So, what is chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies

Hartvigsen, Jan; French, Simon

doi:10.1186/s12998-019-0295-2

Cited by 17 publications

(14 citation statements)

References 20 publications

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“…There is urgent need for further research to describe what chiropractic is, [ 29 ] in order to improve student learning and teaching, develop professional scholarship and penultimately improve patient care. Future studies must emphasise student engagement, potentially through incentivisation to improve research participation.…”

Section: Discussionmentioning

confidence: 99%

Chiropractic students’ cognitive dissonance to statements about professional identity, role, setting and future: international perspectives from a secondary analysis of pooled data

et al. 2021

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Background Chiropractic students demonstrate philosophically opposing views about the chiropractic profession. The primary aim was to describe chiropractic students’ responses to statements about chiropractic identity, role, setting, and future direction. A secondary aim was to describe the frequency of internally conflicting responses. Methods Three datasets from Europe, North America, and Australia/New Zealand were pooled in a secondary data analysis. Chiropractic students from 25 chiropractic training institutions completed interrelating surveys (combined response rate 21.9%) between 2013 and 2018. The survey instrument investigated student viewpoints about chiropractic professional identity, role, practice setting and future direction of chiropractic practice. Student attitudes about chiropractic were described using weighted proportions to adjust for unequal population sampling across the three geographical regions. The frequency of concordant and discordant student responses was described by combining identity items with items that explored responses about practice role, setting and future direction. The relationship between student characteristics (age, sex, education, association membership and geographical region) and ideologically conflicting responses were assessed using the Chi-squared test and Cramér’s V. Results Data from 2396 student chiropractors (50.8% female; from Europe 36.2%, North America 49.6% and Australia/New Zealand 14.5%) were analysed. For identity, nearly half of the chiropractic students (weighted 45.1%) agreed that it is important for chiropractors to hold strongly to the traditional chiropractic theory that adjusting the spine corrects “dis-ease” and agreed (weighted 55.5%) that contemporary and evolving scientific evidence is more important than traditional chiropractic principles. The frequency of discordant (ideologically conflicting) student responses ranged from 32.5% for statements about identity versus role, to 51.4% for statements about identity versus future. There was no association between student age, sex and internally conflicting responses. Chiropractic students’ professional association membership status, pre-chiropractic education and geographical region were associated with ideologically conflicting responses. Conclusions Chiropractic students in this analysis show traditional and progressive attitudes towards the chiropractic profession. Individual student responses frequently contradict in terms of professional ideology, but most (approximately half) students demonstrate concordant progressive and mainstream attitudes. Ideological conflict may raise concerns about some students’ ability to learn and make clinical judgements, and potential for disharmony in the chiropractic fraternity.

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Section: Discussionmentioning

confidence: 99%

Chiropractic students’ cognitive dissonance to statements about professional identity, role, setting and future: international perspectives from a secondary analysis of pooled data

et al. 2021

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“…Most chiropractors provide multimodal treatment of musculoskeletal conditions that includes, manipulation of the spine and extremities, various soft tissue therapies as well as exercise prescription amongst other lifestyle advice [33][34][35]. However, the profession of chiropractic is frequently referred to as a monotherapy [36] particularly by medicine and other allied health professions [37,38].…”

Section: Discussionmentioning

confidence: 99%

An unusual postural headache: a case report

Pollard¹,

Pollard²

2020

Chiropr Man Therap

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Background This paper presents a case of an evolving unusual thunderclap headache that presented to a chiropractor. Case presentation The intense “migraine-like” headache was aggravated by standing up and relieved substantially when lying down. This low pressure, orthostatic headache was diagnosed as a spontaneous intracranial hypotension (SIH) secondary to a spontaneous tear of the dura. It was referred to the local hospital for management with autogolous blood injection to form an epidural blood patch of the defect. It resolved substantially within 3 days. Conclusions The significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation. Discussion is provided of the implications of a missed diagnosis and possible subsequent chiropractic management with the evolving SIH being attributed to the chiropractic intervention rather than its true “spontaneous” nature.

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“…The absence of a common understanding has implications for the creation of an internationally homogeneous quality set of essential accreditation standards or measures of entry-level graduate competencies upon which CCEs can conduct reliable and valid assessments across all CPs. Prominent chiropractic researchers have called this an urgent task that must be undertaken for the profession to remain relevant in today's evidence-based healthcare environment [74]. A method of adopting an evidence-based approach, where clinical uncertainties exist, has been proffered and warrants consideration for situations like this [75].…”

Section: Examining the Insights Of Those Within Ccesmentioning

confidence: 99%

The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary

2020

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Background: Chiropractors see themselves as well positioned to provide safe, effective and economical care for the ongoing financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world's accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research. Main text: We reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs' educational standards and processes. Areas included a lack of definitions for key terms such as, 'chiropractic', 'diagnosis', and 'competency', without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a "big tent" approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is "unique", highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to 'traditional' thinking. This has implications for public safety and patient quality of care. Conclusion: If chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.

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So, what is chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies

Cited by 17 publications

References 20 publications

Chiropractic students’ cognitive dissonance to statements about professional identity, role, setting and future: international perspectives from a secondary analysis of pooled data

Chiropractic students’ cognitive dissonance to statements about professional identity, role, setting and future: international perspectives from a secondary analysis of pooled data

An unusual postural headache: a case report

The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary

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