A survey of the perceptions and behaviors of chiropractic interns pertaining to evidence-based principles in clinical decision making

Dane, Dawn E.; Dane, Andrew B.; Crowther, Edward R.

doi:10.7899/jce-15-26

Cited by 3 publications

(1 citation statement)

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“…Significant barriers exist to the integration of EBCP into curricula, into the practice of EBCP in clinical training settings, and into practice. The following barriers are prominent themes in the literature: time constraints, 2,4,6,7,15,16 confidence, 9,17 a lack of adequately trained faculty, 7,15,16,18 teaching methods, 6,[19][20][21][22][23][24] clinical challenges, 7,8,12,18,25,26 nega-tive attitudes toward EBCP, 4,7,8,18 and the belief that EBCP might degenerate into ''cook-book'' clinical practice. 4 Given the above, the overreaching research question during our process was, ''How does an educational institution prepare students for their intended profession?''…”

Section: Introductionmentioning

confidence: 99%

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

Murdock¹,

Brennan²,

Murphy³

et al. 2021

Journal of Chiropractic Education

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Objective An 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. Methods EBCP 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. Results Fourteen of the topics had increasing linear model trends indicating verb progression. Decreased attention to EBCP topics was identified in some quarters. Conclusion The 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.

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Section: Introductionmentioning

confidence: 99%

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

Murdock¹,

Brennan²,

Murphy³

et al. 2021

Journal of Chiropractic Education

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The usefulness of a novel patient management decision aid to improve clinical decision-making skills in final year chiropractic students

et al. 2019

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Background The process of developing patient management plans requires a series of clinical decision-making skills that can take years in practice to develop. For the inexperienced practitioner, providing a logical, systematic patient management framework may assist in clinical scenarios and accelerate their decision-making skill development. The purpose of this study was to assess whether a novel clinical management decision aid would improve the management decision-making of chiropractic students. Methods A prospective before and after study tracked chiropractic master degree students in their final year of study across a 10-week period from February–May, 2017. Case-based assessments were performed at baseline, after initial exposure to the decision aid, and after repeated exposure over the course of the semester. Outcome measures included the results from the 3 assessments, scored out of 20 by two markers using a standardised marking rubric, then averaged and converted to percentages; and 2 feedback questionnaires, given after initial exposure and at 10 weeks. Results A total of 75 students (44 males; 31 females) participated in the study. The mean score at baseline was 8.34/20 (41.7%) (95% CI: 7.98, 8.70; SD: 1.56) and after initial exposure was 9.52/20 (47.6%) (95% CI: 9.06, 9.98; SD: 2.02). The mean score after repeated exposure was 15.04/20 (75.2%) (95% CI: 14.46, 15.62; SD: 2.54). From baseline to initial exposure, there was a statistically significant absolute increase in mean score of 1.18/20 (5.9%) (95% CI: 0.6, 1.76; p < 0.0001), or a 2.82/20 (14.1%) relative improvement. From baseline to repeated exposure, there was a statistically significant absolute increase in mean score of 6.7/20 (33.5%) (95% CI: 6.02, 7.38; p < 0.0001), or a 16.06/20 (80.3%) relative improvement. The questionnaire results were also favourable. 56/75 (75%) participants agreed that the decision aid was easy to use and 46/75 (61%) of participants agreed that the decision aid improved their ability to integrate various management techniques. Conclusion Implementing a clinical management decision aid into the teaching curriculum helped to facilitate the ability of chiropractic students to develop patient management plans.

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Integrated clinical opportunities for training offered through US doctor of chiropractic programs

Meyer,

Al-Ryati,

Cupler

et al. 2023

Journal of Chiropractic Education

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Objective The primary objective of this study was to assess, summarize, and compare the current integrated clinical learning opportunities offered for students who matriculated in US doctor of chiropractic programs (DCPs). Methods Two authors independently searched all accredited DCP handbooks and websites for clinical training opportunities within integrated settings. The 2 data sets were compared with any discrepancies resolved through discussion. We extracted data for preceptorships, clerkships, and/or rotations within the Department of Defense, Federally Qualified Health Centers, multi-/inter-/transdisciplinary clinics, private/public hospitals, and the Veterans Health Administration. Following data extraction, officials from each DCP were contacted with a request to verify the collected data. Results Of the 17 DCPs reviewed, all but 3 offered at least 1 integrated clinical experience, while 41 integrated clinical opportunities were the most offered by a single DCP. There was an average of 9.8 (median 4.0) opportunities per school and an average of 2.5 (median 2.0) clinical setting types. Over half (56%) of all integrated clinical opportunities were within the Veterans Health Administration, followed by multidisciplinary clinic sites (25%). Conclusion This work presents preliminary descriptive information of the integrated clinical training opportunities available through DCPs.

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A survey of the perceptions and behaviors of chiropractic interns pertaining to evidence-based principles in clinical decision making

Abstract: Interns routinely employed high-quality levels of evidence in clinical decision making. They also considered their early, limited clinical experience as important as that of their clinical supervisor in decision making. This finding should be investigated further.

Cited by 3 publications

References 10 publications

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

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

The usefulness of a novel patient management decision aid to improve clinical decision-making skills in final year chiropractic students

Integrated clinical opportunities for training offered through US doctor of chiropractic programs

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