı sorunudur. Kayropraktik mesleği ile yakından ilişkili olan fizyoterapi öğrencilerinin kayropraktik konusunda bilgi sahibi olması mesleğin gelişimi açısından oldukça önemlidir. Bu çalışmada kayropraktik eğitim seminerinin fizyoterapi öğrencilerinin kayropraktik hakkındaki bilgi düzeyleri ve tutumlarına etkisinin incelenmesi amaçlanmıştır. Araştırma ‘Kayropraktik Eğitim Semineri’ne katılan 216 fizyoterapi öğrencisi üzerinde gerçekleştirildi. Araştırma tek grup deneysel çalışma olarak tanımlanabilir. Öğrencilerin demografik verilerinin yanında kayropraktik hakkındaki bilgi ve tutumlarını değerlendirmek amacıyla 9 sorudan oluşan bir anket ile eğitim semineri öncesi ve sonrası veriler toplandı. Araştırmaya 40 kadın (%18,5) ve 176 erkek (%81,5) olmak üzere 216 öğrenci dahil edildi. Öğrencilerin büyük çoğunluğunun (%41,2) kayropraktik ile ilgili bilgiye ilk kez sosyal medya üzerinden ulaştığı tespit edilmiştir. 2, 4, 5, 6, 7 ve 8. sorularda eğitim semineri öncesi ile sonrası arasında anlamlı bir fark tespit edilmiştir (p=0,000, p=0,000, p=0,000, p=0,016, p=0,032, p=0,023). Ülkemizde henüz lisans programı bulunmayan ve yasal zemini oluşturulmamış olan kayropraktik mesleğine ilişkin yapılan eğitim semineri fizyoterapi öğrencilerinin bilgi düzeyini ve tutumlarını pozitif yönde değiştirdiği gösterilmiştir. ‘Kayropraktik’ mesleği hakkında eğitim seminerlerinin daha fazla yapılması ve tüm toplumda farkındalık oluşturulmasının büyük önem arz ettiği düşünülmektedir.

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.

Rise of Faculty Scholars: Building Capacity for a Stronger Future. Chiropractic Educators Research Forum (CERF), December 3, 2022.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 3, 2022. This meeting provided a forum for the presentation of scholarly works in education theory and practice. This conference specifically focused on research related to education research and building faculty scholarship and research capacity. During the December 2022 CERF meeting, presenters and panelists took an in-depth look at education research and how chiropractic programs work to enhance research and scholarship capacity.

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.

The positive and negative impacts of the COVID-19 pandemic on the European Council on Chiropractic Education accredited programs: A mixed methods audit and thematic analysis.

The objectives of this study were to: (1) determine the impact of COVID-19 on the operations within the 9 sections of the European Council on Chiropractic Education (ECCE) 'Standards'; (2) identify specific rapid changes to the programs; and (3) identify positive changes that will continue post-pandemic. This was a mixed methods audit and thematic analysis of data from interviews conducted via a cloud-based video conferencing tool with program leaders of the ECCE accredited institutions. A validated questionnaire designed around ECCE's "Standards" was used, consisting of 3 sections: (1) Severity of the COVID-19 impact on each ECCE Standard section; (2) Description of program changes made for each section; (3) Identification of positive changes continuing post-pandemic. Descriptive statistics were calculated for Part 1 and compared for significant differences via the Kruskal-Wallis test. Verbal responses to Parts 2 and 3 were evaluated independently by 3 researchers using a modified "thematic analysis" approach. Final thematic categories and themes were agreed upon by the researchers. There was a 100% response rate. Outpatient teaching clinics were most severely affected, followed by teaching chiropractic technique courses. Curricular structure and duration and program management were least affected (p =.033). Four thematic categories were identified: Extreme Stress, Courses Most Severely Affected, Integrity of Examinations and Assessments, and Positive Changes That Will Continue. Final-year students were most negatively impacted due to restricted opportunities in outpatient clinics. Integrity of examinations was also a problem. Positive, innovative teaching materials and methods were quickly developed and should continue.

Academic Integrity for All: Building Better Professionals: Chiropractic Educators Research Forum (CERF), June 25, 2022

This conference was convened by the Chiropractic Educators Research Forum (CERF) on June 25, 2022. This meeting provided a forum for the presentation of scholarly works in education theory and practice. This conference specifically focused on research related to academic integrity and professionalism. During the June 2022 CERF meeting, presenters and panelists took an in-depth look at how chiropractic programs work to address academic integrity.

The Councils on Chiropractic Education International Mapping Project: Comparison of Member Organizations’ Educational Standards to the Councils on Chiropractic Education International Framework Document

ObjectiveThe purpose of this project was to investigate how well each member agency's standards complied with the Councils on Chiropractic Education International (CCEI) framework standards. MethodsEach of the CCEI member agencies were provided with a mapping template that was approved by all representatives. A representative from each agency independently mapped their agency's standards to the CCEI framework standards using the template document. Discrepancies were explored and discussed among members. Member agencies discussed with their constituents the omissions and areas that did not comply or adequately match the CCEI document. Changes or additions to member agency standards were made, and updated versions of the mapping were agreed by all CCEI representatives. ResultsThere were 12 sections containing 30 standards within the CCEI framework standards. The Council of Chiropractic Education Australasia and Council on Chiropractic Education Canada reported relevant standards for all 30 CCEI standards. The European Council on Chiropractic Education had 29 of 30 relevant standards, with no direct standard for service. The products that were created were an executive summary of our findings and a detailed map showing similarities for each of the member agencies. ConclusionThis mapping project demonstrated the similarities of the CCEI member agency standards and that these standards focused on outcomes-based chiropractic education. This quality improvement project resulted in useful dialogue among the member agencies during this project, which clarified areas of difference.

Preparing for the Future: Diversity in Chiropractic Education: Chiropractic Educators Research Forum (CERF), December 4, 2021.

This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 4, 2021. This meeting provided a forum for the presentation of scholarly works in education theory and practice. This conference specifically focused on research related to diversity, equity, and inclusion. During the December 2021 CERF meeting, presenters and panelists took an in depth look at how chiropractic programs work to address diversity issues in the changing landscape of healthcare and to address the needs of the world population.

Chiropractic techniques and treatment modalities included in academic programs: A survey of chiropractic educational institutions.

The chiropractic techniques that chiropractors learn during their training strongly influence the nature of treatments provided by chiropractors and their professional identity. The objective of this project is to provide an exhaustive description of all chiropractic techniques and treatment modalities taught in chiropractic educational institutions. International experts were solicited to provide feedback on the exhaustivity and clarity of our preliminary questionnaire. Following the expert suggestions, we administered our cross-sectional survey representatives of all chiropractic education institutions listed on the World Federation of Chiropractic website. We also asked the contact information for an additional contact from each institution and surveyed them for triangulation purposes. Among the 47 chiropractic education institutions surveyed, 29 completed our survey (response rate: 62%) of which 18 (62%) had 2 respondents. Among all the chiropractic techniques and treatment modalities investigated, only the Diversified technique was included in the core curriculum of all responding institutions. A considerable proportion of the techniques or modalities studied were not included in the educational activities of the institutions, particularly within the manual tonal or reflex techniques, instrument-assisted articular techniques, as well as the other techniques or modalities categories. Surprisingly, exercise prescription was not included in the core curriculum of all the institutions. Some scientifically challenged approaches were included in the educational activities of more than 40% of the institutions. The portfolio of therapeutic teaching varies greatly between chiropractic educational institutions. A more standardized therapeutic curriculum could be beneficial to reduce public and interprofessional confusion toward therapeutic approaches in chiropractic.