Innes Stanley I, Leboeuf-Yde Charlotte, Walker Bruce F
1School of Health Professions, Murdoch University, Murdoch, Australia.
Institut Franco-Européen de Chiropraxie, Ivry sur Seine, France.
Chiropr Man Therap. 2018 Jan 23;26:3. doi: 10.1186/s12998-017-0170-y. eCollection 2018.
The quality of health care provider clinical decisions has long been recognized as variable. Research has focused on clinical decision making with the aim of improving patient outcomes. No studies have looked at chiropractic students´ abilities in this regard.
In 2016, advanced students from two Australian chiropractic programs ( = 444) answered a questionnaire on patient case scenarios for neck and low back pain (LBP). We selected 7 scenarios representing the three categories; continuing care, non-indicated care, and contraindicated care. This represented a total of 21 tested scores. Comparisons of correct answers were made a) for program years 3, 4 and 5, and b) between the three categories of care.
In almost 1/3 of scenarios, correct scores were 70% or greater. Best results were for two neck pain cases (simple and with spinal cord involvement). Continued care showed most improvements with study year. However, the scenarios that reflected non-indication for continued care had much worse results and did not improve in higher years. For the obvious contraindicated neck scenario, the results were good from the beginning and progressively improved and for a contraindicated LBP scenario the results started poorly in year 3 but improved over the program years.
Although student responses were generally good, there is still room for improvement, especially for non-indicated care. The quality of students' clinical decisions can be measured and thus has the potential to be used by chiropractic educators and regulatory bodies to identify student's in need of assistance as well as to monitor chiropractic programs in relation to student competence.
Not applicable.
长期以来，医疗服务提供者的临床决策质量一直被认为存在差异。研究聚焦于临床决策制定，旨在改善患者预后。尚无研究考察过脊椎按摩疗法专业学生在这方面的能力。
2016年，来自澳大利亚两个脊椎按摩疗法课程的高年级学生（n = 444）回答了一份关于颈部和下背部疼痛（LBP）患者病例场景的问卷。我们选择了代表三类情况的7个场景：持续护理、非必要护理和禁忌护理。这总共产生了21个测试分数。对正确答案进行了以下比较：a）针对课程的第3、4和5年；b）在三类护理之间。
在近1/3的场景中，正确分数达到或超过70%。两个颈部疼痛病例（简单病例和伴有脊髓受累的病例）的结果最佳。持续护理随着学习年份的增加改善最为明显。然而，反映继续护理非必要性的场景结果要差得多，且在高年级时没有改善。对于明显禁忌的颈部场景，结果从一开始就很好且逐步改善；对于一个禁忌的下背部疼痛场景，结果在第3年开始时很差，但在整个课程年份中有所改善。
尽管学生的回答总体良好，但仍有改进空间，尤其是在非必要护理方面。学生临床决策的质量可以被衡量，因此脊椎按摩疗法教育工作者和监管机构有可能利用它来识别需要帮助的学生，以及监测与学生能力相关的脊椎按摩疗法课程。
不适用。
