Chambers-Lewis Michelle L, Carleo Beth, Qualls Daniel Jason
Chiropractic Sciences, Palmer Florida, Port Orange, Florida.
J Chiropr Humanit. 2024 Mar 23;31:1-7. doi: 10.1016/j.echu.2024.02.001. eCollection 2024 Dec.
The purpose of this descriptive report is to describe the development of a preparticipation risk assessment screening process for incoming students prior to participation in practical labs.
A committee at the Palmer College of Chiropractic, Florida met to discuss a health history questionnaire, physical examination process, and course of action to have second-year students use their current knowledge to screen incoming students for possible clinical considerations of practice lab participation. The aim was to identify potential risk factors that may require application modification associated with performing and receiving adjustments and other hands-on lab activities within the curriculum. The preparticipation screening process, focused on general health and curriculum referenced chiropractic clinical considerations, and was created as an expansion of the existing informed consent procedures to screen incoming students prior to participating in palpation, technique, physical examination, and open adjusting labs in the chiropractic program. Any clinical considerations identified during the screening were referred to be fully evaluated by a third-year clinic intern and faculty-licensed chiropractor to maintain classroom safety standards for the students. Referred students were restricted from full classroom lab participation until recommendations from the clinic or outside licensed healthcare providers managing their concerns were received.
The program was implemented in April 2022. Eight out of the 48 students evaluated in the first group and 12 of the 81 in the second group had possible clinical considerations to participation and were referred appropriately for a full evaluation. In the third group, 35 out of 146 students with suspected clinical considerations to participation were identified. Of the 55 students referred out, all students are now actively participating in classroom activities. Fifteen have been cleared to return to classroom participation with no restrictions and the remaining 40 students have been released for participation with patient-specific restrictions as directed by their managing health care providers.
The preparticipation screening process was implemented as all incoming students since the inception of the process have been screened, referred for evaluation when deemed appropriate, and cleared to participate in labs either with or without restrictions. This process has also demonstrated the possibility of identifying multiple clinical considerations for safe curricular participation while participating in doctor-patient simulated classroom activities. This process may be helpful for new students to recognize the patient history and examination procedures as an important aspect of a patient encounter prior to receiving treatment.
本描述性报告旨在介绍为即将参加实践实验室课程的新生制定的参与前风险评估筛查流程。
佛罗里达州帕默整脊学院的一个委员会开会讨论了一份健康史问卷、体格检查流程以及让二年级学生运用其现有知识对即将入学的学生进行筛查,以便对实践实验室参与情况进行可能的临床考量的行动方案。目的是识别可能需要对课程中进行和接受整脊调整及其他实践实验室操作进行调整的潜在风险因素。参与前筛查流程聚焦于一般健康状况和课程中涉及的整脊临床考量因素,是对现有知情同意程序的扩展,用于在整脊课程的触诊、技术、体格检查和开放式调整实验室参与前对新生进行筛查。筛查过程中确定的任何临床考量因素都将交由三年级临床实习生和有执照的整脊医师教员进行全面评估,以维持学生的课堂安全标准。被转诊的学生在收到诊所或管理其问题的外部有执照医疗服务提供者的建议之前,被限制完全参与课堂实验室活动。
该项目于2022年4月实施。第一组评估的48名学生中有8名、第二组81名学生中有12名存在可能需要临床考量的参与情况,并被适当转诊进行全面评估。在第三组中,146名存在疑似临床参与考量的学生中有35名被识别出来。在被转诊的55名学生中,所有学生现在都积极参与课堂活动。15名学生已被批准无限制地返回课堂参与,其余40名学生已根据管理其医疗保健提供者的指示,在有特定患者限制的情况下被批准参与。
自该流程启动以来,所有新生都已接受参与前筛查流程,在被认为适当时被转诊进行评估,并被批准在有或无限制的情况下参与实验室活动。该流程还证明了在参与医患模拟课堂活动时,识别多种安全课程参与临床考量因素的可能性。这一流程可能有助于新生在接受治疗之前认识到患者病史和检查程序是医患接触的一个重要方面。