A mixed-method study of chiropractic student clinical immersion placements in nonmetropolitan Western Australia: Influence on student experience, professional attributes, and practice destination

Future Research by the Australian Chiropractic Profession: Analysis of Comments and Suggestions From a Nationwide Survey of Academics and Practitioners

OBJECTIVE

The purpose of this study was to identify and compare the research priorities of Australian practicing chiropractors and academics across listed research domains and to seek their views on existing chiropractic research strategies. Concurrent objectives were to gain insight into the perspectives on characteristics of research and solicit ideas and suggestions for future research from both groups.

METHODS

This study used a mixed-method research design to collect data using an online survey portal. Australian chiropractic academics (n = 220) and practicing chiropractors who were also members of a nationally representative, practice-based research network database (n = 1680) were invited to participate. Data were collected (February 19, 2019, to May 24, 2019). The free-text data were analyzed primarily via semantic coding and verbatim referential units in cases where the category was an exact match for the textual data. Content analyses of the qualitative data were presented in a tabulated and narrative manner as identified domains. Selected representative examples were provided verbatim.

RESULTS

The response rate for the survey was 44% for full-time equivalent academics, 8% for casuals and part-time chiropractic academics, and 21.5% for Australian Chiropractic Research Network database chiropractic practitioners. Open-text data comprised a narrower focus on musculoskeletal (MSK) conditions and opposition or reservations by academics and some practitioners toward the research agenda of those espousing traditional concepts and terminology. Comments from both groups illustrate the strongly held views that characterize divergent factions of the chiropractic profession. Some practitioners were highly critical of the narrow focus and epistemological paradigm of Australian university-based research, while others were strongly supportive of the traditional focus of the Australian Spinal Research Foundation. Australian academics at the 4 university-based programs held the view that MSK and spinal pain, for which some evidence already exists, should be the priority of future research, building on what is known. Practitioners believed that future research should be directed toward expanded areas such as basic science, younger populations, and non-MSK conditions. Respondents were sharply divided on attitudes toward traditional chiropractic terminology, concepts, and philosophy and the utility of future research on these topics.

CONCLUSION

Our qualitative findings suggest there is a division in the Australian chiropractic profession regarding research direction and priorities. This divide exists between academics and researchers and within field practitioners. This study highlights the attitudes, opinions, and perceptions of important stakeholder groups, which should be considered by decision-makers when formulating research policy, strategy, and prioritization of funding.

Examining students' perception of rural practice following an educational strategy aimed at preparing postsecondary students for rural careers: a systematic review protocol for qualitative studies

INTRODUCTION

Rural areas are widely acknowledged as being at a workforce disadvantage when compared with urban populations. One of the factors contributing to this disparity is the paucity of workforce professionals who live and practice in rural areas. Educational strategies used to train these workforce professionals may help better prepare students for rural careers and thus increase retention. The purpose of this systematic review is to examine students' perceptions of rural practice following an educational strategy used to prepare students for rural careers.

METHODS AND ANALYSIS

Searches will be conducted in the following databases: Medline (Ovid), CINAHL (Ebscohost), ERIC (Proquest), Social Services Abstracts (Proquest), PsycINFO (Proquest) and IEEE Xplore. The literature search will be limited to articles published in English in the last 20 years. Data will be extracted for author(s), year of publication (2001-2021), country of origin, research question, research design, participants, where the study takes place (eg, classroom, community), educational strategies used, theoretical approach and findings related to the research question (ie, student perceptions). Methodological validity will be assessed using standardised tools. Two independent reviewers will conduct data extraction and quality appraisal, and any disagreement will be adjudicated by discussion or with a third reviewer. Results will be presented in tabular and narrative formats.

ETHICS AND DISSEMINATION

This review does not require formal ethical approval as it does not involve direct student contact or student-identifiable data. The final systematic review will be submitted to a peer-reviewed journal.

Effect of Rural Clinical Placements on Intention to Practice and Employment in Rural Australia: A Systematic Review

BACKGROUND

Supporting the provision of clinical placement (CP) experiences in rural areas is a strategy used worldwide to promote the rural health workforce. While there is international evidence for this intervention in medicine, there is limited understanding of the influence of rural CP for nursing, midwifery, allied health, and dentistry health professions in Australia, which have received substantial federal investment. This review examined the relationship between rural CP and non-medicine health students' future rural practice intentions and workforce outcomes.

METHODS

Four databases were systematically searched; papers were screened using defined criteria and appraised using the mixed-methods appraisal tool (MMAT). Findings were synthesized using a critical narrative approach.

RESULTS

The methodological quality of the 29 eligible studies (13 quantitative non-randomized, 10 mixed method, 4 qualitative, 2 quantitative description) was appraised. Ten high-quality studies were identified. The review found that positive CP experiences may influence intention to practice rurally amongst undecided students and serve as a reinforcing experience for those students already interested in rural practice. There were mixed findings regarding the influence of CP length. The review also found that there is currently only evidence for the short-term effects of CP on students' future practice outcomes in rural areas with focus thus far on early practice outcomes.

CONCLUSIONS

Those looking to use rural CP to promote the rural health workforce should focus on supporting the quality of a large number of CP experiences that are undertaken in rural areas, as there are currently differing findings on the role of rural CP length. Future studies of rural CP should consider greater use of social and educational theories to guide them.