Who are the chiropractic students favouring a limitless scope of practice? Exploring the relationship with personality, magical thinking, and academic achievement

Abstract

Introduction Some chiropractors seem to have an inflated belief in the powers of spinal manipulation (SMT), for example aiming at preventing future spinal degeneration and health problems, activities that are without supporting evidence. Non-evidenced health beliefs have been shown to be associated with a tendency toward magical thinking. Holding such beliefs about SMT is associated with a limitless scope of practice (LLSoP). Recent studies have shown that “chiropractic conservatism” (ChiroCon) is also associated with such approaches. We wanted to understand ChiroCon and these attitudes toward SMT by exploring three different factors: intolerance to uncertainty, academic achievement, and tendency toward magical thinking and how they relate to ChiroCon and LLSoP. Method A cross-sectional survey of 243 chiropractic students from an Australian chiropractic program was conducted in May 2020. Students answered a questionnaire involving a patient case-scenario for LLSoP, levels of ChiroCon, validated questionnaires on (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. LLSoP was defined as wanting to treat with SMT a 5-year-old asymptomatic child for future (i) Musculoskeletal (MSK) problems and/or (ii) Non-musculoskeletal diseases. Logistic regression models were used to confirm if there was an association between ChiroCon and LLSoP and to explore associations between LLSoP and (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. We repeated the same analyses using ChiroCon as the outcome variable. Results We confirmed that chiropractic students in the more extreme ChiroCon group were more likely to want to prevent future spinal disorders in an asymptomatic 5-year-old child as compared to those with lower levels (OR = 3.9, (95%CI 1.97–7.72). This was also the case for the prevention of future diseases in the same child (OR = 6.9, (95%CI 3.11–15.06). Of the three predictor variables, magical belief was positively associated with both ChiroCon and LLSoP. Conclusion Not surprisingly, ChiroCon is closely related to LLSoP and both were linked to magical thinking. Therefore, the questionnaire ‘Magical Health Beliefs’ could be a useful instrument to screen future chiropractic students to prevent a mismatch between student and institution. Depending on the outlook of the school, some schools would welcome these students, whereas other institutions would want to avoid them in their education program.

A two-year follow-up: Twitter activity regarding misinformation about spinal manipulation, chiropractic care and boosting immunity during the COVID-19 pandemic

“…While it is difficult to know the global extent of all prompting and refuting messaging outside of Twitter, we also note that announcements from chiropractic organizations that promoted the idea of chiropractic/SMT improving immunity also came primarily from the United States. Explanations for this geographic separation are not readily available, but possible avenues of future investigation may include comparing the proportion of senior versus early career chiropractors in various countries and the location of chiropractic schools that emphasize conservative or dogmatic chiropractic views [31]. It is important to emphasize that it is not possible to confirm the occupation or affiliation of those who author tweets.…”

A new paradigm for musculoskeletal pain care: moving beyond structural impairments. Conclusion of a chiropractic and manual therapies thematic series

“… Innes S, Goncalves G, Leboeuf-Yde C. Who are the chiropractic students favouring a limitless scope of practice? Exploring the relation-ship with personality, magical thinking, and academic achievement [ 9 ]. Cross-sectional survey of chiropractic students The aim of our study was to explore whether there are any factors that help explain the adoption of views on chiropractic conservatism (ChiroCon) in an evidence-based chiropractic education environment and its association with an increased likelihood of using SMT for conditions without an evidence-base (e.g., non-MSK).…”

“…The randomized clinical trial from Bronfort et al [ 8 ] included in this series provides one example comparing different models for delivering conservative care (unimodal versus integrated care) and including outcomes such as pain coping strategies and self-efficacy to examine outcomes related to the development of self-management skills in the participants. Finally, Innes and colleagues [ 9 ] examine the attitudes and beliefs of students in chiropractic education programs around the perceived mechanisms of structural interventions and professional identity.…”

“…Innes S, Goncalves G, Leboeuf-Yde C. Who are the chiropractic students favouring a limitless scope of practice? Exploring the relation-ship with personality, magical thinking, and academic achievement [9].…”

Correction: Who are the chiropractic students favouring a limitless scope of practice? Exploring the relationship with personality, magical thinking, and academic achievement

“…Following the publication of the original article [1], it has been brought to our attention that several of the provided references are mismatched in the Background section and are incorrectly recorded in the Reference section.…”