Musculoskeletal anatomy knowledge in Australian chiropractors.

Anatomy is a key knowledge area in chiropractic and is formally offered in the undergraduate component of chiropractic education. There is the potential for loss of anatomy knowledge before the opportunity to apply it in a clinical setting. This study aimed to determine whether chiropractic clinicians retain a level of anatomy knowledge comparable to that of chiropractic students and to compare chiropractors' self-rating of their anatomical knowledge against an objective knowledge assessment tool. A previously validated multiple-choice test was utilized to measure retention of limb musculoskeletal (MSK) knowledge in Australian chiropractors. One hundred and one registered chiropractors completed the questionnaire and responses were scored, analyzed, and compared to scores attained by undergraduate and postgraduate chiropractic students who had previously completed the same questionnaire. The results indicated that practitioners retained their anatomy knowledge, with a significantly higher total mean score than the undergraduate group [total mean score = 36.5% (±SD 13.6%); P < 0.01] but not significantly different to the postgraduate group [total mean score = 52.2% (±SD 14.1%); P = 0.74]. There was a weak positive correlation between chiropractors' self-rated knowledge and test performance scores indicating the effectiveness of this Australian chiropractic group in self-assessing their anatomy knowledge. This study found that Australian chiropractors' knowledge of MSK anatomy was retained during the transition from university to clinical practice and they accurately evaluated their own test performance.

Chiropractic student diagnosis and management of headache disorders: A survey examining self-perceived preparedness and clinical proficiency.

OBJECTIVE: To explore the self-perceived preparedness and clinical proficiency in headache diagnosis and management of Australian chiropractic students in senior years of study. METHODS: Australian chiropractic students in the 4th (n = 134) and 5th year (n = 122) of 2 chiropractic university programs were invited to participate in an online cross-sectional survey. Descriptive analyses were conducted for all variables. Post hoc analyses were performed using simple linear regression to evaluate the relationship between self-perceived preparedness and correctness of headache diagnosis and management scores. RESULTS: Australian chiropractic students in senior years demonstrated moderate overall levels of self-perceived preparedness and proficiency in their ability to diagnose and manage headache disorders. Final-year students had a slightly higher self-perceived preparedness and proficiency in headache diagnosis and management compared to those students in the 4th year of study. There was no relationship between self-perceived preparedness and correctness of headache diagnosis and management for either 4th- or 5th-year chiropractic students. CONCLUSION: Our findings suggest that there may be gaps in graduate chiropractic student confidence and proficiency in headache diagnosis and management. These findings call for further research to explore graduate chiropractic student preparedness and proficiency in the diagnosis and management of headache disorders.

Australian chiropractors' perception of the clinical relevance of anatomical sciences and adequacy of teaching in chiropractic curricula.

BACKGROUND: Human anatomy education is compulsory in the undergraduate curriculum in all Australian chiropractic education programs. There is very little data on clinicians' perceptions of the adequacy of their anatomy training and its relevance to practice. The aims of this study were to evaluate Australian registered chiropractors' perceptions on the relevance and adequacy of anatomy training for clinical practice and analyse their opinion on the usefulness of the teaching resources utilized during their preprofessional training. METHODS: A questionnaire-based survey was conducted on a sample of Australian registered chiropractors focussing on the adequacy of their anatomical science (gross anatomy, histology, neuroanatomy and embryology) training and the clinical relevance of each individual sub-discipline, and the perceived value of each of the different anatomy teaching resources utilized. RESULTS: A total of 128 completed surveys were returned from an estimated 387 attendees at two national chiropractic conferences (estimated 33% response rate). The respondents represent 2.6% of registered chiropractors in Australia in 2016 and were representative in terms of gender (66.4% male) but not age, with older generations being over-represented (peak age group 35-44 vs. 25-34). The majority of the survey respondents obtained their chiropractic qualification in Australia (89.1%) and graduated after 1990 with an average of 21.7 years (SD = 11.3, range = 1-44) in practice. Respondents were equally likely to have undertaken anatomy training in Medicine, Science, Health Science, or other faculties. The disciplines perceived most relevant for clinical practice were neuroanatomy (100% of respondents agreeing) and gross anatomy (99.2%), followed by histology (86.0%) and embryology (81.1%). Respondents also perceived their training to be most adequate in neuroanatomy (99.3%) and gross anatomy (99.2%) followed by histology (91.4%) and embryology (85%). Respondents confirmed exposure to a varied suite of anatomy teaching tools utilized during their pre-professional training and highly valued access to cadavers and prosected specimens. CONCLUSIONS: The majority of respondents perceived anatomy as highly relevant to their clinical practice and noted that it was adequately taught within a wide range of educational approaches. These results will assist educators to refine content and delivery of anatomy course offerings to maximize relevance in chiropractic clinical practice.

Anatomical Sciences in Chiropractic Education: A Survey of Chiropractic Programs in Australia.

Human anatomy knowledge is a core requirement for all health care clinicians. There is a paucity of information relating to anatomy content and delivery in Australian chiropractic programs. The aim of this study was to describe anatomy teaching in Australian chiropractic programs, utilizing a survey which was distributed to all four programs, requesting information on: anatomy program structure, delivery methods, assessment, teaching resources, and academic staff profile at their institution. The survey was undertaken in 2016 and documented practices in that academic year. All four institutions responded. There was a reported difference in the teaching hours, content, delivery and assessment of anatomy utilized in Australian chiropractic programs. Anatomy was compulsory at all four institutions with the mean total of 214 (SD ± 100.2) teaching hours. Teaching was undertaken by permanent ongoing (30%) and sessional academic staff, and student to teacher ratio varied from 15:1 to 12:1. A variety of teaching resources were utilized, including human tissue access, either as prosected cadavers or plastinated body parts. The results of this survey confirm that anatomy has an established place in chiropractic education programs in Australia and while curricular variations exist, all programs had similar course design, delivery, and assessment methods. This study confirmed the provision of a strong foundation in topographical anatomy and neuroanatomy, while other anatomical sciences, such as histology and embryology were not consistently delivered. Formalization of a core anatomy curriculum together with competency standards is needed to assist program evaluation and development, and for accreditation purposes.

A collaborative process for a program redesign for education in evidence-based health care.

OBJECTIVE:: We outline the framework of a collaborative process to redesign an existing 5-year health education program, which may prove useful to other similar institutions. The aim was to strengthen evidence-based practice and curriculum alignment. METHODS:: A whole-of-program approach was used to restructure the existing courses into 3 "streams": professional practice, clinical research, and clinical science. The process incorporated a series of facilitated workshops organized by the department director of learning and teaching and the faculty facilitation team, and it was inclusive of all available members of the department, a clinic supervisor, a sessional (casual teaching) staff member, and a recent graduate of the program. RESULTS:: Unit content and assessments were restructured to progress the program learning outcomes from year to year. The undergraduate program was redesigned to create a more logical learning pathway for students. Consolidation of subject topics in the postgraduate program allowed for the development of stand-alone research-only units. CONCLUSION:: The mechanism of curriculum mapping allowed for discussion about the flow of information from year to year and how evidenced knowledge and understanding can be developed. It is necessary that everyone participates and understands the importance of program goals as developed by the process. Because drift in curriculum can occur incrementally over the years, to be effective, the program requires ongoing monitoring and regular collaboration to continue improvements.

The role of anatomy education in facilitating multidisciplinary collaboration in the treatment of musculoskeletal conditions ­ an example from Australia / El papel de la educación de la anatomía en la facilitación de la colaboración multidisciplinaria en el tratamiento de las afecciones musculoesqueléticas ­ un ejemplo de Australia

Emerging changes to the healthcare system are promoting the adoption of an integrative medicine and a more patient-centred approach to healthcare. A multidisciplinary approach to the management of musculoskeletal conditions has a potential to ease the pressure off the emergency public health care system. Interprofessional collaboration in health care is paramount for this synergism to occur. It is crucial that treatment options be consistent and transparent across different health professions in order for optimum patient centred care. Using the Australian educational and health setting as an example, it is argued in this paper that anatomy education could play an important role in facilitating this consistency and transparency. The first decisive step in this process would be to review the alignment of anatomy syllabi across the academic programs of different health professions. The review and comparison of anatomy content taught across the different health professional curricula should expedite the acceptance of one profession by another. This alignment of anatomy teaching would aid interprofessional relations and ultimately collaboration, beginning from education of students through to professional practice and encompassing accreditation guidelines.

Los cambios emergentes en el sistema de salud están promoviendo la adopción de una medicina integradora y un enfoque más centrado en el paciente en la atención sanitaria. Un enfoque multidisciplinario para el manejo de las afecciones musculoesqueléticas tiene el potencial para aliviar la presión del sistema de salud pública de emergencia. La colaboración interprofesional en el cuidado de la salud es primordial para que este sinergismo ocurra. Es crucial que las opciones de tratamiento sean coherentes y transparentes en las diferentes profesiones de la salud con el fin de que la atención centrada en el paciente sea óptima. Utilizando el marco educativo y de salud australiano como ejemplo, se argumenta en este trabajo que la educación en anatomía podría desempeñar un papel importante para facilitar esta consistencia y transparencia. El primer paso decisivo en este proceso sería revisar la alineación de los programas de anatomía a través de los programas académicos de diferentes profesiones de la salud. La revisión y comparación del contenido de la anatomía enseñada en los diferentes currículos de profesionales de la salud debería acelerar la aceptación de una profesión por otra. Esta alineación de la enseñanza de la anatomía ayudaría a las relaciones interprofesionales y, en última instancia, la colaboración, desde la educación de los estudiantes hasta la práctica profesional y las directrices de acreditación.