Empathy levels in Australian chiropractic students

ObjectiveEmpathy is an important modifiable quality of health care practitioners that relates to the quality of patient care. The educative process may adversely affect the empathy levels of health care students at key phases of training. This topic remains unexplored in chiropractic students to date.MethodsA voluntary and anonymous questionnaire was distributed to all chiropractic students in an Australian university-based program in April 2021. This questionnaire recorded age, sex, year of study, and Toronto Empathy Questionnaire scores.ResultsChiropractic student empathy scores approximated those of other Australian health care students. No statistical differences were found when comparing the mean scores of empathy levels across the 5 student cohorts. The empathy levels of female chiropractic students'' were significantly higher than those of the male chiropractic students.ConclusionThis study provides a baseline from which further explorations on empathy may be conducted in chiropractic students. This holds the potential to improve practitioners'' quality of life and patient outcomes and for educators to identify subject matter that may negatively affect empathy levels.     

Perceptions of chiropractic students regarding interprofessional health care teams

ObjectiveTo describe perceptions of knowledge of interprofessional teams and value of interprofessional education (IPE) among 3 distinct years of chiropractic students at 1 chiropractic college.MethodsA 24-item cross-sectional survey was administered to 247 chiropractic students in years 1–3 within a single institution. Surveys included 5 demographic questions and the 19-item Readiness for Interprofessional Learning Scale (RIPLS). The RIPLS collected information on perceptions and value of interprofessional health care in a health care training program. Each question is scored on a 1–5 scale, with 5 indicating a stronger agreement. Multivariable analysis was used for comparison.ResultsOut of a total 321 eligible students, 247 (148 male) students completed the survey from year 1 (n = 66), year 2 (n = 102), and year 3 (n = 79), respectively. Most students (68%) were 18–25 years old. The mean compiled score of all 3 years (n = 231) was 77.2 (SD = 9.1). Each individual''s year scores were as follows: year 1 (n = 60, mean = 79.7, SD=7.4), year 2 (n = 95, mean = 76.9, SD = 9.1), and year 3 (n = 76, mean = 75.4, SD = 9.9). Of the 247 students who responded, 87% of participantsagreed with “shared learning with other health care students will increase my ability to understand clinical problems.”ConclusionMost participants demonstrated a positive response to IPE and collaborating with health care teams. Participants in earlier years demonstrated a more positive response compared to later years. While positive perceptions to IPE were demonstrated, chiropractic students lacked knowledge and understanding of their role within an interprofessional health care team.     

Depressive symptoms in chiropractic students: a 3-year study

Background:

The intensive training associated with health care education has been suggested to have unintended negative consequences on students’ mental or emotional health that may interfere with the development of qualities deemed essential for proficient health care professionals. This longitudinal study examined the prevalence and severity of depressive symptoms among students at a chiropractic educational institution.

Methods:

Chiropractic students at all levels of training were surveyed at Canadian Memorial Chiropractic College during the academic years of 2000/2001, 2001/2002, and 2002/2003. The measurement tool employed was the Beck Depression Inventory, 2nd edition (BDI-II). Previously established BDI-II cutoff scores were used to assess the severity of reported depression symptoms, and these were compared by sex and year of training.

Results:

The survey was completed by 1303 students (70%) over the 3 years of the study. The prevalence of depressive symptoms was nearly 25%, with 13.7% of respondents indicating a rating of mild depression, 7.1% indicating moderate depressive symptoms, and 2.8% indicating severe symptoms. Significant differences were found between years of training, with 2nd-year students having the highest prevalence of depressive symptoms, and sex, with females having a higher rate of symptoms.

Conclusions:

Chiropractic students surveyed at Canadian Memorial Chiropractic College had high rates of depression similar to those measured in other health care profession students. Chiropractic educational institutions should be aware of this situation and are encouraged to emphasize students’ awareness of their own personal health and well-being and their access to appropriate care, in addition to the same concerns for their future patients.     

Stress and burnout in chiropractic students of European chiropractic colleges:: A cross-sectional study

ObjectiveHigh levels of stress and burnout are known to negatively impact academic success, quality of life, and well-being of students. The purpose of this study was to investigate the degrees of stress and burnout levels of students from several European chiropractic colleges.MethodsStress and burnout were assessed using the Perceived Stress Scale (PSS-10) and the Maslach Burnout Inventory–Student Survey (MBI-SS). Surveys were delivered electronically in November 2017 to chiropractic students from 4 different chiropractic colleges. Data were analyzed using t test and 1-way ANOVA to determine differences between demographic data. Scores in perceived stress and burnout subscales were compared to the general, chiropractic, and medical student populations.ResultsBoth the MBI-SS and PSS had similar response rates (30%–34%) and demonstrated statistically significant differences between institutions, with C-3 demonstrating the highest levels of exhaustion (p < .001) and the highest levels of perceived stress (p = .012). MBI-SS results show that in the general chiropractic student population, 26.4% presented high emotional exhaustion, 18.2% high cynicism, and 43.8% low academic efficacy. Meanwhile, the PSS score indicated “moderate” levels of stress.ConclusionsEuropean chiropractic students experience higher levels of perceived stress than the general population and they may suffer levels of burnout similar to those of medical students. These results suggest that colleges should monitor stress and burnout levels in their students. This may help to establish student support systems in order to improve students'' quality of life and academic performance, as well as help new graduates transition to their professional lives.     

Impostor phenomenon among US chiropractic students

ObjectiveImpostor phenomenon is expressed by feelings of self-doubt and the belief that one is unintelligent. The purpose of this research was to describe the prevalence of impostor phenomenon among students enrolled in a doctor of chiropractic program and to evaluate for any differences in the rates of impostor phenomenon between males and females.MethodsWe performed an anonymous cross-sectional, online survey of all students enrolled in the doctor of chiropractic program at 2 campuses of 1 chiropractic college. We reported the point prevalence of impostor phenomenon and used χ² to evaluate the differences in impostor phenomenon among males and females. We also evaluated for between-group differences for 4 other demographic factors believed to influence impostor phenomenon.ResultsWe received 406 survey responses (34% response rate). Impostor phenomenon was reported in 39% of students responding to our survey. Approximately 46% of all females and 32% of all males met the criteria for impostor phenomenon, and females had significantly higher rates of impostor phenomenon (p = .005). The following variables were not associated with impostor phenomenon: year in which students were enrolled; marital status; whether chiropractic was their first career; and type of clinical experience the student encountered.ConclusionOur findings demonstrate that over a third of students enrolled in a doctor of chiropractic program met the criteria for impostor phenomenon, and females were significantly more likely to experience impostor phenomenon. The results from this survey are similar to those reported in other healthcare educational settings.     

Perception of educational environment among undergraduate students in a chiropractic training institution

Purpose:

The impact of the educational environment in student learning is well documented. However, there is a scarcity in the literature exploring the educational environment in chiropractic training institutions. This study aimed to identify the perceived educational environment in a chiropractic training institution and the possible perceptual differences among different demographic groups.

Methods:

The perceived educational environment was surveyed using Dundee Ready Education Environment (DREEM), which is a validated, self-administered, and Likert-type inventory. DREEM items focus on subdomains related to learning, teachers, self-confidence, academic atmosphere, and social environment. The results were analyzed and interpreted in relation to standard norms of DREEM and demographic variables.

Results:

The survey was completed by 124 chiropractic undergraduate students (response rate 83%). Statistically, the inventory items showed high correlation and the subdomains showed a close relationship. Overall the DREEM score was very high: 156.1/200 (78%). The subdomain scores were also at very high levels. However, the scoring of four items by students was consistently poor: lack of a support system for stressed students, 1.8 (SD 1.1); authoritarian teachers, 1.8 (SD 1.2); inadequate school time-tabling, 2.0 (SD 1.1); and overemphasis on factual learning, 2.0 (SD 1.0). There were no statistically significant differences in DREEM scores between gender, age, minority, and ethnicity groups.

Conclusions:

In general, students perceived that a sound educational environment is fostered by the institution and its educational program for all students despite their demographic variations. However, certain specific elements of the educational process may need to be addressed to improve the educational experience.     

Aromatherapy for test anxiety in chiropractic students:: A feasibility study

ObjectiveUp to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction.MethodsThis study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim.ResultsSixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups'' pre- and posttest anxiety scores (p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future.ConclusionWe demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.     

Differences in learning and study strategies inventory scores between chiropractic students with lower and higher grade point averages

Purpose:

This pilot study was designed to investigate the relationship between chiropractic students'' learning and study strategies and academic performance. Differences in strategic learning between chiropractic students with higher grade points averages (GPAs) and those with lower GPAs have not been previously reported.

Methods:

Fifty-seven consenting first-trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Differences between high and low GPA groups were evaluated for 10 subtests and three factors using independent samples t-tests.

Results:

The high GPA group scored significantly higher (p < .05) on LASSI subtests Anxiety, Attitude, Concentration, Motivation, Test Strategies, and Selecting Main Ideas, and on factors Effort-Related Activities and Goal Orientation. No differences between groups were found for subtests Information Processing, Self-Testing, Study Aids, and Time Management or for the Cognitive Activities factor.

Conclusions:

The results of this study show that differences in LASSI subtest and factor scores are associated with academic performance. For the participants studied, motivational and affective aspects of strategic learning contributed to higher academic performance, whereas cognitive strategies did not. Higher performing students utilized Effort-Related and Goal Orientation learning strategies at significantly higher levels than lower performing students. The LASSI may be useful in identifying students who could benefit from learning and study skills development. Longitudinal study is recommended to investigate the effects of students'' learning and study strategies on different academic content domains as well as the effects of strategic study and learning skills training on academic performance.     

Coping strategies and chiropractic student perceived stress

ObjectiveTo investigate coping strategies adopted by chiropractic college students and how these strategies affect student-perceived stress levels.MethodsFour hundred seven (407) 1st-quarter students were recruited during 2014 and 2015. The validated Brief COPE inventory was used to assess coping strategies during the 1st week of classes. Perceived Chiropractic College Stress (PCCS) was assessed via a modification of Vitaliano Perceived Medical School Stress survey instrument. The modified coping instrument was administered during the 1st quarter (PCCS1) and 6 months later during the 3rd quarter (PCCS2).ResultsMean perceived stress levels were greater after 6 months. Although perceived stress increased more for females than for males over that period, it was not statistically significant. Male and female coping strategies differed only in the preferential use of emotional support by females. Students generally adopted active coping strategies (eg, active coping and planning) rather than avoidant strategies (eg, substance abuse). Regression analysis revealed a moderate positive relationship between avoidant-emotion coping and PCCS1 with a weaker positive correlation between problem-focused coping, sex, and PCCS1. Avoidant-emotion coping also demonstrated a moderate positive correlation with PCCS2. Neither sex nor the 3 coping strategies were predictors of PCCS change (PCCS2 – PCCS1).ConclusionThis study is a starting point for exploring the relationship between perceived stress and coping behaviors in a chiropractic training institution. Students generally used healthy adaptive coping strategies with minimal sex differences. Avoidant-emotion coping appears to be a reliable predictor of PCCS, with sex being a poor predictor.     

Laboratory pre-participation screening examination in a chiropractic college: development, implementation, and results

Introduction:

Chiropractic students often serve as subjects in laboratories where they and their classmates practice examinations, various soft tissue techniques, physiological therapeutic modalities, and active rehabilitation. There are contraindications and risks associated with these procedures. This article describes how a procedure was developed to identify potential health concerns and risks that students may face while serving as subjects or performing procedures in clinical skills laboratories.

Methods:

Screening questions and examination procedures were developed through a consensus process. Findings from the screening process determine whether students may engage in full participation or limited participation (precautions) or are prohibited from receiving certain procedures (contraindications). Skills laboratory students and their instructors are informed of any identifiable precautions or contraindications to participation.

Results:

Since its implementation, precautions regarding delivery of manual therapies were found in 4% of those examined and precautions regarding receiving manual therapies in 11.5%. Contraindications to receiving specified manual therapies were found in 8%, and 4% had contraindications to certain physiological therapeutic modalities.

Discussion:

Further work is necessary to improve compliance with follow-up regarding diagnosis of conditions revealed or suspected. Future efforts should address how well students adhered to precautions and contraindications, the nature and frequency of injuries sustained within the laboratories, and what specific measures were taken by faculty to help students with special needs.

Conclusion:

This chiropractic college now has a method to describe potential risks, explain rules of laboratory participation, and obtain consent from each student.