Chiropractic in North America: Toward a Strategic Plan for Professional Renewal—Outcomes from the 2006 Chiropractic Strategic Planning Conference

Triano, John J.; Goertz, Christine; Weeks, John; Murphy, Donald R.; Kranz, Karl C.; McClelland, George; Kopansky-Giles, Deborah; Morgan, W. John; Nelson, Christine

doi:10.1016/j.jmpt.2010.05.002

Cited by 27 publications

(21 citation statements)

References 36 publications

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“…Efforts to promote EBCP within chiropractic have been identified as a fundamental component for advancing the profession [17-19]. Historically, doctors of chiropractic (DCs) have relied heavily on uncritical rationalism (deduction from theory) and uncritical empiricism (casual observation) as justification for chiropractic clinical practice [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Attitudes toward evidence-based clinical practice among doctors of chiropractic with diplomate-level training in orthopedics

et al. 2013

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BackgroundEvidence-based clinical practice (EBCP) is a practice model gaining prominence within healthcare, including the chiropractic profession. The status of EBCP has been evaluated in a variety of healthcare disciplines, but little is known regarding the attitudes doctors of chiropractic (DCs) hold toward this model of healthcare. This project examines the attitudes toward EBCP within a specialty discipline of DCs.MethodsWe identified a survey questionnaire previously used to evaluate EBCP among non-chiropractic complementary and alternative practitioners. We adapted this questionnaire for use among DCs and pretested it in 5 chiropractic college faculty. The final version was administered to DCs with diplomate-level training in orthopedics. The survey was emailed to 299 potential participants; descriptive results were calculated.Results144 surveys were returned, resulting in a 48% response rate. The majority of respondents perceived EBCP as an important aspect of chiropractic practice. Respondents also believed themselves to have an above average skill level in EBCP, reported that training originated from their diplomate education, and based the majority of their practice on clinical research.ConclusionDoctors of chiropractic with an orthopedic diplomate appear to have favorable attitudes toward EBCP. Further study will help understand EBCP perceptions among general field DCs. A logical next step includes validation of this questionnaire.

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Section: Introductionmentioning

confidence: 99%

“…Even though adoption of EBCP by the chiropractic profession has been promoted by administrators and academics, [17] little is known regarding the attitudes practicing DCs hold toward EBCP. Assessments of EBCP have been conducted in many healthcare subspecialties, [26-34] but not within chiropractic.…”

Section: Introductionmentioning

confidence: 99%

Attitudes toward evidence-based clinical practice among doctors of chiropractic with diplomate-level training in orthopedics

et al. 2013

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“…11 The public consistently and abundantly seeks alternatives to current medical practices, 12,13 indicating that the public is not satisfied with the status quo. In the past decade there has been a push toward a nonsurgical spinal pain specialist model 14,15 as a role for chiropractic within the health care system. However, since its beginnings, there have been many who viewed chiropractic as a model for natural care of the whole person.…”

Section: Discussionmentioning

confidence: 99%

Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services

Grand¹,

Morehouse-Grand²,

Carter³

2016

Journal of Chiropractic Education

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Objective: This pilot study explored the attitudes, beliefs, and intentions of a group of chiropractic interns concerning health promotion, wellness, and preventive services before and after a series of brief educational interventions. Methods: Interns completed a survey before (n ¼ 37) and after (n ¼ 22) the interventions. The survey included 12 Likert scale questions about attitudes and intentions toward wellness and health promotion models. The interventions consisted of classroom lectures, clinical training, and online information pertaining to health promotion and wellness. Results: The interns initially favored wellness models, perceived a need for them, and felt partially prepared to administer them, with mean Likert scores 4 or greater on a 1 to 5 scale. Afterward, the average scores were higher and the interns reported some benefit from this short course of training. Conclusion:The initial survey demonstrated that interns had some understanding of wellness, health promotion, and preventive services, and favored utilization of these services. The follow-up survey suggested that a short educational intervention could have a positive impact on these attitudes and future utilization of wellness procedures in their practices.

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“…Each reviewer presented summary overviews on up to 3 of the patient assessment methods, discussing the quality and content of each paper and the overall quality and content of the body of literature on the topic. Discussion was conducted following presentation of each summary, using a facilitated round-robin method [29,30]. Thus, after each reviewer had made their presentation, each participant was addressed, in turn, with the opportunity to comment with respect to a topic and to ask questions until he/she was satisfied.…”

Section: Methodsmentioning

confidence: 99%

Review of methods used by chiropractors to determine the site for applying manipulation

et al. 2013

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BackgroundWith the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation.MethodsStructured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation.ResultsA total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement.ConclusionsA considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence.

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Chiropractic in North America: Toward a Strategic Plan for Professional Renewal—Outcomes from the 2006 Chiropractic Strategic Planning Conference

Cited by 27 publications

References 36 publications

Attitudes toward evidence-based clinical practice among doctors of chiropractic with diplomate-level training in orthopedics

Attitudes toward evidence-based clinical practice among doctors of chiropractic with diplomate-level training in orthopedics

Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services

Review of methods used by chiropractors to determine the site for applying manipulation

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