Emphasis On Various Subtopics in the Anatomy Curriculum For Chiropractic Training: An International Survey of Chiropractors and Anatomists
SOURCE: Journal of Chiropractic Education 2014 (Dec 17); 29 (1): 37-42
Peter D. Chapman, MChiro, Amanda Meyer, PhD,
Kenneth Young, DC, MAppSc, Daniel Wibowo, MD,
and Bruce Walker, DrPH
Objective: The aim of this study was to conduct an international survey of the perceived optimal level of anatomy teaching from anatomy academics and practicing chiropractors. We hypothesized that the optimum level of anatomical understanding for chiropractic students does not differ between the anatomists teaching the students and practicing chiropractors.
Methods: The opinion of anatomists teaching in a chiropractic course (n = 16) was compared to practicing chiropractors (n = 589). The students’ level of understanding was based on the revised Bloom’s taxonomy for 16 different curriculum areas. Anatomists were recruited by contacting the accredited chiropractic courses worldwide. Snowball sampling was used for the practicing chiropractors. Independent-samples Mann-Whitney U tests were used to compare the results of anatomists and chiropractors.
Results: Opinions differed between anatomists and chiropractors on 9 out of the 16 questions. Where opinions differed, chiropractors recommended a higher standard of anatomical knowledge. The level suggested by chiropractors for these curriculum areas is equal to the “evaluating” level where chiropractic students can remember, understand, apply, and analyze anatomical knowledge to be able to justify a clinical decision.
Conclusion: Compared to anatomists working in chiropractic programs, chiropractors suggest a higher standard of anatomy be taught to undergraduates. Collaboration between chiropractors and anatomists would likely be beneficial in creating or modifying anatomy curricula for chiropractic students.
From the FULL TEXT Article:
INTRODUCTION
A sufficient knowledge or mastery of human anatomy is required by those working in the health professions. The level of knowledge differs among the different professions, with some requiring an in-depth knowledge of specific parts of the body rather than general anatomical knowledge. For example, dental students require emphasis on the oral cavity and podiatrists on the feet. For chiropractors, there is little research on the depth and breadth of research required for safe and effective practice. In Australia this situation is not unique to chiropractic; studies at medical schools have found that there is no consensus on exactly what students need to know. [1] Excerpts from accreditation requirements of several chiropractic bodies are shown in the Appendix (available online as supplemental material at www.journalchiroed.com).
The Council on Chiropractic Education Australasia [2 has broad accreditation standards for teaching basic sciences, including anatomy. The documentation outlines that chiropractic student basic science should cover ‘‘a core of information on the fundamental structures, functions and interrelationships of the body systems.’’ [2] The vagueness of this statement and the lack of a national standardized anatomy curriculum in chiropractic education make teaching anatomy to chiropractic students quite challenging. A review of a convenience sample of the websites of 6 chiropractic schools indicates that the teaching of anatomy differs. We selected these programs because their anatomy syllabi were available online. The reasons for the differences observed are not clear. In addition, it is not clear if the syllabi surpass or meet the level required by the various accreditation authorities. Thus, what is the optimum level of anatomy to be taught? This study attempts to address this question.
From a pedagogical perspective, a synergy exists between the retention of anatomical knowledge and clinical application in chiropractic students. [3] The ability to differentially diagnose patients requires that chiropractic students have sufficient anatomical knowledge. The majority of patients seeking chiropractic care are affected by back and neck problems. [4] However, some serious and life-threatening medical conditions, such as a dissecting aortic aneurysm, ectopic pregnancy, or myocardial infarction, can in fact present as acute back pain. [5] As point-of-entry health care professionals, chiropractors must have enough anatomical knowledge and the ability to apply it clinically to diagnose a patient in order to decide if the patient should be referred to another medical professional. It is therefore necessary to design a suitable course of anatomy that provides fundamental knowledge that enables the chiropractor to be able to diagnose or treat a patient within his or her special interest area.
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What a great article. I only see one mild flaw in their thinking. They seem to wish that anatomy department instructors could add differential diagnosis analysis to an already rigorous program.
Interesting, but out-of-phase. Anatomy classes are usually provided during the first or second years (trimesters 1-4), while the student is still in the gorging phase, piling on serving after serving of basic knowledge.
At least at Palmer, it was in the 5th and later semesters that analytical thinking is brought to bear upon that mass of data.
I completely agree that a specific differential diagnosis class, focused upon life-threatening medical conditions that may (initially) present as acute back or neck pain, would be invaluable.
As it stands, components of this thought process were presented in various classes, but never in a beginning-to-end process, where you mentally dissect the neck and back pain patient who actually are in the pro-dromal states of pain associated with their disease.
A total review of
–initial complaints,
–exam findings,
–(+) or (-) orthopedic tests,
–postural assessment,
–what components of their presentation might lead you to request special studies (blood, radiological, or otherwise),
and finally, a detailed review of the process for making a medical referral, including paperwork and social skills:
–a discussion about relationship building in your community,
–the types of letters, reports and etc. you would use
–and if time is available, a review of how to apply for hospital admission privileges OR other effective means of integration within the larger health care community.