A scoping review to identify barriers and facilitators of research participation among chiropractic faculty.

OBJECTIVE: To describe peer-reviewed literature on chiropractic faculty participation in research and identify important barriers and facilitators. METHODS: We conducted a scoping review using comprehensive searches of relevant databases from inception through November 2022. English language publications of any design were included, with search terms consisting of subject headings specific to each database and free text words related to chiropractic, faculty, and research. Primary and secondary reviewer teams performed article screening and data abstraction using Covidence software, with primary reviewers responsible for consensus. Data were entered into evidence tables and analyzed descriptively. RESULTS: A total of 330 articles were screened, with 14 deemed eligible including 8 cross-sectional/correlational studies and 6 narrative reviews/editorials. Article publication dates ranged from 1987 to 2017. No intervention studies were identified. Facilitators of chiropractic faculty research included research assignment as primary role, institutional culture promoting research, and dedicated release time. Barriers included teaching/clinic assignments, lack of incentives and mentorship, and teaching load. Qualitative results identified 5 domains impacting faculty research: demographics/professional roles; personal empowerment; research culture; institutional setting/policies; and research training. CONCLUSION: Our scoping review found a paucity of recently published articles on chiropractic faculty participation in research. Educational institutions building research capacity among chiropractic faculty must establish cultural environments where scholarship is expected, rewarded, and valued. Tangible support, such as research policies, resources, and space, advanced training, funding, and release time, must be available. Faculty are encouraged to build upon key facilitators, evaluate interventions to address barriers to chiropractic faculty research, and publish their results.

Effect of lavender and rosemary aromatherapy on test anxiety in chiropractic students.

OBJECTIVE: Test anxiety is a debilitating disorder that can impair cognitive performance and affect academic success. Aromatherapy is commonly used for relaxation therapy. The primary aim of the study was to determine if nasal inhaler aromatherapy, utilizing a blend of rosemary and lavender essential oils, could be a useful strategy to reduce testing anxiety in students. METHODS: This study recruited first trimester chiropractic students enrolled in both Neuroanatomy I and Biochemistry I. A randomized crossover design was utilized over 2 study days during final exams, with a 2-day wash-out period. Participants were randomly assigned into groups based on results of test anxiety analysis. On each day, students were given a nasal inhaler with either an aromatherapy blend of lavender and rosemary essential oils or distilled water as the control. Students completed pretest surveys and posttest surveys to rate their anxiety levels. Paired sample t-tests were performed to determine group differences in test anxiety. Both intention-to-treat and per-protocol analyses were conducted. RESULTS: Forty-five students were randomly assigned into the study, whereas only 38 completed per-protocol. Between group comparisons showed no statistically significant difference between change in anxiety scores between aromatherapy and control for both intention-to-treat (p =.10) and per-protocol (p =.07). CONCLUSION: Use of personal inhalers and aromatherapy diffusers were not shown to reduce test anxiety in a chiropractic population under high-stakes examination. Other options should be explored for future research.

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.

Improper Communication Makes for Squat: A Qualitative Study of the Health-Care Processes Experienced By Older Adults in a Clinical Trial for Back Pain.

BACKGROUND: The study focused on perceptions of older adults toward the healthcare processes they experienced during a clinical trial for back pain that involved family medicine residents and licensed chiropractors. METHODS: Individual semi-structured interviews were conducted with 115 older adults after a 12-week, 3-arm, randomized controlled trial. Two researchers conducted thematic analysis with inductive coding using qualitative software to identify participants' salient experiences of the doctor-patient relationship, healthcare process, and collaboration between study providers. Investigators categorized thematic codes within an existing framework of clinical excellence in primary care. RESULTS: Participants emphasized provider communication and interpersonal relationships, professionalism and passion for patient care, clinical and diagnostic acumen, and skillful negotiation of the health-care system. Older adults also described the importance of interdisciplinary collaboration and their preferences for receiving hands-on treatments for musculoskeletal conditions. CONCLUSION: These older adults valued doctors who communicated clearly and spent time listening to their concerns. Many participants appreciated clinicians who supported an active role for patients in their health-care and who provided touch-based care for musculoskeletal conditions.

Potential publication bias in chiropractic and spinal manipulation research listed on clinicaltrials.gov.

INTRODUCTION: Clinical trial registries are used to help improve transparency in trial reporting. Our study aimed to identify potential publication bias in chiropractic and spinal manipulation research by assessing data drawn from published studies listed in clinincaltrials.gov. METHODS: We searched the clinicaltrials.gov registry database for completed trials tagged with the key indexing terms chiropractic or spinal manipulation. We assessed if the trial registry had been updated with data, then searched for publications corresponding to the registered trials. Finally, the frequency of positive or negative results was determined from published studies. RESULTS: For the term 'chiropractic', 63% of studies supported the intervention and 52% supported the intervention for the term 'spinal manipulation'. DISCUSSION: Publication bias in chiropractic and spinal manipulation research listed in clinicaltrials.gov appears to occur. Further work may help understand why this happens and what may be done to mitigate this moving forward.

INTRODUCTION: Les registres des essais cliniques servent à accroître la transparence des rapports sur les essais. Notre étude visait à trouver les éventuels partis pris de publication dans les travaux de recherche sur la chiropratique et les manipulations vertébrales à l'aide de données tirées d'études publiées et répertoriées dans clinincaltrials.gov. MÉTHODOLOGIE: Dans la base de données du registre clinicaltrials.gov, nous avons cherché des essais terminés marqués par les termes d'indexation « chiropratique ¼ et « manipulation vertébrale ¼. Nous avons cherché à savoir si le registre des essais avait été mis à jour par l'ajout de données, puis nous avons recherché les publications correspondant aux essais répertoriés. Enfin, nous avons établi la fréquence des résultats positifs et négatifs à l'aide des études publiées. RÉSULTATS: Avec le terme « chiropratique ¼, 63 % des études étaient en faveur des interventions; avec l'expression « manipulation vertébrale ¼,52 % des études étaient en faveur des interventions. DISCUSSION: Il semble y avoir un parti pris de publication dans les travaux de recherche sur la chiropratique et les manipulations vertébrales répertoriés dans clinicaltrials.gov. D'autres travaux pourraient aider à comprendre la cause de ce phénomène et à trouver des moyens de le réduire dans l'avenir.

A graphical clinical decision aid for managing imaging report information.

OBJECTIVE: The purpose of this article is to propose a graphical decision aid for managing radiology report information to assist learners in developing clinical decision-making skills through a structured approach. METHODS: A graphical decision aid informed by learning theories was constructed to manage radiology report information by identifying an overall strategy, specific decision-making steps, and decision goals. A review of radiology reports was performed to demonstrate the rich source of complex information requiring clinical decision making. Radiology report data were descriptively analyzed, and findings were described as definite or indefinite, while recommendations were reported as required or optional. RESULTS: The graphical decision aid involves 4 stages. The 1st 2 stages interpret report information and consider data obtained during the clinical encounter. The following 2 stages guide decisions by answering questions to ensure patient safety and/or to confirm diagnosis and to address broader case management questions. The mean (SD) age of participants whose imaging reports were reviewed was 73.4 (7.0) years. Of 170 reports, common findings included degenerative disc disease (98%), soft tissue or vascular calcification (94%), bone demineralization (92%), and zygapophyseal joint degeneration (86%). Common indefinite findings were spinal stenosis (15%), compression fracture (12%), bony abnormality (12%), radiodensity (12%), and disc degeneration (10%). One hundred twenty-one recommendations suggested follow-up actions. CONCLUSIONS: Information within imaging reports requires identification and interpretation to inform complex clinical decisions. The graphical decision aid proposed in this article is designed to facilitate the development of decision-making skills by providing a structured and evidence-based information management process.