Chiropractic identity, role and future: a survey of North American chiropractic students

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Abstract

Background

The literature pertaining to chiropractic students’ opinions with respect to the desired future status of the chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single chiropractic college. This current study is an expansion of this pilot project to collect data from chiropractic students enrolled in colleges throughout North America.

Objective

The purpose of this study is to investigate North American chiropractic students’ opinions concerning professional identity, role and future.

Methods

A 23-item cross-sectional electronic questionnaire was developed. A total of 7,455 chiropractic students from 12 North American English-speaking chiropractic colleges were invited to complete the survey. Survey items encompassed demographics, evidence-based practice, chiropractic identity and setting, and scope of practice. Data were collected and descriptive statistical analysis was performed.

Results

A total of 1,247 (16.7% response rate) questionnaires were electronically submitted. Most respondents agreed (34.8%) or strongly agreed (52.2%) that it is important for chiropractors to be educated in evidence-based practice. A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes. A large number of respondents (55.2%) were not in favor of expanding the scope of the chiropractic profession to include prescribing medications with appropriate advanced training. Most respondents estimated that chiropractors should be considered mainstream health care practitioners (69.1%). Several respondents (46.8%) think that chiropractic research should focus on the physiological mechanisms of chiropractic adjustments.

Conclusion

The chiropractic students in this study showed a preference for participating in mainstream health care, report an exposure to evidence-based practice, and desire to hold to traditional chiropractic theories and practices. The majority of students would like to see an emphasis on correction of vertebral subluxation, while a larger percent found it is important to learn about evidence-based practice. These two key points may seem contradictory, suggesting cognitive dissonance. Or perhaps some students want to hold on to traditional theory (e.g., subluxation-centered practice) while recognizing the need for further research to fully explore these theories. Further research on this topic is needed.

Electronic supplementary material

The online version of this article (doi:10.1186/s12998-014-0048-1) contains supplementary material, which is available to authorized users.

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Most cited references 10

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Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey

Marion McGregor, Aaron Puhl, Christine Reinhart … (2014)

Background As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession’s progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions. Methods A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals. Results Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X2 =13.4, p = 0.0002). Conclusion Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession’s factions is important to the anticipation of care delivery when considering interprofessional referral.

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Middle Alternatives Revisited : How the neither/nor Response Acts as a Way of Saying “I Don’t Know”?

Patrick Sturgis, Caroline Roberts, Patten Smith (2014)

A persistent problem in the design of bipolar attitude questions is whether or not to include a middle response alternative. On the one hand, it is reasonable to assume that people might hold opinions which are `neutral’ with regard to issues of public controversy. On the other, question designers suspect that offering a mid-point may attract respondents with no opinion, or those who lean to one side of an issue but do not wish to incur the cognitive costs required to determine a directional response. Existing research into the effects of offering a middle response alternative has predominantly used a split-ballot design, in which respondents are assigned to conditions which offer or omit a midpoint. While this body of work has been useful in demonstrating that offering or excluding a mid-point substantially influences the answers respondents provide, it does not offer any clear resolution to the question of which format yields more accurate data. In this paper, we use a different approach. We use follow-up probes administered to respondents who initially select the mid-point to determine whether they selected this alternative in order to indicate opinion neutrality, or to indicate that they do not have an opinion on the issue. We find the vast majority of responses turn out to be what we term `face-saving don’t knows’ and that reallocating these responses from the mid-point to the don’t know category significantly alters descriptive and multivariate inferences. Counter to the survey-satisficing perspective, we find that those with this tendency is greatest amongst those who express more interest in the topic area.

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Interprofessional collaboration within Canadian integrative healthcare clinics: Key components.

Isabelle Gaboury, Mathieu Bujold, Heather Boon … (2009)

Research shows that interprofessional collaboration has become an important factor in the implementation of effective healthcare models. To date, the literature has not focused on the collaboration between medical doctors and complementary and alternative medicine (CAM) healthcare practitioners, an example of interdisciplinary collaboration called integrative healthcare (IHC). Drawing on in-depth, semi-standardized interviews conducted with 21 practitioners working in Canadian IHC clinics, this paper explored and interpreted how IHC is experienced by those working in Canadian IHC clinics. The interview questions and analysis were guided by the Input, Process, Output conceptual framework drawn from the organizational management theory (McGrath, J. E. (1964). Social psychology: A brief introduction. New York: Holt, Rinehart and Winston.) to study collaboration within teams. We found that constructs contributing to collaboration included practitioners' attitudes and educational background, as well as external factors such as the healthcare system and financial pressures. Major processes affecting collaboration included communication, patient referral and power relationships. These determinants of collaboration were found to result in learning opportunities for practitioners, modified burden of work and ultimately, higher affective commitment toward the clinic. These constructs serve as a guide for further investigation of interprofessional collaboration within an IHC clinic. This exploration of interprofessional collaboration in IHC identified a broad array of key factors associated with interprofessional collaboration. These factors are critical to better understand the functioning of IHC clinics, and provide guidance for creation or maintenance of successful clinics.

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Author and article information

Contributors

Jordan A Gliedt: jordan.gliedt@gmail.com

Cheryl Hawk: hawkcheryl@aol.com

Michelle Anderson: michelle.anderson@logan.edu

Kashif Ahmad: kahmad@nwhealth.edu

Dinah Bunn: dbunn@nwhealth.edu

Jerrilyn Cambron: jcambron@nuhs.edu

Brian Gleberzon: bgleberzon@cmcc.ca

John Hart: jhart@sherman.edu

Anupama Kizhakkeveettil: anu@scuhs.edu

Stephen M Perle: perle@bridgeport.edu

Michael Ramcharan: mramcharan@txchiro.edu

Stephanie Sullivan: stephanie.sullivan@life.edu

Liang Zhang: liang.zhang@palmer.edu

Journal

Journal ID (nlm-ta): Chiropr Man Therap

Journal ID (iso-abbrev): Chiropr Man Therap

Title: Chiropractic & Manual Therapies

Publisher: BioMed Central (London )

ISSN (Electronic): 2045-709X

Publication date (Electronic): 2 February 2015

Publication date PMC-release: 2 February 2015

Publication date Collection: 2015

Volume: 23

Issue: 1

Electronic Location Identifier: 4

Affiliations

[ ]Private Practice, 725 S. Dobson Rd, Suite 100, Chandler, AZ 85224 USA

[ ]Logan University College of Chiropractic, 1851 Schoettler Rd, Chesterfield, MO 63017 USA

[ ]Northwestern University of Health Sciences, 2501 W. 84th St, Bloomington, MN 55431 USA

[ ]National University of Health Sciences, 200 E. Roosevelt Rd, Lombard, IL 60148 USA

[ ]Canadian Memorial College of Chiropractic, 6100 Leslie St, Toronto, Ontario Canada

[ ]Sherman College of Chiropractic, 2020 Springfield Rd, Boiling Springs, SC 29316 USA

[ ]Southern California University of Health Sciences, 16200 E. Amber Valley Dr., Whittier, CA 90604 USA

[ ]University of Bridgeport, Bridgeport, CT 06604 USA

[ ]Texas Chiropractic College, 5912 Spencer Highway, Pasadena, TX 77505 USA

[ ]Life University, 1269 Barclay Circle, Marietta, GA 30060 USA

[ ]Palmer College of Chiropractic - Florida, 4777 City Center Parkway, Port Orange, FL 32129 USA

Article

Publisher ID: 48

DOI: 10.1186/s12998-014-0048-1

PMC ID: 4313466

SO-VID: 021e68d1-d2da-4902-bdf4-ade91a467b53

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.