Student and new graduate perception of hospital versus institutional clinic for clinical educational experience

Abstract

Objective: To explore final-year students and new graduates from 2 North American chiropractic colleges regarding perceptions of the clinical educational experience in a hospital vs the institutional clinical setting. Methods: A qualitative exploratory descriptive design was used for this research. Students and new graduates were invited to participate from a United States and Canadian chiropractic college. Semistructured interviews were conducted with 49 students and 14 new graduates lasting 60 minutes. Content analysis of the transcribed interviews was undertaken. Results: The data identified that there were advantages and disadvantages to having clinical education in both settings. For instance, the hospital setting had a more varied patient case mix (making it more complex and challenging for their clinical skills development), the pace was faster, and there was more evidence-based practice. This compared to the college clinics, which tended to be slower paced and had less variation, students were required to build a patient base, and patient demographics resembled that expected in private practice. Each environment was considered a unique clinical learning experience. Conclusion: Access and opportunity in both clinical environments is considered optimal in regards to providing a broad and varied student clinical experience. Exclusivity to one may not provide the best preparation for the professional context. As most graduate opportunities are private practice, the institutional clinical environment will provide a sufficient clinical teaching and learning environment to support the professional needs. A combination of these environments is considered ideal for the graduate.

Chiropractic student diagnosis and management of headache disorders: A survey examining self-perceived preparedness and clinical proficiency

“…The importance of chiropractic student exposure to a broad patient case mix during student residencies has been previously discussed. 14,32 While accreditation standards for Australian chiropractic training programs do not mandate specific requirements around patient case mix, 8 it is expected that by graduation students will be exposed to a sufficiently broad patient case load during their clinical internship to provide safe and effective patient care across different patient populations. Uncertainty therefore remains as to whether chiropractic graduate students are sufficiently exposed to a broad range of headache types during their clinical internship training in order to be adequately prepared for effective headache patient management.…”

“…8 Previous international studies have identified that chiropractic graduate students can perceive themselves to be unprepared within certain clinical competencies, raising concerns about gaps that may exist between student education and practice-ready practitioners. [13][14][15] To date, little research has specifically examined chiropractic students' perceived preparedness and ability to diagnose and manage headache disorders. In direct response to this research gap, the primary aim of this study was to assess 4th-and 5th-year Australian chiropractic students' selfperceived preparedness for headache disorder diagnosis and management, as well as their performance (correctness) in headache diagnosis and management decision making.…”

Chiropractic and osteopathic students' perceptions of readiness for transition to practice:The educational value of university clinic vs community and private clinics*

“…This has been commonly found in other studies as disadvantages of the institution-based clinics and advantages of community-based clinics and hospital placements. 16 Students and academics alike desire students to be exposed to diverse patient populations, often with comorbidities, to assist in developing students' clinical and professional skills, competence, capability, and confidence: the feeling of being more clinically prepared. Academics and students alike know that the foundation of skills attained through a scaffolded program with placement in the UHC can also contribute to this preparedness.…”

“…Providing a wide range of experiences will ensure students' ability to meet graduate expectations; thus, graduates will be fit for the purpose: well prepared primary care chiropractic or osteopathic physicians. 1,16,37,38…”

“…It also has implications for ''standards of professionalism, patient care and work satisfaction.'' 16 Despite the importance of this marker, it appears that neither chiropractic nor osteopathic students have clear understandings or shared views of their professional identities. [17][18][19] In medical education, Irby 20 comments on the explicit cultivation of a professional identity, a process involving the mastery of competencies and adoption of the values and behaviors of the professions, and these matters are also essential in the education of chiropractors and osteopaths.…”