A survey of chiropractic students' perceived business preparedness at graduation

ObjectiveThe objective of this study was to assess chiropractic college graduates'' business experience, education, and need for further education at the time of graduation.MethodsWe conducted an anonymous survey of graduating chiropractic students in 2015 and 2016 regarding their prior business experience, business courses taken before and during chiropractic education, business abilities and needs, and practice plans.ResultsEighty-one responded out of 114 surveyed (71% response rate). Less than half had taken college-level business courses or had business experience prior to entering chiropractic college. Almost 90% of respondents took 1 or more of 3 elective courses in business skills during their chiropractic education. Sixty-eight percent planned to work as an associate doctor and to be in private practice after 5 years. The respondents indicated that they were more prepared in the business abilities of ethics/risk management/jurisprudence, employee management, strategic planning, and marketing/advertising, and least prepared in business operations, accounting, and billing/reimbursement. In the areas of economics, finance, business taxes, and starting a practice, the respondents indicated a need for further education or experience. It was statistically significant (p < .001) that students who had prior business experience and/or college business education were more confident in operating a health care practice.ConclusionChiropractic business education provides students with some of the practice management skills essential for operating a health care practice. Students with prior business experience and/or education reported more confidence in their ability to run a chiropractic practice immediately after graduation.     

Patient Characteristics Associated With Self-Reported Adherence to Chiropractic Treatment Recommendations: A Feasibility Study

ObjectiveThe purpose of this study was to examine the feasibility of developing and administering a patient adherence survey to assess self-reported adherence to treatment recommendations from a chiropractic doctor within an academic health center.MethodsThe survey items were developed by the authors and vetted by the university's students and faculty, who serve as health care practitioners at an academic health center. Adult patients with spine pain who were seen by a doctor of chiropractic at an academic health center were included in this survey study. A 32-item survey was administered between October 2019 and March 2020.ResultsA total of 62 respondents completed the anonymous survey. We found that 89% of respondents adhered to their clinic appointments. Although 82% of respondents said that their doctor's recommendation made sense, only 44% reported completely following treatment recommendations for at-home stretching and exercise.ConclusionThis study determined that it is feasible to assess patient self-reported adherence to chiropractic treatment within an academic health center setting. In our sample we found that although patient adherence to clinic appointments was high, adherence to treatments was not.     

Separate and Distinct: A Comparison of Scholarly Productivity, Teaching Load, and Compensation of Chiropractic Teaching Faculty to Other Sectors of Higher Education

Background:

Faculty scholarship, teaching load, and compensation can be indicators of institutional health and can impact curricular quality. Periodic data are published by the US Department of Education for all sectors of higher education, but do not list chiropractic colleges as a separate category.

Objective:

To report on the scholarly output, teaching load, and compensation of the full-time faculty at one chiropractic college, and to compare those data to national and local norms.

Methods:

Data on chiropractic faculty were collected from within the institution. External data were collected from the US Department of Education and US Bureau of Labor Statistics.

Results:

The chiropractic faculty assessed create about one-tenth the scholarly output, carried 2.7 times the course load of external doctoral faculty and 1.4 times the course load typical of 2-year (community) college faculty, received two-thirds the salary typical for all segments of education, and one-half the typical retirement benefits.

Conclusion:

Results are suggestive of significant deficiencies within chiropractic education that pose risk to the future of the profession.Key Indexing Terms: chiropractic, education, professional     

The development and evaluation of an online educational tool for the evidence-based management of neck pain by chiropractic teaching faculty

ObjectiveTo develop an online, interactive educational tool to deliver an evidence-based clinical practice guideline to faculty members at a Canadian chiropractic college. Second, to evaluate the learning, design, and engagement constructs of the tool in a sample of chiropractic faculty members.MethodsUsing an integrated knowledge translation methodology and the Knowledge to Action Framework, we developed an evidence-based online learning tool. The context of the tool focused on a clinical practice guideline on the management of neck pain. We evaluated the learning, design, and engagement constructs in a sample of faculty members and residents using the Learning Object Evaluation Scale for Students. Participants were also asked to provide suggestions for improvement of the tool.ResultsSixteen participants completed the evaluation. Most (68.8%) participants were chiropractors, 75% were male and 56% were between the ages of 25 and 44 years. At least 75% of participants agreed that the learning, design, and engagement constructs of the learning tool were adequate. The open-ended suggestions unveiled 3 pedagogical themes, relating to multimedia, thinking skills, and learner control, within the tool that could benefit from further development. These themes informed recommendations to improve the tool.ConclusionOur online, interactive, module-based learning tool has sound pedagogical properties. Further research is needed to determine if its use is associated with a change in knowledge.     

A qualitative assessment of systematic instructional design training by CLS faculty members.

OBJECTIVE: To determine the perceived value clinical laboratory science (CLS) faculty members gave to their participation in workshops on the use of a modified systematic instruction design (SID) model to develop curriculum and on-line courses. DESIGN: A survey assessing the perceived value of SID training was sent to 27 CLS faculty members. The survey asked the respondents to assess the value of the training that they received in developing their skills in Web-based, distance learning course development and teaching, and expanding their skills in traditional course development and teaching. The eight components of SID were listed and the respondents rated each component as to its value to them on a 5-point Likert scale of 5 = very valuable to 1 = not very valuable. In addition to rating the value of each SID component, the respondents were asked if they would like more training in any of the eight components. RESULTS: A majority of the 18 respondents (67%) reported that the training in SID was valuable to them. A strong majority of the respondents indicated that their training in goal and instructional analyses (96%), media selection (94%), and aligning objectives, assessments, and instructional strategies (94%) were valuable to their distance education programs and their traditional teaching skills. CONCLUSION: Faculty members who actively participated in SID training valued their new skills in developing distance education courses as well as improving their traditional teaching activities. Research is needed on the effect these new teaching skills have on student learning.     

Restructuring of an evidence-based practice curriculum and assessment with structural mapping by course outcome verb

ObjectiveAn evidence-based clinical practice (EBCP) subcurriculum within a chiropractic curriculum was restructured to distribute EBCP topics to courses throughout the curriculum. We posited that this would enhance student learning through early exposure, repetition, and the use of progressively more difficult levels of learning. In this paper we describe how we determined if Bloom''s verb level trended upward from the beginning of the curriculum to the end and if there were any gaps in presentation of topics periodically in the curriculum. We describe how we determined if the restructured subcurriculum provided adequate integration of topics.MethodsEBCP committee chairs created templates of the new structure, solicited feedback from the faculty, and faculty members volunteered to assimilate topics into courses. Support for the faculty included comprehensive PowerPoint production and in-service training. Assessment for trends and gaps was performed of the resultant learning outcomes by mapping 13 quarters against 6 Bloom''s verb levels for 19 topics.ResultsFourteen of the topics had increasing linear model trends indicating verb progression. Decreased attention to EBCP topics was identified in some quarters.ConclusionThe graphical mapping process seemed useful to find EBCP topics that did not show progression of Bloom''s verb difficulty and gaps in topics in the restructured subcurriculum.     

Beyond the didactic classroom: educational models to encourage active student involvement in learning

In a chiropractic college that utilizes a hybrid curriculum model composed of adult-based learning strategies along with traditional lecture-based course delivery, a literature search for educational delivery methods that would integrate the affective domain and the cognitive domain of learning provided some insights into the use of problem-based learning (PBL), experiential learning theory (ELT), and the emerging use of appreciative inquiry (AI) to enhance the learning experience. The purpose of this literature review is to provide a brief overview of key components of PBL, ELT, and AI in educational methodology and to discuss how these might be used within the chiropractic curriculum to supplement traditional didactic lecture courses. A growing body of literature describes the use of PBL and ELT in educational settings across many disciplines, both at the undergraduate and graduate levels. The use of appreciative inquiry as an instructional methodology presents a new area for exploration and study in the academic environment. Educational research in the chiropractic classroom incorporating ELT and appreciative inquiry might provide some valuable insights for future curriculum development.     

Troublesome knowledge for entry-level PhD nursing students: Threshold concepts essential for the research-focused doctorate

BackgroundEvidence supports that PhD doctoral students experience conceptually difficult knowledge, or troublesome knowledge, during their studies. These areas of troublesome knowledge are often associated with threshold concepts, those ideas specific to a discipline that must be understood to advance ways of thinking and making knowledge in the discipline.PurposeTo examine troublesome knowledge identified by a group of PhD nursing students during an introductory course and to consider threshold concepts related to that knowledge.MethodDesign: Case study research methodology.Sample: 18 entry-level PhD nursing students recruited with convenience sampling.Data collection: Content analysis was used to analyze data collected from student reflective learning journals. Journal data was triangulated with formative and summative faculty assessments of student learning.ResultsThree essential threshold concepts for entry-level PhD nursing students were identified: developing new ways of knowing, constructing researcher and writer identity, and positioning within the nursing research community. Analysis indicates that entry-level students found the threshold concept of constructing researcher and writer identity most troublesome.ConclusionA PhD introductory nursing course which includes metacognitive activities, scaffolding of assignments, and early positioning within the research community can assist students with mastery of threshold concepts for the research-focused doctorate.     

Incorporating Peer Assessments within a Clinical Practicum Course: Insights from a Clinical Faculty Initiative

IntroductionPeer assessments have been used within health professional programs to provide some degree of judgment of professional behavior and to facilitate feedback among peers. In an attempt to further support the clinical learning of our students, the clinical education team at the Odette Cancer Centre initiated a pilot to introduce peer assessments as a part of strategies for learning and engagement within laboratory sessions. The aim of our work was to retrospectively review peer assessments completed during these sessions in an attempt to identify professional behaviors, both positive and negative, and subsequently correlate the assessments with observed behaviors noted, both formally and anecdotally, within clinical faculty assessments. Further to this, our team attempted to explore student perceptions on the impact of peer assessments to their own learning.MethodsStudents in the final year of a 3-year undergraduate medical radiation sciences program were asked to assess their peers during laboratory sessions using a modified version of an assessment tool previously known to the students, the Assessment of Readiness for Clinical tool. Students (N = 14) were required to evaluate each of their peers who participated in the same session and provide supporting comments for their rating. For each student, responses from peer assessors were anonymized and collated. Comments and numerical ratings on the peer assessments were compared. The student assessments were subsequently compared with similar measures extracted from faculty assessments. Students also participated in a debriefing session to provide feedback regarding the integration of these assessments within the learning sessions and the potential impact they had on their own professional behaviors.ResultsThe majority of students rated their peers in all criteria at a score of 2 (performed or surpassed expectations). There was some correlation between numerical ratings and comments written in the assessments. Comments on peer assessments were in concordance with observations extracted from previous assessments by clinical faculty and teachers for 71% of the students. Students expressed a favorable attitude toward the use of the peer assessments but did not find the numerical ratings useful and instead valued supporting constructive comments that cited specific examples for improvement.ConclusionsPeer assessments were found to be of some benefit to the learning of our students, particularly the anecdotal supporting comments that accompanied the ratings. However, their use must be accompanied by formalized training and guidelines to teachers and learners as well as a careful consideration of the tool chosen to ensure the most purposeful impact on behavior change.     

Horizontal integration of the basic sciences in the chiropractic curriculum

Basic science curricula at most chiropractic colleges consist of courses (eg, general anatomy, physiology, biochemistry, etc) that are taught as stand-alone content domains. The lack of integration between basic science disciplines causes difficulties for students who need to understand how the parts function together as an integrated whole and apply this understanding to solving clinical problems. More horizontally integrated basic science curricula could be achieved by several means: integrated Part I National Board of Chiropractic Examiners questions, a broader education for future professors, an increased emphasis on integration within the current model, linked courses, and an integrated, thematic basic science curriculum. Horizontally integrating basic science curricula would require significant efforts from administrators, curriculum committees, and instructional faculty. Once in place this curriculum would promote more clinically relevant learning, improved learning outcomes, and superior vertical integration.     

A Survey of Geriatrics Courses in North American Chiropractic Programs

Purpose:

There has been a growing interest in meeting the health care needs of the anticipated “age wave.” In order to prepare for the current demographic trends, we sought to describe the status of geriatrics curricula in the 18 North American English-speaking chiropractic colleges by reviewing geriatric course syllabi.

Methods:

A cross-sectional survey was conducted using syllabi and catalog information solicited from each English-speaking chiropractic college in North America, collected from January 1, 2007 through June 30, 2007. Information was then summarized.

Results:

As of June 30, 2007, roughly 78% of colleges submitted their current geriatrics course syllabi. The remaining 4 colleges were estimated using online course catalog information. Sixty-one percent of colleges offered a course that was solely dedicated to the topic of geriatrics. Additionally, 37.5% of syllabi indicating credit load offer 4 or more credits to the course containing the geriatrics component. Also, 31.3% of courses include non-classroom clinical experience, while 50% require an independent study project that provides further geriatrics experience. Furthermore, 41.2% of reported courses classify the teaching strategies as lecture only.

Conclusions:

These results warrant a proposal for improved curricula in this specialty population. It is proposed that more time be dedicated for this topic, more experiential learning be required, and more clinical focus be given on the needs of this population. A restructure of curricula will provide more clinical experiences for students to better equip future doctors of chiropractic for the increase in geriatric health care needs.Key Indexing Terms: Chiropractic, Geriatrics, Education     

Nursing students' attendance at learning activities in relation to attainment and passing courses: A prospective quantitative study

BackgroundStudents' motivation and ways of engaging in their schoolwork are important for their performance, including passing exams. Attendance at learning activities has also been argued to be of major importance, although no causal relationship with passing exams has been established in nursing education.ObjectivesThe aim of this study was to describe the impact of attendance at nonmandatory learning activities on attainment, in terms of passing or failing of exams, in nursing education courses including both mandatory and non-mandatory activities.DesignA prospective quantitative design.SettingThe nursing education programme at a Swedish university.ParticipantsNursing students (n = 361) from two courses and four classes within the nursing programme.MethodsAttendance was registered at every non-mandatory teaching activity by asking the students to note their attendance on a list. Data such as sex, age, and whether the students had passed the exam were also collected for each course and each semester separately.ResultsIncreased participation was associated with an increasing proportion of students passing the exam. The chance of passing the exam increased by 13% for every additional learning occasion attended. Logistic regression showed an OR of 5.4 for an attendance of 100%.ConclusionsAn increase in attendance gave a higher proportion of exam passes. Encouraging students to attend non-mandatory learning activities could be of value, and potentially contribute to an increased graduation rate for nursing students.     

Inter-professional learning: discussion groups in a minor surgery skills course for nurses

Inter-professional teaching and learning takes many forms. This paper describes an inter-professional educational intervention using structured discussion groups of nurses and medical students within an innovative course on minor surgery for nurses. During an initial course, nurses were required to demonstrate competence in technical and communication skills by undergoing scenario-based assessments. Unhelpful levels of anxiety before and after these assessments interfered with learning and performance. Semi-structured discussion groups facilitated by medical students were introduced during a second course, running parallel with assessments and replacing the self-directed activities scheduled in the pilot course. Written evaluations and group interviews explored participants’ experiences of taking part in these discussion groups. Results indicate that the groups were successful in reducing unhelpful anxiety and that they conferred additional benefits for both nurses and medical students. Future courses incorporating these inter-professional learning opportunities will evaluate immediate and longer-term benefits in greater depth.     

Onboarding orientation for novice nurse faculty: A quality improvement pilot project

BackgroundNovice nurse faculty have a challenging time transitioning into academia, resulting in reduced satisfaction and retention. After conducting a thorough literature review, it was determined that formalized mentoring combined with professional development workshops could improve the transition into academia, thus improving the satisfaction and retention of novice nurse faculty.MethodsIn fall 2020, an onboarding orientation program for novice nurse faculty was implemented. The objectives included matching mentoring dyads based on similar interests and goals, developing mentoring guidelines, implementing the Department of Nursing (DON) Orientation Checklist, and providing five monthly professional development workshops with topics ranging from creating learning objectives to the promotion and tenure requirements. Five novice nurse faculty participated in the study, and each was matched with a mentor with similar goals.ResultsAfter 6 months of project implementation, overall faculty satisfaction dropped slightly from 4.1 to 4.0. A dependent t-test (p = 0.83) and Wilcoxon signed ranks test (p = 0.461) both indicated no significant difference in satisfaction post project implementation. Although, the results indicate the novice nurse faculty and mentors agreed that the program was effective and should continue. The novice nurse faculty reported that the DON Orientation Checklist, mentoring relationships, and professional development workshops contributed to their successful transition into academia. Retention was 100% 2 years after project implementation. One significant factor noted after program evaluation was conducted is that there should be regular meetings with mentors to support them in their role.ConclusionsThe onboarding orientation program for novice nurse faculty was an effective strategy to ease the transition into academia and maintain satisfaction within the role.