Clinical experiences of first-time registered Master's chiropractic students during their clinical practicum

Abstract

Background The imperative of clinical education in chiropractic is to endow students with the clinical competencies and professional attributes necessary for independent practice. The clinical practicum exposes chiropractic students to the realities, demands and expectations of patient care through immersion into the clinical learning environment. Various authors emphasise the importance of obtaining a student’s perspective of their experiences within this environment as it is essential to curriculum development and improvement, delivery of quality clinical education, and student satisfaction with their standard of education. Interestingly, unlike in other health professions’ disciplines, the clinical experiences of chiropractic students who have commenced their clinical practicum have scarcely been described in international literature. This study is the first of its kind to record the clinical experiences of chiropractic students during their clinical practicum in South Africa.

Aim The aim of this study was to explore and describe the clinical experiences of first-time registered Master’s chiropractic students during their clinical practicum component at the Durban University of Technology Chiropractic Day Clinic in 2016.

Method A qualitative, exploratory, descriptive approach was utilised. A purposive sample of 15 first-time registered Master’s chiropractic students was interviewed. Their clinical experiences during the clinical practicum were obtained through semi-structured interviews. Seven key questions, each relating to a specific aspect of the clinical practicum, were used to stimulate discussion. The data were recorded electronically and thereafter transcribed. Thematic analysis was used to interpret the data.

Results Four main themes were identified, viz. undergraduate education and pre-clinical preparation; experiences within the clinical learning environment; inter-personal relationships in a clinical learning environment, and appraisal of the clinical practicum. Participants reported that the undergraduate and pre-clinical preparatory phase needed to be more practically orientated in order to provide relevance and cohesion to clinical learning. Significant experiences in the clinical learning environment included personal and professional growth and development, perceptions of preparedness for independent practice, perceptions of patient responses to chiropractic care, administrative duties and clinic infrastructure. The interpersonal relationships that contributed to the overall clinical experience were between students and their clinical supervisors, and students and the administrative staff. The appraisal of the clinical practicum included highlights and positive aspects that shaped the attitudes, values and philosophies of students, as well as the challenges and obstacles they encountered within the clinical learning environment.

Conclusion This is the first South African study to document the clinical experiences of first-time registered Master’s chiropractic students. These clinical experiences were based on a variety of organisational and curriculum-orientated factors, as well as interpersonal dynamics. While students acknowledged and appreciated the critical importance of clinical education, and valued the learning opportunities within the clinical setting, they also provided constructive feedback on matters needing improvement to enhance the overall clinical experience. The lack of exposure to patient care prior to the commencement of the clinical practicum negatively impacted the clinical experiences. It is recommended that the findings of this study be utilised by the key stakeholders within chiropractic education to enhance chiropractic clinical education in South Africa.