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Start date: 2021Subject: search.filters.subject.Chiropractic students

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    The perceptions and experiences of chiropractic students with regards to objective structured clinical examinations at a South African University of Technology
    (2024) Vawda, Nabeel; Varatharajullu, Desiree
    BACKGROUND A vast amount of literature has contributed to the topic of students’ perceptions and experiences of objective structured clinical examination (OSCE). Many of these studies address the challenges that students face during those examinations, but few discuss the perceptions and experiences that university students may face before, during, and after the OSCE. In the realm of chiropractic education, abundant literature exists about the chiropractic field, as well as the curriculum and the accreditation of chiropractic education around the world. Noteworthy, unlike other healthcare professional programmes, literature regarding the perceptions and experiences of the chiropractic student with regard to the OSCEs in the course, and how that experience affects their clinical competence in the programme and future is scarce. This study recorded the perceptions and experiences of chiropractic students at a selected South African university of technology regarding the format, use and testing of the OSCE. AIM To explore the perceptions and experiences of chiropractic students towards the OSCE at a South African university of technology. METHOD A qualitative, exploratory, descriptive approach was utilised for this research. A purposive sample of 20 chiropractic students who have been examined in minimum of three OSCEs were interviewed. Their perceptions and experiences regarding the OSCEs were obtained through semi-structured interviews. A total of three key questions, each relating to how students feel before, during, and after the OSCE process were used to stimulate a discussion. The data were recorded electronically and thereafter transcribed verbatim. Thematic analysis was used to interpret the data. RESULTS The participants indicated that, for the most part, the OSCE is valued but, to some extent, could be tailored closer to the chiropractic scope of practice. This meant that while they were taught adequately, they were not fully prepared for the OSCEs as they did not adequately simulate real world clinical scenarios in the field of chiropractic. The examiners demeanour also played a substantial role in the participants’ experiences of the OSCEs. The participants indicated that their experiences were negative, stressful, and full of anxiety due to the format of the OSCEs, with its time constraints and difficulties with the examiners who were testing them. Another factor which contributed to the participants’ experiences of the OSCEs was the way they were being tested. The participants felt they were being examined differently to the way in which they were taught as many of the examiners were external clinicians. In contrast, the participants also mentioned that they benefitted from the OSCEs with regard to learning how to work well under pressure and building confidence, allowing them to be better prepared for clinical practice. The participants recommended that the OSCEs should be closer aligned with the chiropractic scope of practice, that the format of the OSCE be changed, and the time limit per a station increased. CONCLUSION This is the first South African study to document the perceptions and experiences of chiropractic students regarding the OSCEs at a South African university of technology. These perceptions and experiences were based on a variety of internal and external factors in relation to the university, chiropractic course, and examiners of the OSCEs. While the participants acknowledged and appreciated the positive aspects of the OSCEs, they provided constructive feedback on different aspects to help improve the experiences of the OSCE for chiropractic students. For many of the participants, the overall experience of the OSCEs was negative and they felt it could be significantly improved in the chiropractic course. It is advisable for educational institutions and stakeholders within chiropractic education to leverage the findings of this study to improve chiropractic education in South Africa.
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    Perception of chiropractic students in their preparedness in the diagnoses and management of headache disorders at a selected University of Technology
    (2024) Abrahams, Tamia; Abdul-Rasheed, Ashura
    A headache is defined as “pain found in the head above the orbito-meatal line and or nuchal ridge” and widely affects both males and females globally. Chiropractic treatment and the management of headaches is substantial, with one in five new patients’ chief complaint being a headache and, thus, the use of chiropractic care in the management and treatment of headaches is popular. The term “self-perceived preparedness” refers to how people view themselves in terms of confidence and competency with regard to certain skills. Self-perceived preparedness is essential as it relates to one’s confidence and the ability to accurately diagnose and manage headache disorders. There is a definite scarcity in South African literature as to the self-perceived preparedness of students in the diagnosis and management of headache disorders. In a South African chiropractic context, the literature, with regard to students’ confidence, awareness and self-assessment of skills is lacking. There are a number of advantages that can come from exploring the concept of self-perceived preparedness. The benefits include, but are not limited to, the assessment of whether or not the curricula goals have been achieved, the readiness of chiropractic students to confidently and correctly diagnose and manage patients sufficiently, and the different aspects that can lead to one feeling unprepared. Aim The aim of this study was to explore and describe the self-perceived preparedness of the chiropractic students’ in the diagnosis and management of headache disorders. Methodology This study design employed a qualitative, explorative and descriptive design. Purposeful sampling was utilised and individual, semi-structured interviews were conducted with 13 Master’s degree students in the chiropractic programme. These interviews took place “in person” and an interview guide was utilised in each interview. The interviews were conducted over a week from the 18th to the 23rd of September 2023. The questions surrounded the topics of self-perceived preparedness, confidence, challenges (whether educational or personal) and the effect of clinical exposure on one’s confidence and skills. The interviews were analysed and themes were extracted utilising Tesch’s eight-step approach of data analysis. Results The chief themes that emerged from the data collection included the level of preparedness, educational and environmental challenges, as well as the positive role that clinical exposure had on students’ views of their self-perceived preparedness. The participants felt largely unprepared to deal clinically with headache disorders. This stemmed from the feeling of isolation within academia, lack of support from staff and clinicians, lack of practical aspects within the curriculum and the COVID-19 pandemic, which resulted in a lack of in-person interaction. Conclusion The findings of this study highlighted the lack of confidence and feeling of under-preparedness to deal with headache disorders within a clinic setting by chiropractic Master’s students. This was mainly attributed to educational and environmental challenges. However, the exposure students gained within a clinical environment greatly improved their feeling of overall self-perceived preparedness
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    Chiropractic students’ perception and practice of patient education on management of musculoskeletal conditions at a tertiary education teaching clinic
    (2023-05-31) Nieuwenhuis, Hardus; Maharaj, Praveena; Korporaal, Charmaine Maria
    Background Modern healthcare is characterised by patient-centred care, which requires that healthcare professionals have equal proficiency in communication and practical skills. As part of their duty as healthcare professionals, chiropractors must show patients how to help themselves through patient education, which requires communication skills. Patient education no longer solely involves or refers to knowledge transfer alone, but rather working with patients in their specific context to build knowledge together from a partnership perspective and to share power in this dynamic. From this perspective, patient education becomes a tool to empower patients and improve their self-efficacy and coping habits, without constantly relying on passive care. This study presents a detailed evaluation of patient education within a South African chiropractic student context at the Durban University of Technology. Aims and Objectives This study aimed to describe chiropractic students’ perceptions and practice of patient education of musculoskeletal conditions at a teaching clinic. The objectives were to evaluate the students’ perception of patient education and the strategies they use; their self-reported practice of patient education; barriers that students face when educating patients; factors that contribute to their patient education skills development, and to determine whether there is an association between demographics, their perception and practice. Methods The study was an anonymous web-based questionnaire with a cross-sectional design within a quantitative paradigm. The survey used in this study stems from a physiotherapist study. Permission was obtained from the author to replicate the study in a South African context at the Durban University of Technology Chiropractic Day Clinic (DUT CDC). The original survey was then put through a focus group and pilot study and subsequently adapted to include questions related explicitly to chiropractic and the student population at the Durban University of Technology. Weekly reminders were sent via email to class representatives to distribute among their respective classes. A total of 42 completed questionnaires were used for analysis in this study. Cronbach’s alpha was used to assess internal consistency of scales. The scale scores were computed by averaging the 18 items for Question 6 and Question 5 respectively where Ttests were used to compare these scores between the demographic variables for binary data, ANOVA for ordinal data and Pearson’s correlation analysis, where the demographic variable was quantitative and normally distributed. A Wilcoxon signed ranks test was used for the comparison of time spent on patient education at initial consults and time spent on patient education at follow-up consults Results Overall, the students viewed most of the patient education items to be important and should be discussed with patients. In practice, however, the frequency of their practice did not correspond to the perceived importance. Only a few items were practised to the same extent as the perceived importance thereof. The chiropractic students’ discussions with their patients tend to focus on the main complaint of patients. In most cases, students educate their patients through one-on-one discussions, physical demonstration and anatomy models. During initial visits, students usually spend between 6–15 minutes educating their patients; in follow-up visits, the time is reduced to 6–10 minutes. In most cases, students cited patient characteristics as a barrier to effective patient education. For the chiropractic students, developing their patient education skills was largely dependent on their interactions with supervising clinicians. There was no association between demographics, perceived importance, and practice behaviour in this study. Conclusion Although the patient education topics were generally deemed important by chiropractic students, the topics considered most important are directly related to the main complaints of their patients, with more complex topics not being perceived as necessary as those directly related to the complaint, such as diagnosis. Like their perceptions, the students most frequently addressed the topics they deemed important; thus, their perceptions and practice were congruent (for issues related to the main complaint of the patients). An important finding of this study was that, although DUT follows an evidence-based paradigm, many students perceived pathoanatomical explanations to be important and, thus, provided their patients with such explanations, even though the literature does not support it. In addition, the students reported several methods through which they educate their patients. However, the assessment of whether it was successful was mainly centred around physical activity rather than the patients’ understanding of the information discussed. The results indicate an opportunity to improve the patient education skills of students, as they appear to have difficulty adjusting to difficult situations, and thereby perceive factors to be barriers that are not actual barriers but rather challenges.
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    Identification and management of yellow flags in chronic low back pain by Chiropractic Master's students at a University of Technology teaching clinic
    (2023-05-31) Egumbo, Shameez; Ghuman, Shanaz
    Chronic low back pain (CLBP) is one of the leading causes of disability worldwide, preventing many people from performing day to day tasks. Low back pain is the third most common reason for visits to the doctors, right after skin disorders and osteoarthritis. Even though doctors of chiropractic treat more than just back pain, many patients initially visit a chiropractor looking for relief from this persuasive condition. Yellow flags are psychosocial issues that can be indicative of long-term chronicity in low back pain. It is therefore appropriate for chiropractors to know how to manage yellow flags in patients with low back pain, since the two are related. The aim of this study, therefore, is to investigate the identification, knowledge, and the management of yellow flags at teaching clinic by chiropractic master’s students. AIM AND OBJECTIVES OF THE STUDY The aim of the study was to explore and describe the identification and management of yellow flags in chronic low back pain by chiropractic master’s students at a university of technology teaching clinic. METHODOLOGY A qualitative, exploratory, descriptive study was conducted. Master’s degree chiropractic students, who had been clinically active for five months and treated a minimum of five low back pain patients were interviewed to establish their identification and management of yellow flags in CLBP. Semi-structured interviews were conducted in English, which were then transcribed to a Microsoft Word document. The transcripts were analysed using Tsech’s eight steps of thematic analysis to establish the themes, categories and codes. RESULTS AND DISCUSSION This qualitative, descriptive study explored 10 chiropractic master’s students’ identification and management of yellow flags in their chronic low back pain patients. It was found that the chiropractic master’s students had limited understanding of psychosocial factors. Their lack of information and clinical expertise lead to uncertainty pertaining to the identification, assessment and management of yellow flags. The participants acknowledged their shortcomings and suggested numerous limitations to the integration of psychosocial assessments as part of routine practice. The lack of formal education in the theory, assessment and management was the most frequently cited barrier among those raised by the participants. The review of the chiropractic curricula was outside the purview of this study. Nevertheless, considering the comparable findings reported in the literature further supported this, it may suggest a need for chiropractic education of yellow flag assessment and management to be reviewed and strengthened. CONCLUSIONS This is the first South African study that had been conducted on registered master’s degree chiropractic students’ identification and management of yellow flags in chronic low back pain. This study will add to the existing literature and enable other registered master’s degree students and new graduate chiropractors to have a better understanding of the of the management of yellow flag patients.
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    The clinical experience of registered master's chiropractic students in the management of elderly patients during their practicum
    (2021-05-27) Naidoo, Kimone; Varatharajullu, Desiree; Sibiya, M.N.
    Background The elderly population is increasing rapidly worldwide. As elderly individuals age, their physiological process changes, which means that elderly patients present differently, as a result of associated comorbidities and challenges in their physical and cognitive function, and thus the management of an elderly patient could present as a challenge. Registered master’s degree chiropractic students complete a theoretical elderly module during the fifth year of their studies, while entering their clinical practicum. The registered master’s degree chiropractic students need to acquire and refine their clinical skills, as well as apply their theoretical knowledge during their clinical practicum. The healthcare system in South Africa has limited knowledge on the management of elderly patients. Therefore, the aim of this study has been to determine the clinical experiences of registered master’s degree chiropractic students during their clinical practicum with respect to the management of elderly patients. Aim of the study The aim of the research study was to explore and discuss the experiences of registered chiropractic master degree students in the management of elderly patients presenting at the Chiropractic Day Clinic at the Durban University of Technology. Method A qualitative, exploratory, descriptive study was conducted, using an interpretivist paradigm. The master’s degree chiropractic students, who had been clinically active for four months during their clinical practicum, were interviewed to establish their experiences in the management of elderly patients during their clinical practicum. The interviews were semi-structured and conducted in English, and later transcribed verbatim into a Microsoft® Word document. The transcripts were then analysed using Tesch’s eight steps of thematic analysis to establish the themes, categories and codes. Results Of the twenty-four registered master degree chiropractic students, twelve (50%) participated in the study. There were five overarching themes that emerged from the data: attitudes and opinions towards the management of an elderly patient; important aspects of the management towards an elderly patient; positive aspects of managing an elderly patient; challenges faced during the management of an elderly patient and suggestions to improve a chiropractic clinical practicum. The participants discussed the importance of having practical experience in managing an elderly patient and the significance of elderly patients being interactive with their own management protocols. The participants elaborated that they did have a sufficient basis to manage elderly patients. Many participants mentioned that they needed to be more involved in the management of elderly patients. Most of the participants felt that managing elderly patients was beneficial and they suggested that learning about elderly patients earlier in their studies would be beneficial to their clinical experience of managing elderly patients. Conclusion This is the first South African study that has been conducted on registered master’s degree chiropractic students’ clinical experiences in managing elderly patients during their clinical practical. This study will add to the existing body of literature and enable other registered master’s degree chiropractic students and new graduate chiropractors to have a better understanding of the management of elderly patients.
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    Upper extremity work-related musculoskeletal injuries among chiropractic students at the Durban University of Technology
    (2021-05-27) Singh, Kyle Andrew; Padayachy, Keseri
    Background: Chiropractic students the world over undergo rigorous training in manual therapy, specifically musculoskeletal manipulation and adjustment. These therapeutic modalities involve the use of the upper extremity to deliver its effects, usually with high velocity and force. This leaves the upper extremity vulnerable to injury, as a result of the repetitive and forceful nature of these manual techniques. Despite this risk, the research available on work-related musculoskeletal injuries of chiropractic students in South Africa is limited. This study aims to determine the prevalence of upper extremity work-related musculoskeletal injuries among chiropractic students at the Durban University of Technology, and selected risk factors associated with work-related musculoskeletal injuries. Method: The study design was a quantitative, descriptive, self-administered questionnaire study that used the total available population. The questionnaire was adapted from a similar study and included the use of a pilot study. The questionnaire had three sections: the first for demographic data, the second was applicable for any new injury to the upper extremity from work-related tasks, and the third was applicable for any old injuries to the upper extremity that were aggravated by work-related tasks. Prevalence was estimated using 95% confidence intervals. Factors associated with injury were assessed at univariate level, using Pearson’s chi-square tests and t-tests, and factors associated at the <0.1 level were selected as independent variables in a multiple logistic regression model to predict risk of injury. The odds ratios and 95% confidence intervals were reported. A stepwise backward selection method, based on likelihood ratios, was used to arrive at a final model consisting only of statistically significant risk factors (p<0.05). Chi-square testing and cross-tabulations were performed on the use of dominant hand and injury. Results: Eighty-six chiropractic students (n=86) were eligible for the study, seventy-seven elected to participate in the study, giving a response rate of 93.9%. The period prevalence of upper extremity work-related musculoskeletal injuries was 59.7% (95% CI 47.93 to 70.57%). The most commonly injured areas were the wrist (60%), shoulder (20%) and hand (17%), with majority of the injuries involving the soft tissue structures: muscle/ tendon strain (42%), ligament sprain (17%) and tendinitis (17%). Most injuries occurred during adjustive procedures (74%) and ischemic compression (19%). None of the demographic variables showed a significant association with prevalence of injury, apart from a moderately non-significant association with year of study (p=0.080). The frequent use of electro-modalities (p=0.073) and temperature therapy (p=0.077) were suggestive of possible associations, however, were not statistically significant. The results showed no significant differences between frequency of adjustments and injury. Despite an absence of statistical significance, a trend was noted showing an increased likelihood of injury when adjusting with the dominant hand. Conclusion: The study findings are consistent with those of similar international and local studies on the chiropractic profession (both academic training and professional), determining a high prevalence of work-related musculoskeletal injuries. The wrist was most commonly injured when performing adjustive procedures with the dominant hand. This study is in response to a call for further investigation and will help in future efforts to develop an injury preventative strategy for chiropractic training institutions.