Association of pain neurophysiology knowledge and application amongst UK chiropractic students: A cross-sectional study.

OBJECTIVE: To investigate if chiropractic placement students in the United Kingdom are aware of current pain evidence and how they relate this to the management of chronic pain patients. Moreover, to gain an understanding of how this can lead to improved pain education planning and engagement in the future. METHODS: The revised Neurophysiology of Pain Questionnaire and the researchers' own questionnaire were administered online to chiropractic placement students. The aggregated total number of correct responses and the individual mean scores were calculated. Statistical analysis included tests of normality and difference using the Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, and Χ2 tests. RESULTS: There was an overall response rate of 21.6% (n = 50). The mean score achieved on the revised neurophysiology of pain questionnaire was 37.8%. A significant difference between individual mean scores on the revised Neurophysiology of Pain Questionnaire was observed between male and female participants. No differences in mean score were observed between age, number of chronic pain patients seen, and previous qualifications. For the study-specific questionnaire, statistically significant differences were found in mean score for previous qualifications, number of patients seen, and sex. CONCLUSION: Chiropractic placement students in the United Kingdom appear to have a lower level of pain knowledge than other health care professionals and education institutions may wish to consider how to best address this within their curricula.

COVID-19: how has a global pandemic changed manual therapy technique education in chiropractic programs around the world?

BACKGROUND: Manual therapy is a cornerstone of chiropractic education, whereby students work towards a level of skill and expertise that is regarded as competent to work within the field of chiropractic. Due to the COVID-19 pandemic, chiropractic programs in every region around the world had to make rapid changes to the delivery of manual therapy technique education, however what those changes looked like was unknown. AIMS: The aims of this study were to describe the immediate actions made by chiropractic programs to deliver education for manual therapy techniques and to summarise the experience of academics who teach manual therapy techniques during the initial outbreak of COVID-19 pandemic. METHODS: A qualitative descriptive approach was used to describe the immediate actions made by chiropractic programs to deliver manual therapy technique education during the COVID-19 pandemic. Chiropractic programs were identified from the webpages of the Councils on Chiropractic Education International and the Council on Chiropractic Education - USA. Between May and June 2020, a convenience sample of academics who lead or teach in manual therapy technique in those programs were invited via email to participate in an online survey with open-ended questions. Responses were entered into the NVivo software program and analysed using a reflexive thematic analysis by a qualitative researcher independent to the data collection. RESULTS: Data from 16 academics in 13 separate chiropractic programs revealed five, interconnected themes: Immediate response; Move to online delivery; Impact on learning and teaching; Additional challenges faced by educators; and Ongoing challenges post lockdown. CONCLUSION: This study used a qualitative descriptive approach to describe how some chiropractic programs immediately responded to the initial outbreak of the COVID-19 pandemic in their teaching of manual therapy techniques. Chiropractic programs around the world provided their students with rapid, innovative learning strategies, in an attempt to maintain high standards of chiropractic education; however, challenges included maintaining student engagement in an online teaching environment, psychomotor skills acquisition and staff workload.

Nonacademic qualities as predictors of performance in an undergraduate healthcare program.

OBJECTIVE: Nonacademic qualities such as time management, study skills, stress, and motivation have been linked to academic performance. The purpose of this study was to gain an understanding of this relationship to enable early remediation in a chiropractic training program. METHODS: Questionnaire data were collected at the beginning of the academic year, end of semester 1, and end of semester 2. Questions were related to participants' time management, study skills, stress, and motivation. These were compared to summative assessment results. Semistructured interviews were conducted at the end of semester 1 and end of semester 2. RESULTS: Amount of time spent studying did not correlate significantly with assessment results. At the beginning of the year, 85.7% of students participated in extracurricular activities. This reduced throughout the year; students who stopped activities were significantly more successful in assessments. When stress at the beginning of the year was compared to end of semester 1, there was a significant increase (p = .012), with further significant increases from semester 1 to the end of semester 2 (p = .001). Students were very motivated at the beginning of the year, and this was maintained to the end of semester 1 (p = .257). However, at the end of semester 2, students became significantly less motivated (p = .007). End-of-year motivation correlated with poor student outcomes (p = .056). CONCLUSION: Time management, study skills, stress, and motivation influenced academic performance in this sample of students. This study supports the notion that student assistance is needed. Additional research into student assistance would be beneficial.

Engagement as predictors of performance in a single cohort of undergraduate chiropractic students.

OBJECTIVE: To investigate the potential association of novel academic and nonacademic factors with chiropractic student academic performance. METHODS: Students enrolled into year 1 of a chiropractic master's degree (MChiro) at our college were selected for this study. Data collected included demographics, attendance, virtual learning environment use, additional learning needs, previous degree qualifications, and summative marks. Differences between students who had to take an examination more than once (resit) and nonresit students were explored using t test and χ2 analysis. Relationships between attendance and end-of-year marks were explored using regression analysis. RESULTS: Male students outperformed female students in four of the six units and as the total year average. Students who attended <80% of classes were more likely to have a resit in one or more units (relative risk [ RR] = 2.6; 95% confidence interval [CI], 1.4-4.9). Students who performed poorly (<70%) in the semester 1 unit of a course on human structure and failed the semester 1 practical assessment of a course on clinical management were significantly more likely to have one or more resit assessments in semester 2 units ( RR = 3.5 [95% CI, 2.2-5.7]; RR = 3.2 [95% CI, 2.0-4.9]). Attendance and unit 105 were independent predictors of one or more resits at the end-of-year ( R2 = 0.86, p < .001). CONCLUSION: Attendance and first semester summative marks were associated with end-of-year performance. As such, these markers of performance may be used to flag struggling students in the program.

Influence of year-on-year performance on final degree classification in a chiropractic master's degree program.

OBJECTIVE: We explored if any predictors of success could be identified from end-of-year grades in a chiropractic master's program and whether these grades could predict final-year grade performance and year-on-year performance. METHODS: End-of-year average grades and module grades for a single cohort of students covering all academic results for years 1-4 of the 2013 graduating class were used for this analysis. Analysis consisted of within-year correlations of module grades with end-of-year average grades, linear regression models for continuous data, and logistic regression models for predicting final degree classifications. RESULTS: In year 1, 140 students were enrolled; 85.7% of students completed the program 4 years later. End-of-year average grades for years 1-3 were correlated (Pearson r values ranging from .75 to .87), but the end-of-year grades for years 1-3 were poorly correlated with clinic internship performance. In linear regression, several modules were predictive of end-of-year average grades for each year. For year 1, logistic regression showed that the modules Physiology and Pharmacology and Investigative Imaging were predictive of year 1 performance (odds ratio [OR] = 1.15 and 0.9, respectively). In year 3, the modules Anatomy and Histopathology 3 and Problem Solving were predictors of the difference between a pass/merit or distinction final degree classification (OR = 1.06 and 1.12, respectively). CONCLUSION: Early academic performance is weakly correlated with final-year clinic internship performance. The modules of Anatomy and Histopathology year 3 and Problem Solving year 3 emerged more consistently than other modules as being associated with final-year classifications.