Monday, November 24, 2014

Thanksgiving. Thank You.!

On this occasion of a short week and a time to celebrate thanks, I send mine to you. I am grateful to all who work here, who give so much of their time and their energy. I hope that you enjoy the time off later this week, I hope you are with family (as I will be- 3 children coming, with 3 spouses, 1 grandchild and 1 twin sister to a spouse), and I hope that you are able to eat, relax and catch your breath.

Happy Thanksgiving!

Monday, November 17, 2014

Three New Papers

Rowher A, Schoonees A, Young T. Methods used and lessons learnt in conducting document reviews of medical and allied health curricula - a key step in curriculum evaluation. BMC Medical Education 2014, 14:236  doi:10.1186/1472-6920-14-236

Background: This paper describes the process, our experience and the lessons learnt in doing document reviews of health science curricula. Since we could not find relevant literature to guide us on how to approach these reviews, we feel that sharing our experience would benefit researchers embarking on similar projects.
Methods: We followed a rigorous, transparent, pre-specified approach that included the preparation of a protocol, a pre-piloted data extraction form and coding schedule. Data were extracted, analysed and synthesised. Quality checks were included at all stages of the process.
Results: The main lessons we learnt related to time and project management, continuous quality assurance, selecting the software that meets the needs of the project, involving experts as needed and disseminating the findings to relevant stakeholders.

Conclusion: A complete curriculum evaluation comprises, apart from a document review, interviews with students and lecturers to assess the learnt and taught curricula respectively. Rigorous methods must be used to ensure an objective assessment.

Jones MR, West DJ, Harrington BJ, Cook CJ, Bracken RM, Shearer DA, Kilduff L. Match play performance characteristics that predict post-match creatine kinase responses in professional rugby union players. BMC Sports Science, Medicine and Rehabilitation 2014, 6:38  doi:10.1186/2052-1847-6-38
Background: Rugby union players can take several days to fully recover from competition. Muscle damage induced during the match has a major role in player recovery; however the specific characteristics of match play that predict post-match muscle damage remains unclear. We examined the relationships between a marker of muscle damage and performance characteristics associated with physical contacts and high-speed movement in professional rugby union players.

Methods: Twenty-eight professional rugby union players (15 forwards, 13 backs) participated in this study. Data were obtained from 4 European Cup games, with blood samples collected 2?h pre, and 16 and 40?h post-match, and were subsequently analysed for creatine kinase (CK). Relationships between changes in CK concentrations and number of physical contacts and high-speed running markers, derived from performance analysis and global positioning system (GPS) data, were assessed.
Results: Moderate and moderate-large effect-size correlations were identified between contact statistics from performance analysis and changes in CK at 16 and 40?h post-match in forwards and backs, respectively (e.g. backs; total impacts vs. ?CK (r?=?0.638, p?

Conclusions: Our data demonstrate that muscle damage induced by professional rugby union match play is to some extent predicted by the number of physical contacts induced during performance. Furthermore, we show for the first time that muscle damage in backs players is predicted by high-speed running measures derived from GPS. These data increase the understanding of the causes of muscle damage in rugby union; performance markers could potentially be used to tailor individual recovery strategies and subsequent training following rugby union competition.

Young KJ. Gimme that old time religion: the influence of the healthcare belief system of chiropractic’s early leaders on the development of x-ray imaging in the profession.School of Arts; Senior Lecturer, School of Health Professions, Murdoch University, South Street, Murdoch 6150, Australia  Chiropr ManTher 2014, 22:36  doi:10.1186/s12998-014-0036-5

Background: Chiropractic technique systems have been historically documented to advocate overutilization of radiography. Various rationales for this have been explored in the literature. However, little consideration has been given to the possibility that the healthcare belief system of prominent early chiropractors may have influenced the use of the diagnostic modality through the years. The original rationale was the visualisation of chiropractic subluxations, defined as bones slightly out of place, pressing on nerves, and ultimately causing disease. This paradigm of radiography has survived in parts of the chiropractic profession, despite lacking evidence of clinical validity. The purpose of this paper is to compare the characteristics of the chiropractic technique systems that have utilised radiography for subluxation detection with the characteristics of religion, and to discover potential historical links that may have facilitated the development of those characteristics.

Discussion: Twenty-three currently or previously existing technique systems requiring radiography for subluxation analysis were found using a search of the internet, books and consultation with experts. Evidence of religiosity from the early founders’ writings was compared with textbooks, published papers, and websites of subsequently developed systems. Six criteria denoting religious thinking were developed using definitions from various sources. They are: supernatural concepts, claims of supremacy, rules and rituals, sacred artefacts, sacred stories, and special language. All of these were found to a greater or lesser degree in the publicly available documents of all the subluxation-based chiropractic x-ray systems.
Summary: The founders and early pioneers of chiropractic did not benefit from the current understanding of science and research, and therefore substituted deductive and inductive reasoning to arrive at conclusions about health and disease in the human body. Some of this thinking and rationalisation demonstrably followed a religion-like pattern, including BJ Palmer’s use of radiography. Although access to scientific methods and research education became much advanced and more accessible during the past few decades, the publicly available documents of technique systems that used radiography for chiropractic subluxation detection examined in this paper employed a historically derived paradigm for radiography that displayed characteristics in common with religion.


Monday, November 10, 2014


This will be a brief but an important post. You may have heard of Coursera. It is an education platform that “partners with top universities and organizations worldwide to offer courses online for anyone to take, for free.” And this is no small thing. Just to give you an idea of their power, I want to draw your attention to a program that was brought to my attention by my friend and colleague, Dr. Stephen Perle, of the University of Bridgeport College of Chiropractic. The specific course he told me about is entitled “Instructional Methods in Health Professions Education.”  It will be offered 4 times in the next year, with the next session beginning in February of 2015.

A link to information about this course can be found at On this page, you can view an introductory video, look at the course objectives, and view the week-by-week format. It is free.
Please look this over and consider taking a course!

Monday, November 3, 2014

World Federation Educational Conference, Miami, October 30-November 1, 2014

I am just back from a program where I was fortunate enough to be a member of the planning committee. This was a program put on by the World Federation of Chiropractic, dedicated to looking at the educational advances and opportunities within the chiropractic profession. What follows below is the full list of presentations.

  • A Case Example of Change: Chiropractic Education and Practice in Denmark.
  • Ten-Year Experience of Chiropractic Services and Education in the US Veterans’ Administration Healthcare System.
  • Integration of Chiropractic Services in Primary Care Teams and Hospitals in the Province of Ontario, Canada.
  • Teaching an Inter-professional Approach to Managing Low Back Pain in the Primary Care Setting.
  • Chiropractors in Academic Hospitals: Opportunities for Integrated Education.
  • Interdisciplinary Clinical Training in a Chiropractic College Setting: Dental and Chiropractic Co-management of Temporomandibular Joint Disorders (TMD).
  • Inter-professional Education Initiatives to Improve Pain Care: the VA Connecticut Healthcare System Experience.
  • Interdisciplinary Clinical Education: Midwifery and Chiropractic Students’ Perceptions of Combined Service in a Chiropractic Teaching clinic in the UK.
  • Healthcare Professional Education and Chiropractic.
  • Establishing Interdisciplinary Practice in Two Challenging Environments: A View from the Field.
  • Incorporating Inter-professional Education (IPE) in a Curriculum – Benefits, Methods, Challenges.
  • Preparing Faculty and Students for Integrated Care – Values and Skills.
  • Creating a Climate for Innovation.
  • Scope of Diagnostic Imaging/Laboratory/Other Exams.
  • SMT Remains the Core – But What Other Manual Treatments?
  • McKenzie Method: Given its Evidence Base it Should be Core Curriculum.
  • The Role of Chiroprctic in Wellness and Lifestyle Assessment and Advice.
  • The Significance of Evidence-Based Care for Education and Practice Today.
  • The Rise and Role of Spinal Care Pathways.
  • The Jordan Hospital Spine Care Program.
  • Outcomes Chosen for CareResponse and Reasons Why.
  • EHR as the New Standard of Care: Empowering Outcomes, Evidence and Research.
  • The Masters and Doctors Degree Programmes in Chiropractic Medicine at the University of Zurich Faculty of Medicine: An Example of Interdisciplinary Education.
  • The Place of Anatomy Education in Inter-professional Health Curricula: An Example from Australia and New Zealand.
  • A Descriptive Study Relating the Experience of Radiographic Film Interpretation by Graduating Interns: Preliminary Results.
  • Faculty Development Increases Attitudes and Use of Evidence-Based Clinical Practice.
  • A Study to Describe Process of Introducing Validated Outcome Measures (CareResponse) as Part of Final Year Clinic Training and Management of Patients at the Welsh Institute of Chiropractic.
  • An Innovative Teaching Strategy Used to Address the Role of Chiropractors As Community Health Care Advocates: A Case Report .
  • Creating an Evidence-Based Teaching Program.
  • Establishing Inter-Professional Clinical Training Opportunities.
  • Alternate Career Paths – Research and Education.
  • Effective Use of the OSCE in Current Health Sciences Education.
  • Clinical Skills Testing for Chiropractic Licensure in a Changing Healthcare Environment: Signposts of Change and Navigating the Transition.
  • Accreditation Standards: Do they Require Amendment in the Changing Healthcare Environment: A North American View.
  • Accreditation Standards: Do they Require Amendment in the Changing Healthcare Environment: A European View.
  • Teaching Anatomy at Two New York City Medical Schools.
  • Serving as a Medical Director for Chiropractic for the Washington State Department of Labor and Industries.
  • For the NIH to PCORI and Lessons Learned.
  • The Canadian Experience.
  • The Role of a Chiropractic Researcher at Palladian Health.
  • Environment for Innovation: Exploring Associations with Individual Disposition Toward Change, Organizational Conflict, Justice and Trust.
  • Preparing the Leaders of Tomorrow – The Evolution of the Residency Program at the Canadian Memorial Chiropractic College.
  • Alternative Careers for Doctors of Chiropractic through a Master of Science Program in Clinical Research.
  • A Chiroprctic Academy of Educators.
  • Insertion of Chiropractic in Public Health System.
  • The “Flipped Classroom”.
  • What the Best College Teachers and Students Do.
  • Perspectives from Chiropractic Education.