Evaluating students' research literacy knowledge, confidence, and attitudes at the beginning and end of a doctor of chiropractic program.

OBJECTIVE: The doctor of chiropractic program (DCP) graduate must demonstrate competency in clinical research literacy (CRL), per accreditation standards. This study aimed to compare student CRL knowledge, confidence, and attitudes between the beginning and end of their DCP. METHODS: We collected data on 245 matriculating students' CRL knowledge, confidence, and attitudes between 2017 and 2018. In 2021 and 2022, 78 of these students enrolled in a course with an extra credit assignment that was used to re-collect CRL data as they approached graduation. We assessed changes between entry and exit using statistical analyses in STATA17. RESULTS: Paired data were collected for 56 students. The mean CRL scores on a scale of 10 at the DCP beginning and end were 5.25 (SD 2.06) and 6.54 (SD 1.89), respectively (p = .0001). We observed statistically significant (p ≤ .05) positive changes in students' abilities to answer questions about Medical Subject Headings, the hierarchy of evidence, systematic reviews, meta-analyses, and the limitations of abstracts. There was also a statistically significant increase in confidence, with over 80% of students nearing graduation reporting good or excellent abilities to find and judge health information for their patients. The proportion of students who envisioned searching a database to help manage a challenging clinical case decreased from 96% to 89% (p > .05). The proportion seeing themselves submitting a case report for publication declined from 16% to 4% (p ≤ .05). CONCLUSION: Students' self-perceived CRL abilities and knowledge improved between the beginning and end of their DCP; however, their attitudes toward applying these in practice declined.

Chiropractic faculty experiences of burnout and the COVID-19 pandemic.

OBJECTIVE: The Maslach Burnout Inventory (MBI) is frequently used to assess occupational burnout and the Epidemic-Pandemic Impacts Inventory (EPII) is a new tool for assessing pandemic impacts. This study's objective is to describe chiropractic faculty members' experience of the COVID-19 pandemic, their burnout as professional educators, and their strategies for coping with stress. METHODS: A Qualtrics survey link was emailed to 73 current faculty and 10 previously employed faculty from 1 chiropractic school. The survey included 22 MBI, 31 EPII, and 2 questions about coping strategies. Faculty were given several weeks to complete the survey, were reminded via emails and meeting announcements, and were given paper surveys to increase participation. Responses were analyzed in STATA17. RESULTS: Forty-three faculty completed the survey (response rate = 52%). Of these, 25.8% reported testing positive for COVID-19, 30.23% reported difficulties transitioning to working from home, and 25.5% scored high on the MBI subscale for emotional exhaustion (EE) (mean 15.79, SD 13.68). Higher EE was associated with pandemic-related increases in mental health and sleep problems. Common coping strategies included self-care and social support. CONCLUSION: The majority of faculty reported neither contracting COVID-19 nor having difficulty transitioning to work from home. Average EE for participating faculty was lower than previous reports although a quarter scored high in EE, which may be associated with pandemic-related mental health and sleep problems. These results suggest chiropractic faculty might need support coming out of the COVID-19 pandemic and indicate the need for future research on burnout among faculty from other chiropractic institutions.

Mental health and lifestyle behaviors of students in a doctor of chiropractic program.

OBJECTIVE: Health professional students' mental health and lifestyle behaviors may impact their personal health as well as their clinical practice. The objective of our retrospective study was to see if there were changes in students' mental health and lifestyle behaviors during their doctor of chiropractic program (DCP). METHODS: In 2019, we identified health center files for 198 students who graduated from our DCP between 2015 and 2016, of which 69% (n = 137) contained Health Insurance Portability and Accountability Act (HIPAA) consent forms granting permission for file review. From each of these files, we extracted mental health and lifestyle behavior data that students self-reported at the beginning and end of their DCP. Data were analyzed with descriptive statistics, paired t test, sign test, and McNemar's chi-square test. RESULTS: The majority of our students reported drinking alcohol, engaging in regular exercise, and not smoking at the beginning and end of our DCP. Comparing pre and post data, there was a statistically significant increase in water, fruit, and vegetable consumption along with an increased proportion of students reporting eating junk food and drinking 1 or more servings of caffeine (p ≤ .002). The proportion of students reporting anxiety or depression decreased between the beginning and end of our DCP (p = .002). CONCLUSION: This study provided information about student mental health and lifestyle behaviors at 1 DCP. We recommend future studies use validated questionnaires across multiple DCPs. There also may be a need for intervention research to decrease DCP student alcohol use.

Information literacy of matriculating chiropractic students assessed via research readiness survey.

OBJECTIVE: We developed a Research Readiness Survey (RRS) to identify students' information literacy needs prior to instruction by a team of faculty members and librarians in our doctor of chiropractic program clinical research literacy courses. In addition to describing students' responses to our RRS, we explored associations between (1) students' overall performance on the RRS and their prior earned degrees and (2) their self-reported ability and performance on questions pertaining to evaluating information quality (standard 3 of the Association of College and Research Libraries [ACRL] Information Literacy Competency Standards for Higher Education). METHODS: The RRS is composed of 50 questions, of which 22 pertain to information literacy knowledge assessment per ACRL standards. We calculated means and standard deviations for summary scores on 4 ACRL standards and for a total RRS score. We used analysis of variance to assess whether standard 3 scores differed by students' self-reported ability to judge health information quality and whether there was an association between total RRS scores and students' previously earned degrees. RESULTS: In 2017-2018, 245 students (70% of matriculates) completed the RRS. Students performed best on standard 3 (average score 67%) and worst on standard 2, the ability to access information (average score = 59%). Students who reported an average ability to judge information quality had higher standard 3 scores than students who reported poor ability (p = .003). Students with bachelor's degrees had higher total RRS scores than students with associate's degrees (p = .004). CONCLUSION: Matriculating students had the most difficulty with accessing information, supporting the need to include librarians on the teaching team.

Association Between Chiropractic Utilization and Opioid Prescriptions Among People With Back or Neck Pain: Evaluation of the Medical Expenditure Panel Survey.

OBJECTIVE: The purpose of this study was to assess the association between patients in the United States seeing a chiropractor and receiving an opioid prescription for back or neck pain. METHODS: Medical Expenditure Panel Survey (Years 2012 to 2015) respondents for longitudinal panels 17 to 19 who participated in all 5 rounds were at least 18 years of age, did not have cancer, and reported back or neck pain. We defined chiropractic users as participants reporting at least 1 chiropractic visit for back or neck pain and opioid users as participants reporting purchase or receipt of a prescription classified as Multum Lexicon "60" and "191" for back or neck pain. We adjusted for socioeconomic and clinical variables using multiple logistic regression. RESULTS: The sample contained 4686 people, 21% of whom reported an opioid prescription for back or neck pain. Among opioid users, 14% reported a chiropractic visit for back or neck pain compared to 31% of nonopioid users. The adjusted odds ratio for chiropractic use among opioid users compared to nonopioid users was 0.46 (95% confidence interval, 0.36-0.57). CONCLUSION: Patients with back or neck pain who saw a chiropractor had approximately half the odds of reporting an opioid prescription compared to those who did not see a chiropractor.

Evaluating a service-learning assignment in a doctor of chiropractic program public health course.

OBJECTIVE: Despite the use of service learning in other health care education programs, little is published about its use in doctor of chiropractic programs. Since 2017, the public health course at our institution has included a service-learning assignment in which students volunteer for nonprofit organizations and write an essay about their experience. The objective of this study was to assess the effects of the assignment on students' self-reported public health knowledge and attitudes. METHODS: Between April 2017 and June 2018, 56 essays were collected from students who volunteered at a nonprofit organization focused on 3 categories: youth, the environment, or poverty. Each essay was deidentified and assigned random 4-digit-number file names. Ten files were randomly selected from each of the 3 categories for qualitative thematic analysis using deductive and inductive coding. RESULTS: Student essays demonstrated competency in public health concepts, including organizational systems, levels of prevention, and the social ecological model. In addition, a majority of the students went beyond discussing knowledge gained from this assignment and described the impact of their experience on their personal growth. CONCLUSION: This study demonstrates that students respond favorably to a service-learning assignment that addresses public health competencies and may foster personal and professional development.