Monday, August 29, 2011


Prezi is on online software program that provides you with a new method of presenting information. It’s strength, as you will see, is that it works in non-linear fashion, as opposed to a standard PowerPoint presentation. As a result, it can better engage your students as they grapple with the information you wish to teach them.

Presentation technology has certainly evolved in the 31 years I have been involved in chiropractic academia. There was a time when I used a mimeograph machine to make copies of information for students. This was supplanted in the early 1980s by the use of slide technology. We had slides in carousels that we took to class. We turned off the lights and clicked through our slides. It was costly to make them (and often they were converted from overhead projections we had made earlier) , and it took special expertise to photograph pictures from texts, but make them we did. Then I got my first computer, back in 1984, a Macintosh 2e. The world changed! I could begin to make my own graphics, from drawing and paint programs, and later from clip art and online sources. PowerPoint became ascendant (as did its detractors- see my old columns on Death by PowerPoint). Today, virtually all faculty at Palmer who teach in a lecture hall use PowerPoint in one way or another and for better or for worse. And PowerPoint is strictly linear; you move from slide to slide and from bullet point to bullet point. Where Prezi differs is that it allows for movement. The screen has layers and you can zoom in and out and around those layers.

Prezi describes itself as a digital storytelling tool. In the instruction book that I have (1), the author makes the following comment: “Most slide programs dictate a process. They’re set up to organize material for a presenter to talk about in a linear fashion, which is great for the presenter but not always great for the audience. Prezi, on the other hand, uses content to create a story line. With Prezi, the organization of the material doesn’t dictate a particular process- the story does.”

Prezi requires you to think differently about how you wish to present material. Next week I will provide a bit of information on how to get going with it, but for this week, let me leave you with a link to a Prezi presentation on its many uses. Simply go to and click on play to begin seeing how you might incorporate this technology into your classroom settings. Enjoy!

1. Diamond S. Prezi for dummies. Hoboken, NJ; Wiley and Sons, 2010.

Monday, August 22, 2011

Preparing for ACC-RAC 2012

We are coming close to the deadline for submissions of abstracts to the upcoming Association of Chiropractic Colleges Research Agenda Conference, which will be held at the Treasure Island Hotel in Las Vegas in March of 2012. Last year, Palmer College had a tremendous showing, comprising nearly a third of all papers and workshops presented at the 2011 program. I am hoping we will continue to have such a huge presence at this program, and encourage you to consider submitting your work.

I do wish to remind you that if you are conducting human subject research you must have approval from the PCC Institutional Review Board or from the Human Protections Administrator in the case of exempt studies. College policy prevents us from granting approval retroactively, and this makes sense. The purpose for IRB review is to assess human risk and benefit, and obviously this can't be done after the fact. Risk has to be assessed prior to the entry of a person into a study.

Instructions for the conference submission can be found at The organizers note that the theme for this next program is “Diversity,” but that you may feel free to submit papers from a variety of disciplines: basic science, clinical science/health care systems, and educational research. You will need to prepare both a short abstract (limited to 195 words) and a longer and more detailed abstract (of up to 2100 words). In addition, you must submit an authorship form and provide information about IRB approval where it is appropriate to do so. Also, if you are presenting a case report, you will need to provide a signed patient release form with your submission. These are required, and copies of each form are included with the submission requirements on the website. The instructions have one statement worth noting: “If the submission does not meet the submission requirements (e.g., not a completed research study, missing items), it will be rejected without review. The ACC RAC Peer Review Chair will not contact authors if any submission does not meet the requirements. Notification will be sent out as a rejection notice.”
The Center for Teaching and Learning can help you with preparation of your material. I can help review your abstracts to ensure they comply with submission requirements, and if you are later accepted, we can help you develop your slides (using college templates) and your posters. Please also note that in addition to submitting your own research or other scholarship, you can also propose workshops. As example, I have submitted one with Stu Kinsinger of CMCC about the bioethical principle of autonomy in research and clinical practice.

We have done so well with past conferences. Let’s all work together to continue the streak. I know I have reviewed a growing number of submissions, and let’s send in more. Looking forward to it!

Monday, August 15, 2011

Setting Limits

I am quite enjoying the slight text “The Power of Less: The Fine Art of Limiting Yourself to the Essential… in Business and in Life” by Leo Babauta (1). It is a text that is designed to help you become more productive and effective in your work, largely by streamlining your life and focusing on what is essential. He notes that our lives have become cluttered; there is too much information, too much to do, too much clutter (yes, have you seen some faculty offices?). So we have what seems like unlimited work but limited time, and we have trouble trying to get all of everything done. We live without limits, so to say.

Being limitless is weak, according to Babauta. Learning to focus yourself with limits helps increase strength. Having limits simplifies things, so that life become manageable. It helps focus you, so that you put your energy toward a smaller number of things. It helps you focus on what is important, so that you stop trying to do everything but get done what is important to you. As a result, it helps you achieve. By focusing on a smaller number of things, we can actually get them done. It helps you show others that your time is important; we no longer say yes to everything, but only to those things that we know are important. And we become more effective.

We should set limits on all that we do. Think of how you would address this with regard to trying to do the following: answer emails, address daily tasks, talk on the phone, work on projects and reports, read information on the net and in print, address everything on your desk. When you first set limits, doing so might be arbitrary. How often should you check email? I know that I fail here; I tend to respond to emails as they arrive on my desktop. I need to stop doing so, since that interrupts what I am already doing, breaking my concentration. So perhaps I will check email every 3 hours- but that may or may not be best if so many come in over that period.

Babauta suggests that you analyze your current usage levels for a given activity, and then pick a lower limit. Test it out for about a week and see if it is working for you. If it does not, adjust it to a different level and test again. Do so until you find the level that works. I suggest you start with your email. Try to change your pattern and see if that works for you.

1. Babauta L. The power of less: the fine art of limiting yourself to the essential… in business and in life. New York City, NY; Hyperion 2009

Monday, August 8, 2011

New Papers of Interest

Mirtz T, Perle S. The prevalence of the term subluxation in North American English-Language Doctor of chiropractic programs. Chiro Man Ther 2011; 2011,19:14

Background: The subluxation construct has been a divisive term in the chiropractic profession. There is a paucity of evidence to document the subluxation. Some authors have questioned the propriety of continuing to use the term.
Aim: The purpose of this study is to examine current North American English language chiropractic college academic catalogs and determine the prevalence of the term subluxation in the respective chiropractic program curricula.
Methods: Sixteen current English-language North American chiropractic college academic catalogs were studied. The term subluxation was searched for in each of the catalogs. Categories were developed for the usage of the term. These included "total times mentioned", "subluxation mentioned in a course description", "subluxation mentioned in a course title", "subluxation mentioned in a technique course description", and "subluxation mentioned in a philosophy course description." The prevalence of the "subluxation mentioned in a course description" was compared to the total programmatic curriculum.
Results: Palmer College in Florida devoted 22.72% of its curriculum to courses mentioning the subluxation followed by Life University (Marietta, GA) and Sherman College with 16.44% and 12.80% respectively. As per specific coursework or subjects, an average of 5.22 courses or subjects have descriptions mentioning the term subluxation. Three schools made no mention of the term subluxation in their academic catalogs; they were National University of Health Sciences, Canadian Memorial Chiropractic College, and Southern California University of Health Sciences.
Conclusion: Despite the controversies and paucity of evidence the term subluxation is still found often within the chiropractic curricula of most North American chiropractic programs. Future research should determine if changes in accreditation standards and research on evidence based practice will affect this prevalence.

White MR, Jacobson IG, Smith B, Wells TS, Gackstetter GD, Boyko EJ, Smith TC and the Millennial Cohort Study team. Health care utilization among complementary and alternative medicine users in a large military cohort. BMC Compl Alternative Med 2011,11:27

Background: Complementary and Alternative Medicine use and how it impacts health care utilization in the United States Military is not well documented. Using data from the Millennium Cohort Study we describe the characteristics of CAM users in a large military population and document their health care needs over a 12-month period. The aim of this study was to determine if CAM users are requiring more physician-based medical services than users of conventional medicine.
Methods: Inpatient and outpatient medical services were documented over a 12-month period for 44,287 participants from the Millennium Cohort Study. Equal access to medical services was available to anyone needing medical care during this study period. The number and types of medical visits were compared between CAM and non-CAM users. Chi square test and multivariable logistic regression was applied for the analysis.
Results: Of the 44,287 participants, 39% reported using at least one CAM therapy, and 61% reported not using any CAM therapies. Those individuals reporting CAM use accounted for 45.1% of outpatient care and 44.8% of inpatient care. Individuals reporting one or more health conditions were 15% more likely to report CAM use than non-CAM users and 19% more likely to report CAM use if reporting one or more health symptoms compared to non-CAM users. The unadjusted odds ratio for hospitalizations in CAM users compared to non-CAM users was 1.29 (95% CI: 1.16-1.43). The mean number of days receiving outpatient care for CAM users was 7.0 days and 5.9 days for non-CAM users (p < 0.001).
Conclusions: Our study found those who report CAM use were requiring more physician-based medical services than users of conventional medicine. This appears to be primarily the result of an increase in the number of health conditions and symptoms reported by CAM users.

Tiffin PA, Finn GM, McLachlan JC. Evaluating professionalism in medical undergraduates using selected response questions: findings from an item response modelling study. BMC Med Educ 2011,11:43

Background: Professionalism is a difficult construct to define in medical students but aspects of this concept may be important in predicting the risk of postgraduate misconduct. For this reason attempts are being made to evaluate medical students' professionalism. This study investigated the psychometric properties of Selected Response Questions (SRQs) relating to the theme of professional conduct and ethics comparing them with two sets of control items: those testing pure knowledge of anatomy, and; items evaluating the ability to integrate and apply knowledge ("skills"). The performance of students on the SRQs was also compared with two external measures estimating aspects of professionalism in students; peer ratings of professionalism and their Conscientiousness Index, an objective measure of behaviours at medical school.
Methods: Item Response Theory (IRT) was used to analyse both question and student performance for SRQs relating to knowledge of professionalism, pure anatomy and skills. The relative difficulties, discrimination and 'guessabilities' of each theme of question were compared with each other using Analysis of Variance (ANOVA). Student performance on each topic was compared with the measures of conscientiousness and professionalism using parametric and non-parametric tests as appropriate. A post-hoc analysis of power for the IRT modelling was conducted using a Monte Carlo simulation.
Results: Professionalism items were less difficult compared to the anatomy and skills SRQs, poorer at discriminating between candidates and more erratically answered when compared to anatomy questions. Moreover professionalism item performance was uncorrelated with the standardised Conscientiousness Index scores (rho = 0.009, p = 0.90). In contrast there were modest but significant correlations between standardised Conscientiousness Index scores and performance at anatomy items (rho = 0.20, p = 0.006) though not skills (rho = .11, p = .1). Likewise, students with high peer ratings for professionalism had superior performance on anatomy SRQs but not professionalism themed questions. A trend of borderline significance (p = .07) was observed for performance on skills SRQs and professionalism nomination status.
Conclusions: SRQs related to professionalism are likely to have relatively poor psychometric properties and lack associations with other constructs associated with undergraduate professional behaviour. The findings suggest that such questions should not be included in undergraduate examinations and may raise issues with the introduction of Situational Judgement Tests into Foundation Years selection.

Monday, August 1, 2011

Transforming a Presentation into a Publication

I am just back from riding RAGBRAI, which this year involved 500 miles of biking over a 7-day period. I have to say it was hot, and one day it hit 101 degrees. But overall it was great fun and a superb ride. And coming into davenport at the very end was a nice touch; I was able to ride my bike home, a real treat in that I did not have to disassemble it to ship it home from a distant location. And Davenport looked great itself with all the Bix runners and RAGBRAI riders.

I had planned to continue presenting a continuation of my last two entries, but I came across a useful little paper that provides information on how to transform a presentation into a publication (1). It is well known that the yield of papers from conference presentations is rather low, usually around 10%. I am mindful that we had well over 30 papers presented at ACC-RAC last year, and if this rule were to hold true, at best we would see only 3 papers published. I would like to think we could do better than that, so this paper is timely. Let’s look at its suggestions.

The author recommends that you use PowerPoint for facilitating the transformation of a conference presentation into a potentially publishable article. This provides you the means to develop an outline of key ideas and topics, and the notes page allows you to add your own thoughts as you work out the details. In essence, this is similar to how some of us develop lectures. Schrager suggests you follow these steps:

1. Determine if the topic is appropriate for publication. Is your topic important and one that has not been adequately covered in the literature. Are you offering a new educational approach or a new look at an old topic? If the answer to such question is “no,” then perhaps this might not make a good paper for publication. But you might even then be able to prepare a review of that topic.

2. Identify a journal for the article. This will depend on the topic, the type or article and the audience you wish to reach. We have relatively few journals in our profession to choose from, but for educational papers the Journal of Chiropractic Education makes sense; other journals may also accept such papers. Make sure your content matches the goals of the journal you are submitting to.

3. Develop the article content. Set aside some time to ponder the ideas you wish to incorporate into your paper. Do a literature search on that topic as well so that you are grounded in the area to be discussed. Look for the best evidence-based information that is out there.

4. Write the manuscript. Now, you have to write. Keep mindful that you need to be more formal in your manuscript than you might have been in making a verbal presentation. Here at Palmer you have a CTL that will help you with writing and manuscript presentation. We have a dedicated wiki for developing papers, where I can immediately go in and help edit or work with you on your paper. If you are interested but do not have access, let me know and I can direct you to the site. Do not try to be perfect; it will frustrate you and that is why we have editors.

With just a little effort we can turn our ACC-RAC presentations into manuscripts and increase our yield of published papers. I am happy to help you do so.

1. Schrager S. Transforming your presentation into a publication. Fam Med 2010;42:268-272