Objective:Peer mentoring is increasingly valued in healthcare education for developing professional and clinical competencies. In the chiropractic program at our university, Force-Sensing Table Technology (FSTT®) was first integrated to enhance manual therapy training. After this, the CHIRO-Force Peer-Assisted Learning (PAL) program was launched as a collaborative learning process to further train students in practical skills related to chiropractic manual therapies. This paper introduces the program and reports findings from its first year. Methods:The CHIRO-Force program was structured and evaluated using the PAL learning framework. After pilot funding approval, 2 fourth-year students were selected as mentors. Then, they and 2 faculty members completed intensive training from the developers of the FSTT® technology. Mentors then designed session protocols and organized a booking system. Mentees were invited to complete a short questionnaire after each session and a comprehensive one at the end of the pilot year. The program launched in September 2023 and the pilot year ended in April 2024. Results:Mentors created 5 distinct session protocols and each dedicated about 5 hours weekly to mentoring. From September to April, more than 100 sessions were provided, involving over 100 students. Group mentoring was also integrated into clinical internships. Feedback was highly positive, with 97% of sessions rated as "highly appreciated". Conclusion:The CHIRO-Force PAL program shows promise in supporting students' practice of spinal manipulative therapy outside class. Future steps include assessing its impact on clinical competency and self-efficacy.
Objective:This study explored chiropractic educators' perceptions of work-life balance and its perceived implications for mental and social well-being in Malaysia. Methods:A descriptive qualitative study was conducted using purposive sampling of full-time chiropractic educators with varied gender, academic experience, administrative responsibility, and clinical supervision load. Ten faculty members consented to participate and completed semistructured interviews conducted in person or by videoconference. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results:Seven themes were identified: blurred boundaries and overwork; role identity tension across educator, clinician, researcher, and student roles; collegial support as a buffer; community belonging, ranging from solidarity to estrangement; boundary negotiation and personal rules; cultural and interpersonal friction; and institutional friction tied to administrative intensification and leadership signals. These were organized into 4 domains: work-life balance, social well-being, mental well-being, and institutional support. Conclusion:Chiropractic educators in Malaysia described blurred work-life boundaries, competing role demands, and institutional and cultural factors that shaped their mental and social well-being. Experiences of collegial support and boundary negotiation varied across participants and influenced perceived capacity for recovery and social connection. Together, these findings highlight the interplay between individual practices and institutional contexts in shaping educator well-being.
Objective:The objectives of this study were to (1) describe the pedagogical framework and design of an asynchronous online concussion management course for clinicians and (2) report usability testing results. Methods:A multidisciplinary team developed an interactive, evidence-based course in Articulate Rise 360 software. Modern instructional strategies were incorporated, including chunking, quizzes, gaming elements, video demonstrations, and clinical vignettes. Content drew on current guidelines for adult and pediatric concussion and the 6th International Consensus on Concussion in Sport. Usability testing was conducted with a convenience sample of clinicians using an adapted System Usability Scale, Likert ratings for relevance and impact, and open-ended questions. The course was refined based on participant feedback. Results:Eight clinicians (3 physiotherapists, 3 chiropractors, 2 occupational therapists) from 3 Canadian regions completed usability testing. All participants (8/8) felt confident using and navigating the course, with 7/8 (87.5%) agreeing that its functions were well integrated. All participants reported improved confidence in adult concussion assessment and management, and 7/8 (87.5%) in adolescent concussion management. Although 7/8 (87.5%) felt confident assessing persistent symptoms, only 3/8 (37.5%) felt confident managing them. Qualitative feedback emphasized interactivity and convenience as strengths and suggested improvements to navigation and content scope. Conclusion:An asynchronous online concussion management course engaged clinicians and enhanced confidence in concussion assessment and management. Future research should evaluate its long-term impact on clinical practice.
Objective:The purpose of this study was to investigate the services and resources health sciences libraries and librarians can provide to support chiropractic faculty in conducting research and increase institutional research capacity. Methods:A one-time, anonymous, online survey was administered to a convenience sample of 120 faculty at a North American chiropractic college in December 2024. The 11-item questionnaire was adapted from prior research in academic health sciences libraries and included both quantitative and qualitative questions about respondents' research interests, experience, needs and library use. Descriptive data analysis was completed. Results:The survey was completed by 39 faculty (response rate = 32.5%). Seventy-four percent (n = 29) of respondents had sought research assistance from the library. The areas of greatest interest in library research support were literature searching (56%, n = 20), citation management (53%, n = 19), data analysis (53%, n = 19), research design (39%, n = 14), and journal selection (39%, n = 14). Fifty-six percent (n = 22) of respondents were interested in library research workshops, particularly asynchronous video training. Respondents reported the following research interests: educational research (62%, n = 24), case reports (46%, n = 18), clinical research (44%, n = 17), evidence synthesis (38%, n = 15), historical research (23%, n = 9), and other (5%, n = 2). Conclusion:Most respondents had sought research assistance from the library in the past, and more than half were interested in future research training from the library which suggests that the library supports research capacity building within the organization.
Objective:To explore and describe master's chiropractic students' self-perceived preparedness in diagnosing and managing headache disorders. Methods:A qualitative, exploratory, descriptive design was used. Thirteen master's chiropractic students participated in semistructured interviews guided by an interview protocol. Interviews were thematically analyzed using Tesch's 8-step approach. Results:Participants reported and expressed limited preparedness and low initial confidence in diagnosing and managing headache disorders. Educational and environmental challenges were identified as key roles in this result whilst clinical exposure positively influenced students' perceptions of their preparedness. Conclusion:The exploration of students' self-perceived preparedness in diagnosing and managing headache disorders identified multiple contributing factors. Educational and environmental challenges were associated with feelings of limited preparedness. However, increased clinical exposure enhanced both confidence and perceived competence.
Objective:The study evaluated the test-retest reliability of the scores obtained from the Chiropractic Professional Identity Embodiment Scale (CPIES), a brief self-report tool assessing professional identity in chiropractors and students. Methods:Students were invited across all 4 year levels at a chiropractic college to complete an online survey featuring 15 CPIES statements rated on a 5-point Likert scale. The survey was administered twice, 4 weeks apart, with participants matched across time points using three sociodemographic identifiers. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC) with a 2-way mixed-effects model for absolute agreement. Results:Due to anonymous participation, the exact response rate could not be calculated; the estimated response rate was 24%. Of these respondents, 23 participants (35%) were matched across 2 time points. The CPIES sum score demonstrated good to excellent test-retest reliability (ICC = 0.92; 95% CI, 0.81-0.97). Most items demonstrated moderate reliability across assessments. Conclusion:Data collected using the CPIES demonstrated good to excellent test-retest reliability, supporting its temporal stability. This provides further evidence to support use of the CPIES in research, education, and policy, when professional identity is increasingly recognized as a key competency.
Objective:This study aimed to evaluate the quality of 3 objective structured clinical examinations (OSCEs) administered at a chiropractic college in 2024. The focus was on applying postexamination quality assurance methods suitable for small cohorts to assess examiner consistency, scoring patterns, and how well the exams distinguished between different levels of student performance. Methods:Data were collected from 3 summative OSCEs: Clinic Entrance, Chiropractic Management, and Introduction to Chiropractic Practice. Borderline regression was used to calculate cut-scores. Additional QA metrics included number of failures, coefficient of determination (R2), intergrade discrimination, and between-group variation. Results:Cut-scores for most OSCE stations were above the standard 70% threshold, indicating generally strong student performance. The exception was the neurological station in the Clinic Entrance exam, which had a cut-score of 66.7% and a failure rate of 53.1 percent. R2 values ranged from 0.40-0.79, with several stations showing moderate to strong alignment between checklist scores and overall examiner judgments. Between-group variation ranged from 40.9-79.5, suggesting examiner consistency varied across stations. Intergrade discrimination was low overall, indicating limited discrimination between performance levels and some examiner inconsistency. Conclusion:Evidence-informed analysis of examinations is an important aspect of quality control in teaching. These findings suggest that OSCE quality is constrained more by examiner inconsistency and weak intergrade discrimination than by student performance per se. Targeted calibration of examiners and program-level redesign of station checklists and global rating scales are priorities for quality improvement.
This conference was convened by the Association of Chiropractic Colleges in Kansas City, Missouri from March 26 to 28, 2026. The theme for this Association of Chiropractic Colleges Educational Conference and Research Agenda Conference program was Connected Care. This document includes the names of the Peer Review Committee members and the platform and poster abstracts presented at the conference.
Objective:This study reviewed women's health (WH) curricula at chiropractic colleges and developed core competencies for WH. Methods:Instructors of chiropractic colleges who taught WH-related course(s) were contacted to complete a survey that gathered pertinent material, including course objectives and targeted competencies. Survey results were used to develop an initial set of WH competencies. These were presented at an international conference workshop, with feedback from attendees who chose to participate. An e-Delphi panel was convened to finalize the core competencies, which required greater than 80% consensus for approval of each statement. Results:Based on surveys from 7 institutions and 13 courses, 11 individuals at the international conference workshop recommended 62 core competencies within 10 domains, which were subsequently evaluated by 42 Delphi panelists (DP). After one round, all competencies met consensus. Conclusion:The study provided insight into the WH curriculum offered at participating chiropractic colleges. This resulted in a set of 10 domains and 62 core competencies to inform curricula that may be used by chiropractic training programs to enhance future chiropractors' knowledge and skills around WH across the lifespan and for post-graduate courses to ensure that proficiency may continue to advance in practice. These competencies go beyond women's reproductive health to include less considered milestones throughout the lifespan, including that gender is a social determinant of health, and the biological impact of social conditions, such as age in this population.
Objective:To investigate chiropractic students' comfort and confidence levels in modifying care for vulnerable patient groups. A second aim is to present data on students' self-identification as belonging to one or more of these groups. Methods:A cross-sectional survey of 117 second-year students enrolled in a Special Populations course was conducted. Respondents selected special population groups (SPG) to which they identified as belonging. They rated their comfort interacting with and confidence levels modifying care for each SPG on a 5-point scale. A general patient group (GPG), representing patients not belonging to any SPG, served as a benchmark. Responses were grouped into 3 categories: those lacking comfort or confidence, those unsure or neutral, and those with comfort or confidence. Results:Comfort and confidence levels were found to be higher for the GPG than the SPG average. Perceptions of a sociocultural vulnerable subgrouping were much closer to GPG than a physically vulnerable subgrouping. Students perceived themselves most comfortable and confident with ethnically, racially, and religiously diverse patient groups and least comfortable and confident with physically and mentally disabled groups. Thirty-seven percent of respondents identified as belonging to one or more SPG. Conclusion:Respondents perceived their comfort levels to be higher than their confidence levels. Ratings for sociocultural vulnerable groups were higher than physically vulnerable groups. Gaps between comfort and confidence were higher in the sociocultural subgroup than the physically vulnerable subgroup. A significant minority of students identified as belonging to one or more of the studied groups.
Objective:Burnout among educators, particularly in high-stress environments like chiropractic education, is a significant issue with implications for both educators' well-being and educational outcomes. This study examines the prevalence and levels of burnout among chiropractic educators at a Malaysian institution, using dual classification methods to compare prevalence estimates. Methods:A quantitative, descriptive, cross-sectional study was conducted with 15 chiropractic educators. Burnout was assessed using the Maslach Burnout Inventory-Educators Survey (MBI-ES), encompassing 3 subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). Burnout profiles were classified using the 2016 and 2018 MBI manuals. Data were analyzed with descriptive statistics, Pearson correlation, t tests, regression, and Fisher exact test. Results:Using the 2016 classification method, most respondents exhibited moderate levels of emotional exhaustion (73.3%) and depersonalization (73.3%), while most reported low levels of personal accomplishment (86.67%). In contrast, the 2018 classification method identified 33.3% of respondents as Engaged and 13.3% as experiencing Burnout. Multiple regression revealed moderate but nonsignificant associations between age, sex, and EE and DP scores. Fisher exact test found no significant associations between sex and burnout profiles or subscale categories. Overall, burnout prevalence was 0% based on the 2016 criteria and 13.3% using the 2018 method. Conclusion:This study underscores variability in burnout prevalence depending on classification method. While burnout affects a portion of chiropractic educators, findings highlight the importance of tailored interventions to address specific dimensions of burnout and promote well-being. Institutions should consider adopting flexible frameworks to capture burnout's complexities and mitigate its effects on academic environments.
Objective:This study aimed to determine an evidence-based, common, undergraduate, pediatric competency framework specific to the chiropractic profession through competencies and entrustable professional activities (EPAs). Methods:A pragmatic, exploratory, mixed-methods design was implemented to specify competencies and EPAs through grounded theory. Sequentially, 3 nominal group techniques were conducted. The results of a systematic literature review led to a curriculum enrichment process. A survey instrument was methodically developed and administered to 321 participants. Thematic analysis was used to write the curriculum, which resulted from this mixed-methods process. Results:The undergraduate pediatric chiropractic curriculum framework consisted of 5 EPAs, 12 aggregate domains, 53 competency domains, and 393 items. The overall agreement with the curriculum was 90.0% by UK stakeholders. A total of 236 competencies emerged from the nominal group techniques, rising to 393 after curriculum enrichment. The curriculum reached data saturation, and no additional items were identified during the survey. Conclusion:Undergraduate chiropractic pediatric competencies and EPAs were created. They align to specify educational outcomes based on stakeholders' input and accreditation standards. This study also indicates that literature reviews could be performed during curricular design processes to reach earlier data saturation.
Objective:The purpose of this study was to describe the frequency of patient-centered communication (PCC)-related terminology in US doctor of chiropractic degree program (DCP) curricula, chiropractic accreditation standards, and chiropractic national boards testing content. Methods:Sixteen academic course catalogs, Council on Chiropractic Education accreditation standards, and National Board of Chiropractic Examiners test plans for parts I-IV were collected from November 2024 through December 2024. The documents were searched using terminology related to patient-centered communication. Context of each term, frequency of use, and percentage of related terminology relative to the overall curriculum at each respective DCP are described. Results:The frequency of PCC-related terminology ranged from 2% to 17% in DCP required coursework. A total of 47% of DCP's in this study had a frequency of 5% or less of PCC-related terminology included in their curriculum. The most recent DCP accreditation standards outline a total of 8 Council on Chiropractic Education meta-competencies, 4 of which included terminology related to PCC. PCC-related terminology was absent from the National Board of Chiropractic Examiners primary test categories, with 2 instances found in the secondary test categories. Conclusion:There is large variability in frequency of PCC-related terminology used in US DCP curricula. Council on Chiropractic Education accreditation standards include PCC-related terminology in half of their stated meta-competencies. PCC-related terminology has limited representation in the National Board of Chiropractic Examiners test plans. Further study is needed to understand the real-time PCC-related content exposure that occurs within chiropractic education.
Objective:The purpose of this study was to explore motivators and barriers to participation in scholarly activity among chiropractic faculty and administrators. Methods:A faculty workgroup undertook a sequential explanatory mixed methods study to assess perceptions of research and scholarship across 3 campuses of a US chiropractic college. Data collection included an anonymous online survey (November 2023 to January 2024), followed by department-level group and individual interviews (May to September 2024). Descriptive data analysis and cross-tabulations were conducted using SPSS. Content analysis of qualitative data identified research participation themes. Results:Among 95 respondents, patterns emerged across academic ranks, with assistant and associate professors reporting specific motivators and barriers more frequently compared with instructors or professors. Primary motivators for research participation included career advancement (75.8%), skill development (58.9%), increased credibility (48.4%), mental stimulation (48.4%), and job satisfaction (41.1%). Research participation barriers were lack of time (82.1%), competing work priorities (67.4%), work-life balance concerns (55.3%), and perceived skill deficiencies (47.9%). Eleven qualitative themes were classified as motivators and barriers. Personal motivators could be enhanced by affirming research cultures, organizational support and resources, mentorship, and a commitment to advancing the profession. Dedicated time to develop research skills and learn creative/scientific processes, plus streamlined institutional ethics reviews were recommended. Conclusion:Faculty and administrators share similar outlooks on primary motivators and barriers to scholarly activity in this chiropractic educational setting.
Objective:Imposter phenomenon (IP), characterized by feelings of incompetence and self-doubt, is common among high-achieving individuals, including students. As chiropractic students transition into practice, they must develop clinical skills and confidence as IP can impair their decision making and patient interactions. This study aimed to explore the prevalence of IP among chiropractic students at a South African university and assess whether factors such as age, year of study, and clinical experience influence its occurrence. Methods:A cross-sectional quantitative design was employed, using an online survey completed by bachelor and master of health science chiropractic students (n = 258). The survey collected demographic information and included the Clance Imposter Phenomenon Scale (CIPS) to measure IP. Scores were rated on a scale of 100 with higher scores reflecting more frequent IP experiences. Data analysis involved frequency and descriptive statistics, reliability testing (Cronbach alpha), and demographic comparisons of IP scores. Results:The survey achieved a 47% response rate (n = 122) with 81% of respondents being female and ages ranging from 18 to 38 years. Most respondents (62%) lacked clinical experience. The mean CIPS score was 66.25 (SD = 17.02), suggesting frequent IP experiences. No significant differences in IP were observed across age, year of study, or clinical experience. Reliability testing yielded a strong Cronbach alpha of 0.94. Conclusion:Frequent IP experiences were identified among chiropractic students, potentially linked to challenges in developing knowledge and skills. These findings highlight the importance of offering targeted support to enhance students' sense of competence and confidence, aiding their professional growth.
Objective:Empathy is an essential interpersonal skill underpinning patient-centered and biopsychosocial approaches that are globally advocated for in musculoskeletal health care for better patient outcomes. This study aimed to gauge chiropractic students' self-reported empathy levels at a South African university. Methods:The Toronto Empathy Questionnaire (TEQ) was distributed to Bachelor of Health Sciences (BHSc) and Master of Health Sciences (MHSc) chiropractic students at the University of Johannesburg between February 26, 2024 to March 6, 2024. The questionnaire consisted of 16 Likert-scale questions related to both cognitive and affective aspects of empathy. Data were analyzed using frequencies, descriptive statistics, assessing group differences and reliability testing. Results:Of the 142 participants (55.68% response rate), most were aged 22-24 (41.6%, n = 59) and female (79.6%, n = 113). Undergraduates (first to fourth-year BHSc) made up 59.9% (n = 85), while 40.1% (n = 57) were postgraduates (first to second-year MHSc). The mean self-reported empathy score was 49.36 (SD = 7.27), with 77.5% (n = 110) showing high empathy. Undergraduates reported higher empathy (M = 50.28) than postgraduates (mean = 47.98) with a statistical difference of p = .064. Affective empathy items showed higher scores than cognitive empathy items. The TEQ demonstrated acceptable internal consistency (α = 0.841). Conclusion:This study shows a high self-reported empathy among chiropractic students at the university that declines in postgraduate years, affective empathy scores were higher than cognitive empathy scores, similar to trends in other health care students locally and abroad. Integrating empathy training, especially in later years, could help maintain empathy levels. Future research should track empathy development longitudinally and explore its impact on patient treatment adherence.
Objective:To determine the perceptions and experiences of chiropractic students on the implementation of evidence-based practice (EBP) during their clinical practicum at a teaching clinic in KwaZulu-Natal, South Africa. Methods:A qualitative, exploratory, and descriptive design was utilized, interviewing 14 clinically active chiropractic master's students. Semi-structured interviews were conducted to obtain data, which were stored electronically and transcribed verbatim. Transcripts were then coded and analyzed into relevant themes and subthemes and thereafter interpreted. Results:Four main themes were identified: (1) the perceptions and necessity regarding the roles of EBP, (2) undergraduate education and its role in the implementation of EBP, (3) the importance of clinical experience in the implementation of EBP, (4) implementation of EBP. Conclusion:Students held positive perceptions regarding EBP and believed training at the institution provided a solid foundation. However, there is much to be done in the current chiropractic curriculum to increase the efficiency of the implementation of EBP given that a lack of training in multiple aspects was identified and the challenges faced could be forestalled by implementing the suggested measures of improvement.
The Chiropractic Educators Research Forum (CERF) convened a conference on June 28, 2025. During the meeting, presenters and panelists took an in-depth look at concepts and research related to the continuous quality improvement efforts of educators and chiropractic programs.
Objective:To evaluate changes in chiropractic students' spinal manipulation force-time parameters from the beginning to end of an academic term and compare pre-post differences by students' level of self-reported training outside of required class time. Methods:Students were recruited using campus-wide flyers and club announcements. Participants performed 12 mannequin adjustments and total peak force, impulse peak force, and time to peak force were measured using force sensing table technology. Changes in pre and post data were assessed with paired t-test and signed-rank tests. The rank-sum test was used to test the association between out of class practice time and changes in adjustment parameters. Alpha was set at p ≤ .001. Results:Twenty students agreed to participate and pre-post data were collected for 17 students. Average time to peak force decreased and impulse peak and total peak forces increased over the academic term. Statistically significant changes were observed for cervical adjustment time to peak (mean decrease of 38 ms, SD = 59 ms) and thoracic adjustment total peak force (mean increase of 86 N, SD 113 N). No statistically significant differences were observed between students based on practice time. Conclusion:Using force sensing table technology in this doctor of chiropractic program, student changes in adjusting force-time parameters were documented. Future research, with a larger sample size, is needed to evaluate student characteristics associated with changes in student adjustment parameters.
OBJECTIVE:The study aimed to explore the experiences and perceptions of newly graduated chiropractors in the musculoskeletal management of pregnant women from our university in KwaZulu-Natal, South Africa. METHODS:A qualitative, explorative, descriptive research design was used. A purposive sample of 12 newly graduated chiropractors participated in semistructured interviews. The data were electronically stored, transcribed verbatim, and analyzed using thematic analysis. RESULTS:The participants expressed a lack of self-perceived confidence and knowledge, particularly regarding patients in their 3rd trimester. However, many graduates demonstrated an interest in treating pregnant patients and sought guidance from more experienced chiropractors. There was a notable desire for post-qualification enhancement with participants expressing the use of external resources, such as webinars and consultations, to refine their management strategies for pregnant women. Challenges with patient positioning, contraindications for spinal manipulation, and the need to develop trimester-specific treatment plans were key obstacles noted. New graduates emphasized the need for more comprehensive training on pregnancy-related issues within the chiropractic program. Overall, these findings highlight the need for enhanced educational chiropractic frameworks to better prepare chiropractors for the complexities of managing pregnant patients effectively. CONCLUSION:Newly graduated chiropractors from our program felt underprepared due to limited practical training and exposure. Participants expressed a desire for enhanced practical experiences and specialized courses, emphasizing the need for curriculum improvements that bridge the gap between theoretical knowledge and practical application. The findings can assist in the development of a chiropractic program that better prepare graduates for managing pregnant patients.
