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PURPOSE: To compare the effect of two learning opportunities, clinician feedback and video self-assessment, on 5th-year chiropractic students' patient communication skills, specifically those required for history taking. METHODS: A cohort of 51 final-year students was divided into two groups. The first group received immediate feedback from a clinical supervisor following a history-taking encounter with a patient. The second group performed self-assessments of their videotaped history-taking encounter. An end-of-year Viva Voce examination was used to measure the effectiveness of the students' history-taking skills, using two subscores, one for behavior and another for content, as well as an overall total score. An unpaired t-test was performed to determine whether any significant difference occurred between the two groups of students. Each group was then subdivided into two subgroups based on gender, and a two-way analysis of variance was performed to determine whether the type of feedback or the students' gender had any significant effect on the outcome of the Viva Voce. RESULTS: There were no significant differences between the two groups of students in terms of their final scores in the Viva Voce. After dividing each group into their gender subgroups and further analysis of the results, neither the mode of feedback nor the students' gender had any significant effect on the outcome of the Viva Voce. CONCLUSION: This study suggests that, for a mixed cohort, video self-assessment and clinician feedback are equivalent in their ability to enhance students' communication skills relating to history taking.
RESUMO
Introduction: Continuing professional education activities such as professional conferences and passive dissemination of literature appear to have no little or no impact on changing clinicians' practice. A clinical activities audit was carried out with a group (44) of chiropractors and osteopaths as part of the Chiropractic and Osteopathic College of Australasia's continuing professional development program to determine whether it was likely to generate improvement in practice.Methods: The participants gathered data relating to six audit criteria on ten patient records in round 1 and ten in round 2 (six months later). Each participant received a learning guide relating to useful clinical tools for pain and disability measurement immediately after completing the first round. The audit criteria relate to: methods used to assess the site and severity of pain, methods used to assess disability, other investigations performed or ordered, referrals made and outcome measures used for pain and disability. The data were analysed to determine whether the participants increased their use of objective pain and disability and outcome measures over the course of the audit.Results: Results of the first round of audit were compared with those of the second round. Practitioners' use of objective measures of pain and disability and outcome measures was significantly higher in the second round of audit.Conclusion: This indicates that this clinical activities audit is a useful tool for improving practice.
RESUMO
BACKGROUND: Objective outcome measures reflecting the level of effectiveness of care is a clinical imperative for practitioners dealing with neck and back pain. It is widely recognised that there is no relationship between physical pathology, pain and disability. Traditional measures of function such as range of motion and strength, on their own, are no longer sufficient when assessing treatment outcomes. OBJECTIVE: Five patient-based objective outcome tools for measuring pain and four for measuring disability are outlined with a view to encouraging their use when managing back and neck pain. DISCUSSION: All of the outcome measures presented in this review have a high clinical utility when managing patients with neck and back pain. That is, they have been shown to be valid and reliable as well as being easy to administer and score.
