Monday, March 25, 2013

New From BMC

Axen I, Leboeuf-Yde C. Conducting practice-based projects among chiropractors: a manual. Chiropr Man Ther 2013, 21:8 doi:10.1186/2045-709X-21-8

Introduction: Practice-based research is a challenge as clinicians are busy with their patients and any participation in research activities will be secondary to the needs of the patients and the clinic. As a result, it is difficult to obtain high compliance among clinicians. A method to enhance compliance in multicentre practice-based research has been developed and refined for use in the chiropractic setting and possibly also by other researchers in different settings.
Method: This manual provides a stringent step-by-step approach for conducting clinic-based research. It describes the competencies and requirements of an effective working group, how to recruit participating clinicians and how to empower, encourage and support these clinicians to obtain good compliance.

Discussion: The main advantage of the method is the high compliance of participating clinicians compared to many other clinical studies. Difficulties with the method are described and suggestions for solutions are presented.
Conclusions: This manual is a description of a method that may be of use for clinical researchers in the chiropractic setting.

Samarakoon L, Fernando T, Rodrigo C, Rajapakse S. Learning styles and approaches to learning among medical undergraduates and postgraduates. BMC Med Educ 2013, 13:42 doi:10.1186/1472-6920-13-42
Background: The challenge of imparting a large amount of knowledge within a limited time period in a way it is retained, remembered and effectively interpreted by a student is considerable. This has resulted in crucial changes in the field of medical education, with a shift from didactic teacher centered and subject based teaching to the use of interactive, problem based, student centered learning. This study tested the hypothesis that learning styles (visual, auditory, read/write and kinesthetic) and approaches to learning (deep, strategic and superficial) differ among first and final year undergraduate medical students, and postgraduates medical trainees.

Methods: We used self administered VARK and ASSIST questionnaires to assess the differences in learning styles and approaches to learning among medical undergraduates of the University of Colombo and postgraduate trainees of the Postgraduate Institute of Medicine, Colombo.
Results: A total of 147 participated:73 (49.7%) first year students,40 (27.2%) final year students and 34(23.1%) postgraduate students. The majority (69.9%) of first year students had multimodal learning styles. Among final year students, the majority (67.5%) had multimodal learning styles, and among postgraduates, the majority were unimodal (52.9%) learners. Among all three groups, the predominant approach to learning was strategic. Postgraduates had significant higher mean scores for deep and strategic approaches than first years or final years (p < 0.05). Mean scores for the superficial approach did not differ significantly between groups.

Conclusions: The learning approach suggest a positive shift towards deep and strategic learning in postgraduate students. However a similar difference was not observed in undergraduate students from first year to final year, suggesting that their curriculum may not have influenced learning methodology over a five year period.

Nisbet MC, Fahy D. Bioethics in popular science: evaluating the media impact of The Immortal Llife of Henrietta Lacks on the biobank debate. BMC Med Ethics 2013, 14:10 doi:10.1186/1472-6939-14-10
Background: The global expansion of biobanks has led to a range of bioethical concerns related to consent, privacy, control, ownership, and disclosure. As an opportunity to engage broader audiences on these concerns, bioethicists have welcomed the commercial success of Rebecca Skloot’s 2010 bestselling book The Immortal Life of Henrietta Lacks. To assess the impact of the book on discussion within the media and popular culture more generally, we systematically analyzed the ethics-related themes emphasized in reviews and articles about the book, and in interviews and profiles of Skloot.

Methods: We conducted a content analysis of a population of relevant English-language articles and transcripts (n = 125) produced by news organizations and publications in the U.S., Canada, Great Britain/Ireland, and Australia/New Zealand. We scored each article for the emphasis and appearance of 9 ethics-related themes. These were informed consent, welfare of the vulnerable, compensation, scientific progress, control/access, accountability/oversight, privacy, public education, and advocacy.
Results: The informed consent theme dominated media discussion, with almost 39.2 percent of articles/transcripts featuring the theme as a major focus and 44.8 percent emphasizing the theme as a minor focus. Other prominent themes and frames of reference focused on the welfare of the vulnerable (18.4 percent major emphasis; 36.0 percent minor emphasis), and donor compensation (19.2 percent major; 52.8 percent minor). Ethical themes that comprised a second tier of prominence included those of scientific progress, control/access, and accountability/oversight. The least prominent themes were privacy, public education, and advocacy.

Conclusions: The book has been praised as an opportunity to elevate media discussion of bioethics, but such claims should be re-considered. The relatively narrow focus on informed consent in the media discussion generated by Skloot’s book may limit the ability of ethicists and advocates to elevate attention to donor control, compensation, patenting, privacy, and other ethical issues. Still, ethicists should view the book and a pending major TV film translation as opportunities to highlight through media outreach, consultation exercises and public forums a broader range of bioethical concerns that would otherwise be under-emphasized in news coverage. Such efforts, however, need to be carefully planned and evaluated.


Monday, March 18, 2013

More From ACC-RAC 2013

As always, the Palmer presence at ACC-RAC was significant. This year we had 2 large plenary presentations, 11 accepted platform papers, 13 posters, and 7 workshops. And in most cases, we had attentive and engaging audiences who truly appreciated the information we presented. Last post I listed all of Palmer’s involvement and all I wish to do here is to list a few more papers that I thought were interesting. These are part of a larger effort in our profession to enhance our instruction.

  • Pilot study on the impact of student feedback using in-depth interviews on assessment and achievement of student learning outcomes- presenter Noni Threinen
  • Predictors of National Board of Chiropractic Examiners (NBCE) performance- presenter Angela McCall
  • GPA as a predictor of performance on a high stakes comprehensive competency assessment- presenter Gloria Hinck
  • Participation strategies and student performance: a case study- presenter David Starmer
  • Assessing critical thought in a chiropractic program- presenter Joseph Guagliardo
  • Self-perceived skills confidence: a follow-up study of chiropractic students in the early phases of a college’s clinic program- presenter Deborah Bisiacchi
  • A proposed bioethics curriculum for accredited chiropractic institutions- presenter Stuart Kinsinger
  • Using educational videos to teach spinal manipulation- presenter Karen Numeroff
  • The development of a critical appraisal tool for the quantitative assessment of case reports- presenter Shari Wynd
  • Utilizing learner response systems to enhance student learning and retention in the basic science classroom- presenter Alena Coleman
  • The use of debate as an active learning strategy in a chiropractic classroom- presenter Drew Rubin
As you can see, the topics were varied and covered all aspects of education from basic sciences through clinical training. As always, much to consider, and as much learning occurring the hallways as in the sessions. All good.

Monday, March 11, 2013

Palmer Involvement in ACC-RAC 2013

Once again, Palmer shows why it is the Trusted Leader in Chiropractic!
Plenary Open Session
·         Chiropractic and Healthcare Reform: Improving Outcomes, Delivery, and Affordability of Healthcare:  Bob Mootz, DC , Partap S. Khalsa, DC, PhD , Christine Goertz, DC, PhD, Dan Hansen, DC

·         Current State of Chiropractic Education, Research, and Practice: Report from ACC Executive Officers: Richard Brassard, DC, Brian McAuley, DC, PhD, Dennis Marchiori, DC, PhD

 Plenary Presentations
·         Predictors of performance of students in biochemistry in the doctor of chiropractic program:
Kathryn Shaw,DC, Christopher Meseke, PhD Veronica Dishman, PhD

·         Instantaneous rate of loading during manual high-velocity low-amplitude spinal manipulations:
Maruti Ram Gudavalli, PhD

·         Doctors of chiropractic self-reported practice patterns and attitudes toward interdisciplinary co-management of older adults with back pain:  Stacie Salsbury, RN, PhD, Kevin Lyons, PhD,  Cynthia Long, PhD, Maria Hondras, DC, MPH, Robert Vining, DC, Lisa Killinger, DC,  Christine Goertz, DC, PhD

·         Prevalence of radiographic findings in a chronic low back pain population:
Robert Vining, DC, Eric Potocki, DC, MS,  Ian McLean, DC, DACBR,  Michael Seidman, DC, Paige Morgenthal, DC, MS, James Boysen, DC, MS

·         Surveys as a method for informing a chiropractic technology program curriculum:
Cathy Eberhart, MBA, Stacie Martel, DC, MS

·         Rubric referenced self-assessment vs Traditional way in students' anatomy laboratory learning:
Xiaohua He, MD, Ali Rabatsky, PhD

·         The correlation of the arm-fossa test with other sacroiliac findings: a feasibility study:
Robert Cooperstein, DC, Charles Blum, DC, Elaine Cooperstein, DC, MS

·         How reliable are manual therapists' procedures in detecting positional asymmetry of the PSIS?
Robert Cooperstein, DC

·         Intraexaminer reliability of compressive leg checking and correlation with the sit-stand test for anatomic leg length inequality:
Robert Cooperstein, DC, Morgan Young, DC, Baljinder Gill, BS

·         A case-based approach to pharmacology using wikis as a collaborative tool:
Lia Nightingale, PhD

·         Test anxiety and academic performance in chiropractic students:
Niu Zhang, MD, Charles Henderson, DC, PhD

·         Utilization of an iPad throughout a nutrition curriculum:
Lia Nightingale, PhD

·         Student iPad use in a neuromusculoskeletal diagnosis course: the influence of iPads on course grades and student opinions and attitudes toward iPads in the classroom:
Michael Tunning, DC, Christopher Roecker, DC, MS, DABCO, Robert Rowell, DC, MS, Michael VanNatta, DC

·         IPilots, digital natives and digital immigrants: a pilot project using iPads in a chiropractic college setting:
Dana Lawrence, DC, MMedEd, MA, Rita Nafziger, MBA, Dan Weinert, DC, MS, DABCR

·         Investigating high quality interactive applications for value added teaching:
Judy Bhatti, DC, Mary Frost, DC, Elissa Twist, DC

·         Complying with CCE meta-competencies 6 and 7 through the development of an EBCP educational module with an emphasis on a comparative analysis of two systematic reviews:
Gregory Cofano, DC, Kimberly Keene, DC, Heather Bowyer, DC, Edward Pappagallo, DC,  Jacqueline Beres, DC

·         Patient and payment sources of Palmer College of Chiropractic's teaching clinics:
Gregory Snow, DC, Makani Lew, DC

·         Is interprofessional education a common factor in chiropractic continuing education?
Edward Bednarz, DC, Anthony Lisi, DC

·         A comprehensive learning series on yellow flags for the DC and DC Student:
Teresa Brennan, DC

·         The use of chiropractic manipulation in the post-surgical spine:
Christopher M Coulis, DC, Anthony J Lisi, DC

·         Avulsion fracture of the iliac crest apophysis in a 15 year-old football player:
Stephen Grand, DC, DABCO, Matthew Richardson, DC, DACBR

·         Defining and measuring quality in chiropractic health care: toward six sigma success:
Nicole Homb, DC, Shayan Sheybani, DC, MBA

·         Resolution of hearing loss after chiropractic manipulation:
Kimberly Keene, DC, Melissa Ferranti, DC, Chelsea Prothero, BS

·         Essential literature for the chiropractic profession:
Barbara Mansholt, DC, John Stites, DC, MS, DACBR, DACBO, Dustin Derby, EdD, Ron Boesch, DC, DACBO

·         A pediatric case of McCune-Albright syndrome in a 5 year old female at a chiropractic teaching clinic:
Kenice Morehouse, DC, Stephen Grand, DC, DABCO, Matthew Richardson, DC, DACBR

·         Salter Harris II fracture of second proximal phalanx of toe: a chiropractic perspective:
Mark Murdock, DC

·         Tibial plateau fracture following ACL reconstruction: co-management of a rare complication:
J Ali Rabatsky, PhD

·         A case of breech repositioning unresponsive to Webster technique: coexistence of oligohydramnios:
Christopher Roecker, DC, MS, DABCO

·         The association between body mass index and response to spinal manipulation for patients with subacute and chronic low back pain
Christopher Roecker, DC, MS, DABCO,  Joel Pickar, DC, PhD, Dana Lawrence, DC, MMedEd, MA, Robert Vining, DC, Cynthia Long, PhD

·         Treatment of a patient with post cortical atrophy with chiropractic manipulation and dynamic neuromuscular stabilization (DNS): a case report
Michael Tunning, DC, Vinicious Francio, BS, Ron Boesch, DC, DABCO

·         The association between low back pain and bowel and bladder dysfunction: a narrative review
Anna Walden, DC, Stacie Salsbury, RN, PhD

·         Writing a grant: What is the statistician's role and how do I find one?
Cynthia R. Long, PhD, Laura Lee Johnson, PhD

·         Understanding the Language of Clinical Outcomes or Yeah, yeah, but what does it really mean? Ron LeFebvre, DC, Shireesh Bhalerao, DC, John Stites, DC, MS, DABCR, DABCO, Tammi Clark, DC, Robert M. Rowell, DC, MS

·         Chiropractic Colleges' research coursework and curricula: Implications for Evidence Based Education (EBE) and Evidence Based Practice (EBP) and NBCE exams.
Rodger Tepe, PhD, Greg Cramer, DC, PhD, Thomas J. Augat, DC, Cynthia Long, PhD, Kathleen Linaker, DC, PhD
·         Teaching Business Courses in Chiropractic School: Lessons Learned, Challenges Identified.
William J. Lauretti, DC, Leanne N. Cupon, DC, Thomas M. Frank, DC, MBA, Mary E. Frost, DC, Teresa M. Hoban, DC, MBA, Steven R. Jaffe, DC, Jason G. Napuli, DC, MBA

·         Placing Health Front and Center in Discussions of Health Care Reform:
            Lisa Zaynab Killinger, DC, Gerald Clum DC, Christine Goertz, DC, PhD

·         Assessing Information Literacy: Why, when, and how:
            Rodger Tepe, PhD, Chabha Tepe, Daniel Wright, MA, MLIS, Ron LeFebvre, DC

·         Enhancing the Integration of Chiropractic Technique, Academia, and Research:
Anthony Rosner, PhD, Charles L. Blum, DC, Robert Cooperstein, DC, Mitchell Haas, DC, MA, Stephen Perle, DC, Michael Schneider, DC, PhD, Arlan Fuhr, DC


Monday, March 4, 2013

A Welcome Back

I hope that you had a week to relax and enjoy yourself. Today is the first day of our new term, and as always it will be an in-service. After the normal introductions from myself and Dr. Paustian, the morning session is devoted to discussing a process used to develop a curricular approach to the teaching and testing of orthopedic evaluation. This combined literature with clinical expertise and expert opinion.

Speakers will include Drs. Tom Souza (from PCCW) and Al Luce (from PCCF).
Tom will present an overview of a process used to generate a core set of orthopedic tests taught in the PCCW curriculum based on combining the best available literature evidence with faculty members’ clinical expertise.  Implementation of this process included categorizing orthopedic testing into skill-based teaching versus lecture-based teaching, leading to skill-based testing versus written-examination-based testing.  The final application of this curricular process included integration into the clinical environment and the electronic medical record system.

Al’s session discusses the implementation of an evidence-based approach to the application of literature-based and expert-opinion-modified approaches to the most common conditions seen in chiropractor practice.  It also describes the extension of this process to a pragmatic application in the Medicare environment.

The afternoon session is devoted to ACC-RAC presentations. Come listen to your colleagues:
  • Michael Tunning, DC. Student iPad use in a Neuromusculoskeletal Diagnosis Course: The Influence of iPads on Course Grades and Student Opinions and Attitudes Toward iPads in the Classroom
  • Cathy Eberhart, MBA. Surveys as a Method for Informing a Chiropractic Technology Program Curriculum
  • Lia Nightingale, PhD. A Case-Based Approach to Pharmacology Using Wikis as a Collaborative Tool
  • Robert Vining, DC. Prevalence of Radiographic Findings in a Chronic Low Back Pain Population”
  • Judy Bhatti, DC. Investigating High Quality Interactive Applications for Value Added Teaching”
And again, welcome back!