Resilient responses to stressful events among chiropractic students: A cross-sectional survey.

OBJECTIVE: Resilient students may better navigate the challenges of chiropractic training. This study explored the relationships between response to stressful experiences, perceived stress, and quality of life among students at 1 US chiropractic college campus. METHODS: A cross-sectional survey was conducted with 873 students. The anonymous online questionnaire included demographics, quality of life, perceived stress, and the Response to Stressful Events Scale (RSES). Hierarchical multiple regression analyses assessed for significant relationships among variables. RESULTS: A sample of 221 students (60% female) completed the survey (25% response rate). Male respondents reported greater psychological health. Participants reporting high quality of life exhibited higher resiliency on the RSES flat score and many RSES domains. Respondents who rated greater psychological health and social relationships exhibited greater spiritual resiliency. Respondents reporting higher psychological health and lower levels of perceived stress exhibited higher self-efficacy resilience. Psychological health was the most important predictor for RSES flat score and domains, except for spiritual resilience, for which social relationships were most important. Male gender was predictive of 3 RSES domains: meaning making, active coping, and cognitive flexibility. CONCLUSION: More resilient responses to stressful events were reported by male chiropractic students and those who reported greater psychological health, higher quality of life, or lower perceived stress. Female students and those experiencing psychological challenges or lower quality of life might consider resilience training to increase the use of protective coping strategies. These findings may permit academic institutions to identify students at highest risk and employ interventions to prevent program withdrawal.

Aromatherapy for test anxiety in chiropractic students.

OBJECTIVE: Up to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction. METHODS: This study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim. RESULTS: Sixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups' pre- and posttest anxiety scores (p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future. CONCLUSION: We demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.

Scarlet letters: The association of alternative admissions track plan status with key programmatic outcomes in a chiropractic training program.

OBJECTIVE: In 2012, the Council on Chiropractic Education (CCE) enacted new admission standards with related provisions under a new Policy 7, the Alternative Admissions Track Plan (AATP). The current study examined the relationships between typically admitted students and their AATP counterparts on three student success outcome measures: Graduation at the 150th percentile time frame, National Board of Chiropractic Examiners (NBCE) Part I pass rates, and completion of all four NBCE examinations within 6-months after graduation. METHODS: The authors used three random samples (n = 1050) drawn from a relational database, containing program outcome variables and student characteristics. Assessment of the outcome measures occurred using Pearson χ2 test of independence and the Φ coefficient effect size measure. RESULTS: Significant relationships with small effect sizes and weak associations were found between AATP status and graduation at the 150th percentile (p < .01, Φ = .118) and NBCE Part I pass rates (p < .01, Φ = .114). No significant association between AATP status and NBCE Completion rates 6-months after graduation (p = .144, Φ = .045) was found. CONCLUSION: The weak associations between variables indicate that AATP status did not meaningfully relate to the outcome variables. There likely are other subtle characteristics and attributes that influence successful completion of key programmatic outcomes. The weak associations found in the current study suggest that when governed under the same academic policies with equal access to support resources, there does not appear to be a meaningful association between the programmatic success of AATP and non-AATP students on key outcomes.

The influence of online review videos on gross anatomy course performance among doctor of chiropractic students.

OBJECTIVE: Technology-enhanced learning is on the rise within healthcare education. This pilot study evaluated the relationship between the use of online review videos and students' performance and satisfaction in gross anatomy. METHODS: For this quasi-experimental study, we developed a series of online gross anatomy review videos, and surveyed students enrolled in a doctor of chiropractic program regarding use of the videos and their attitudes towards using the videos. Ordinal regression was used to evaluate the relationship between students' video use and course performance and the Mann-Whitney U test was used to determine whether there was a difference in course performance between students who did and did not report using the review videos. RESULTS: We received 143 responses to our survey, resulting in a 73.3% response rate. Most students (71%) had engaged with the online review videos. No significant differences in course performance were detected between students who did and did not report using the videos. Many students (82%) reported the review videos as being "helpful" and 73% perceived them as "an enjoyable way to study." CONCLUSION: While chiropractic students perceived a series of online gross anatomy review videos as being an enjoyable and helpful way to study, engagement with this form of technology-enhanced learning did not have an impact on their overall gross anatomy course performance.

Building a chiropractic academy of educators: A needs assessment of selected faculty educators.

OBJECTIVE: Professional demands have led to health-care educator specialization in research or patient care. The academy movement is an avenue that attempts to return prestige and importance to improved instruction. The authors performed a needs analysis of selected faculty at 3 chiropractic colleges to assess the need for, and willingness to participate in, an academy of educators program. METHODS: An expert-developed, pretested survey was deployed using SurveyMonkey. Analysis of variance and regression analysis were used to address 3 research questions related to the academy of educators program. RESULTS: The study achieved a 53% response rate and reflected that an overwhelming majority of chiropractic faulty members (89%) reported the need for an academy of educators. The study found no significant differences between faculty ranks, years of experience, and participation willingness. CONCLUSION: A structured approach, such as an academy, to foster professional teaching development may create positive outcomes for an institution. Faculty educators were willing to engage in an efficient program that may improve teaching methods and create opportunities for collaborative working relationships, which signals the potential for wide acceptance of the program.

Essential literature for the chiropractic profession: a survey of chiropractic research leaders.

BACKGROUND: Evidence-based clinical practice (EBCP) is an accepted practice for informed clinical decision making in mainstream health care professions. EBCP augments clinical experience and can have far reaching effects in education, policy, reimbursement and clinical management. The proliferation of published research can be overwhelming-finding a mechanism to identify literature that is essential for practitioners and students is desirable. The purpose of this study was to survey leaders in the chiropractic profession on their opinions of essential literature for doctors of chiropractic, faculty, and students to read or reference. METHODS: Deployment of an IRB exempted survey occurred with 68 academic and research leaders using SurveyMonkey®. Individuals were solicited via e-mail in August of 2011; the study closed in October of 2011. RESULTS: Forty-three (43) individuals consented to participate; seventeen (17) contributed at least one article of importance. A total of 41 unique articles were reported. Of the six articles contributed more than once, one article was reported 6 times, and 5 were reported twice. CONCLUSIONS: A manageable list of relevant literature was created. Shortcomings of methods were identified, and improvements for continued implementation are suggested. A wide variety of articles were reported as "essential" knowledge; annual or bi-annual surveys would be helpful for the profession.

Data quality assurance: an analysis of patient non-response.

PURPOSE: Patient satisfaction is paramount to maintaining high clinical quality assurance. This study seeks to compare response rates, response bias, and the completeness of data between paper and electronic collection modes of a chiropractic patient satisfaction survey. DESIGN/METHODOLOGY/APPROACH: A convenience sample of 206 patients presenting to a chiropractic college clinic were surveyed concerning satisfaction with their chiropractic care. Paper (in-clinic and postal) and electronic modes of survey administration were compared for response rates and non-response bias. FINDINGS: The online data collection mode resulted in fewer non-responses and a higher response rate, and did not evince response bias when compared to paper modes. The postal paper mode predicted non-response rates over the in-clinic paper and online modalities and exhibited a gender bias. RESEARCH LIMITATIONS/IMPLICATIONS: This current study was a single clinic study; future studies should consider multi-clinic data collections. Busy clinic operations and available staff resources restricted the ability to conduct a random sampling of patients or to invite all eligible patients, therefore limiting the generalizability of collected survey data. PRACTICAL IMPLICATIONS: Results of this study will provide data to aid development of survey protocols that efficiently, account for available human resources, and are convenient for patients while allowing for the most complete and accurate data collection possible in an educational clinic setting. ORIGINALITY/VALUE: Understanding patient responses across survey modes is critical for the cultivation of quality business intelligence within college teaching clinic settings. This study bridges measurement evidence from three popular data collection modalities and offers support for higher levels of quality for web-based data collection.

International web survey of chiropractic students about evidence-based practice: a pilot study.

BACKGROUND: Positive attitude toward evidence-based practice (EBP) principles in healthcare education may be one of the first steps for motivating a healthcare professional student to later apply EBP principles in clinical decision-making. The objectives for this project were to pilot an international web-based survey of chiropractic students and to describe student attitudes, behaviors, and knowledge about EBP principles. METHODS: We used SurveyMonkey™ to develop our survey based on an existing questionnaire used to measure basic knowledge, skills and beliefs about EBP among allied healthcare professionals and CAM practitioners. We invited 26 chiropractic educational institutions teaching in English and accredited by official organizations to participate. Academic officials and registrars at participating institutions forwarded an invitation email and two reminders to students between July and September 2010. The invitation contained a link to the 38-item web-based questionnaire. Descriptive statistics were performed for analysis. RESULTS: Fourteen institutions from Australia, Canada, US, Denmark and New Zealand participated. Among an estimated 7,142 student recipients of invitation letters, 674 participated in the survey for an estimated response rate of 9.4%. Most respondents reported having access to medical/healthcare literature through the internet, but only 11% read literature every week and 21% did not read literature at all. Respondents generally agreed that the use of research evidence in chiropractic was important. Although 76% of respondents found it easy to understand research evidence and 81% had some level of confidence assessing the general worth of research articles, 71% felt they needed more training in EBP to be able to apply evidence in chiropractic care. Respondents without previous training in research methods had lower confidence in assessing published papers. While more than 60% marked the correct answer for two knowledge items, the mean number of correct answers to the five knowledge questions was 1.3 (SD 0.9). CONCLUSIONS: Although it is feasible to conduct an international web survey of chiropractic students, significant stakeholder participation is important to improve response rates. Students had relatively positive attitudes toward EBP. However, participants felt they needed more training in EBP and based on the knowledge questions they may need further training about basic research concepts.