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Establishing a residency program for a chiropractic specialty in a public hospital system: Experiences from Denmark.

ABSTRACT: OBJECTIVE:We describe the experiences and lessons learned from establishing a 5-year postgraduate hospital-based residency program for chiropractors in Denmark. The program was established with the aim of qualifying those chiropractors to undertake common and several specialized functions in relation to musculoskeletal disorders, at the highest professional level, within the particular conditions of a hospital setting. METHODS:We provide an overall description of this unique program, examples of specific educational goals, and the process used to develop the program. RESULTS:Three pilot programs were conducted between 2009 and 2016. The internship program and educational goals were revised extensively during this period. Between revisions and semistructured interviews with key medical officers following the pilot program, the program was well received and considered appropriate for further qualifying chiropractors for specialized, hospital-based practice. CONCLUSION:The structure and content of the program will likely require further improvements in years to come, but currently forms the basis of the first regular 5-year, postgraduate in-hospital residency program for chiropractors in Denmark and perhaps elsewhere.

SUBMITTER: O'Neill SFD

PROVIDER: S-EPMC7682646 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Establishing a residency program for a chiropractic specialty in a public hospital system: Experiences from Denmark.

O'Neill Søren F D SFD Konner Mikkel B MB Fejer Rene R Vesterager Susanne V SV

The Journal of chiropractic education 20201001 2

<h4>Objective</h4>We describe the experiences and lessons learned from establishing a 5-year postgraduate hospital-based residency program for chiropractors in Denmark. The program was established with the aim of qualifying those chiropractors to undertake common and several specialized functions in relation to musculoskeletal disorders, at the highest professional level, within the particular conditions of a hospital setting.<h4>Methods</h4>We provide an overall description of this unique progr ...[more]

PMID: 31039054

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Project description:Background: The chiropractic profession is split between those practicing evidence-based and those whose practice is honed by vitalism. The latter has been coined 'chiropractic conservatism'. In Denmark, the chiropractic education program is university-based in close collaboration with a medical faculty. We wanted to investigate if such conservative attitudes were present in this environment. Our objectives were to i) determine the level of chiropractic conservatism, ii) investigate if this was linked to academic year of study, iii) determine the level of clinical appropriateness, and iv) to investigate if this was affected by the level of conservatism among students in a chiropractic program, where the students are taught alongside medical students at the University of Southern Denmark (SDU).Methods: A cross-sectional survey of 146 (response-rate 76%) 3rd to 5th year pre-graduate students and 1st year postgraduate clinical interns from the chiropractic degree course at the University of Southern Denmark was conducted during autumn of 2019. The students' levels of conservatism were dichotomized into appropriate/inappropriate, summed up, and used in a linear regression model to determine the association with academic year of study. Thereafter, the conservatism score was categorized into four groups (from low -1- to high -4-). Conservatism groups were cross-tabulated with the ability to answer appropriately on nine cases concerning i) contra-indications, ii) non-indications, and iii) indications for spinal manipulation and analyzed using logistic regression.Results: Generally, the Danish chiropractic students had low conservatism scores, decreasing with increasing academic year of study. Seventy percent of the students were placed in the two lowest conservative groups. The level of conservatism (categories 1-3) was moderately (but not statistically significantly) associated with an inability to recognize non-indications to treatment. Three outliers (category 4), however, revealed a highly inappropriate handling of the clinical cases.Conclusions: Chiropractic students enrolled at a university-based course closely integrated with a medical teaching environment are not immune to chiropractic conservatism. However, the course appears to attenuate it and limit its effect on clinical decision-making compared to other educational institutions.

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Establishing a residency program for a chiropractic specialty in a public hospital system: Experiences from Denmark.

Publications

Establishing a residency program for a chiropractic specialty in a public hospital system: Experiences from Denmark.

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