The Journal of Chiropractic Education 

About: The Journal of Chiropractic Education is an academic journal published by Brighthall. The journal publishes majorly in the area(s): Chiropractic & Medicine. It has an ISSN identifier of 1042-5055. It is also open access. Over the lifetime, 301 publications have been published receiving 2851 citations. The journal is also known as: Journal of Chiropractic Education.

Educating Physicians: A Call for Reform of Medical School and Residency

Abstract: Educating Physicians: A Call for Reform of Medical School and Residency by Molly Cooke, David M. Irby, and Bridget C O’Brien summarizes the Carnegie Foundation study of medical education 100 years after the prior Carnegie study, often called the Flexner Report. The book is the culmination of a study of the medical education literature and a series of site visits to 11 of the 130 accredited allopathic medical schools in the United States and to three teaching hospitals. The authors did not visit osteopathic or chiropractic schools. Thus, the focus was strictly on allopathic medical education through the continuum of undergraduate medical education through residency training and beyond. The primary purpose of the book was to “stimulate discussion about the current status and future direction of medical education and advance health globally” (p. 8). I believe that educators within chiropractic education will find much of the discussion very relevant and thus can make use of the book to stimulate their own discussion. The authors focused on areas that could be improved and provided a succinct statement of what is lacking in medical education on page 3 of the introduction, greatly expanded in chapter 1 (Educating Physicians: Contexts and Challenges). In part they stated that “medical training is inflexible, excessively long, and not learner centered.” They noted that allopathic education is overly focused on inpatient clinical experience, that formal knowledge is poorly linked to clinical experience, and that not enough attention is paid to issues of population health and health care delivery. They observed that students often lack understanding of the nonclinical roles of the physician (teaching, inquiry, and advocacy) and that the “pace and commercial nature of health care” is impeding development of appropriate professional values. Based on their examination of medical education today, the authors provided four recommendations discussed in the introduction and in chapters 1 and 7. Medical education should strive for: 1) standardization of learning outcomes and individualization of the learning process; 2) integration of formal knowledge and clinical experience; 3) development of habits of inquiry and innovation, and 4) an appropriate focus on professional formation at all levels of training. The discussion surrounding these recommendations, and the specific challenges related to each, is well worth reading and reviewing as a means to gain insight into chiropractic educational programs. In chapter 2 (Being a Doctor: Foundations of Professional Education), the authors tackled the three domains of a physician’s work: caring for patients, engaging in inquiry and innovation, and participating in professional communities. They did this through a very helpful discussion of two exemplars: Dr. Caldwell, a trauma surgeon, and Dr. Alvarado, a family physician. To shed light on learning in each domain, the authors integrated many perspectives from the science of learning into each discussion, building on three assumptions about learning: it is progressive and developmental, participatory, and situated and distributed. As they wove learning theory together with the stories of the two exemplars, I found many points of connection with my own experiences as a teacher. I also found myself setting the book down frequently, as each section stimulated a new idea about how I might help enhance education for both novice and more advanced learners. My only caution with this chapter is that it brings to the discussion a wide array of concepts on the science of learning; thus prior knowledge in this arena is very helpful. Educational leaders in chiropractic education with that background should find the discussion very stimulating. In chapter 3 (The Student’s Experience: Undergraduate Medical Education) the discussion focused on the models of education used in preclinical and clinical training, comparing each to their criteria that medical education provide opportunities for learning to be progressive and developmental moving from the simple to the complex; participatory with active learning strategies; and situated in clinical settings with opportunities to appreciate that the knowledge needed to provide excellent care is distributed among all members of the setting. Chiropractic educators should find the discussion of the models of preclinical education most enlightening and might want to examine the arguments made for early clinical exposure. Chapter 4 (The Resident’s Experience: Graduate Medical Education) explored the challenges of training in an environment of increasing information load, decreasing resident work hours, and increasing demands on faculty to generate clinical income. Although the discussion is thought provoking and provides insight to this level of training in today’s health systems, readers may find the content less relevant to chiropractic education. Chapter 5 (Regulating and Financing Medical Education) provided a useful summary of the current and historic trends in financing medical education as well as the current challenges. There was also a discussion of the regulatory environment. The chapter closed with a statement that may resonate with those in chiropractic education: “The regulatory burden on schools and residency programs is great, and the standards of one agency are not always consistent with those of others.” The authors noted a need for change and provided their ideas later in the book. Chapter 6 (Leadership for Organizational Change) addressed the characteristics that the team uncovered in their study as being necessary for transforming education. These elements include: 1) effective leaders and productive teams; 2) an institutional culture of creativity, inquiry, and continuous improvement; 3) organizational structures that promote action, discipline, and innovation; 4) educational resources and supportive services to fuel innovation and excellence; and 5) academic communities that advance the scholarship of teaching and learning. Again, as in chapter 2, the use of exemplar stories enhanced the discussion and provided a means to gauge our own organizations for readiness to change. Chapter 7 (Realizing the Vision: Transforming Medical Education) and chapter 8 (Supporting Excellence Through Effective Policy) provided the report’s call to action, with chapter 7 focusing on local programs and institutions, while chapter 8 focused on policy and regulatory changes that would help promote the changes felt necessary by the authors. It is in this section where the authors’ creativity is demonstrated as they go beyond their observations and synthesis of relevant learning sciences, to posit a set of principles related to curriculum, pedagogy, and assessment. Educators must distinguish more clearly between core curricular content and everything else. Learners at all levels should not be obliged to spend time unproductively repeating clinical activities once they have mastered the competencies appropriate to their level. At every level it should be emphasized that competence means minimal standard. It is the aim to have learners develop the motivation and skill to teach themselves. Medical education must ensure through assessment that learners achieve predetermined standards of competence with respect to knowledge and performance in core domains. Assessment must go beyond what learners know and can do to address learner ability to identify gaps and next steps for learning. Commitment to excellence is a hallmark of professionalism in medicine, and expertise is likewise a continuing commitment, not an attribute. They argue that these seven principles are “broadly applicable” and should be “widely employed” (p. 214). However, it will be up to those in each educational institution to examine the relevance to their setting and to determine what advances are possible within their means. This is even more true for the 11 programmatic approaches that they offered, “to stimulate creative thinking” for educational leaders (p. 217). As the discussion in chapter 8 made clear, any transformational change in professions’ education must be accompanied by changes in the regulations governing that profession, allowing for flexibility and innovation. It is yet to be seen whether this report will have the same ultimate impact as the Flexner Report of 1910; however, I believe that it behooves all of us who are leaders in health professions education to be familiar with the report’s contents and to be open to the continuous improvement of the training that we provide in each institution and health profession.

Interprofessional collaboration in research, education, and clinical practice: working together for a better future

Abstract: Interprofessional collaboration occurs when 2 or more professions work together to achieve common goals and is often used as a means for solving a variety of problems and complex issues. The benefits of collaboration allow participants to achieve together more than they can individually, serve larger groups of people, and grow on individual and organizational levels. This editorial provides an overview of interprofessional collaboration in the areas of clinical practice, education, and research; discusses barriers to collaboration; and suggests potential means to overcome them.

How Learning Works: Seven Research-Based Principles for Smart Teaching

Abstract: We are delighted to review the book How Learning Works: Seven Research-Based Principles for Smart Teaching by Susan A. Ambrose, Michael W. Bridges, Michele DiPietro, Marsha C. Lovett, and Marie K. Norman. It is a gem. It is the first time that one of the reviewers (RJ) has read a book that deconstructs learning into various parts, discusses the theory and research, then offers concrete strategies to enhance teaching related to the concepts presented. This is not only a book that we have read and found useful in our teaching, but it is also one that the other reviewer (JN) has assigned to faculty learners in both a masters degree course and a teaching fellowship. These 25 health professions faculty educators have uniformly found the book to be useful. As one faculty member stated, “I enjoyed reading Ambrose et al at multiple levels. First and foremost were the many cool practical strategies that the book listed that could easily be adapted and applied by me in my own teaching endeavors.” This has been a common sentiment. The book is introduced with a definition of learning. The authors define learning as “a process that involves change that unfolds over time and is a result of how students interpret and respond to their experiences” (page 3). The introduction describes 7 principles of learning (listed in brief here). Students' prior knowledge can serve to help or hinder learning. Students' organization of knowledge impacts how students learn and apply what they know. Motivation determines, directs, and sustains what students learn. To develop mastery, students must develop the skills, practice integrating them, and know when to apply them. Goal-directed practice coupled with targeted feedback enhances learning. Level of learner development interacts with “course” climate to impact learning. To become self-directed, learners must be able to monitor and adjust their approaches to learning (pages 4–6). The authors divide the book into 7 chapters, each devoted to 1 principle. Nestled in every chapter are tables and figures that summarize an important “take home” concept. The chapters open with 2 stories of teacher frustration with poor learner performance. The stories serve as attention grabbers for the reader. They remind us of our own similar frustrations when learner performance is disappointing. The authors do a very good job selecting the stories and tying each story directly to the principle for each chapter in sections entitled, “What Is Going on in These Stories.” Following the analyses of the stories in each chapter is a section entitled “What Principle of Learning Is at Work Here.” In this section of each chapter, the authors describe the principle, which is followed by discussion of that chapter's principle entitled “What Does the Research Tell Us.” These sections were well written and help the readers judge for themselves the evidence supporting each principle of learning. However, for us the magic in each chapter was in their final section, “What Does the Research Suggest,” in which the authors provide specific suggestions to enhance that element of teaching. For example, in chapter 1, which discusses how prior knowledge can help or hinder current learning, the authors discuss a variety of possible techniques. In methods that could be used to gauge the extent of prior knowledge (page 27), they suggest and explain 6 possible methods: talk to colleagues who teach prerequisite courses, administer a pretest, have learners complete a self-assessment, use brainstorming to estimate prior knowledge, assign a concept-mapping activity, and look for patterns in student errors. For every component of each principle, the authors provide this same level of guidance. Also in chapter 1, the authors provide suggestions for how to activate accurate prior knowledge, how to address insufficient prior knowledge, and how to help students recognize and correct inappropriate or inaccurate prior knowledge (pages 31–38). Each chapter is a treasure trove of practical ideas to help the teacher enhance student performance. The authors close the book with a summary discussion of how to use these principles to enhance the reader's own lifelong learning. The authors note that the chapters can be read in any order because each principle is independent of the others. This is very helpful for the busy clinical instructor who can read a chapter at a time without losing any understanding. Carnegie-Mellon University, the home institution for the authors, also maintains a Web site that offers structured exploration into the concepts presented in the book, including sections on how to design and teach a course, solve a teaching problem, assess learners, and use technology for education (http://www.cmu.edu/teaching/index.html). This is a useful supplement to the book. We have one caveat. The book was written for the college teacher with the undergraduate student in mind. Thus, those of us in health professions education need to think of our own stories for each of the principles when reading the opening for each chapter. However, the application examples in most chapters are stated in a manner that can be applied easily to clinical teaching settings as well as classroom, simulation center, or laboratory settings. Since our initial introduction to this book 1 year ago, these principles have become a mainstay in our teaching of health professions students, as well in our many faculty development efforts. The principles make sense to both our learners and the teachers. These principles provide a common language that could be as useful within chiropractic education as it is for education in other health professions. In today's electronic world, you could have the “book” in your hands in less than 10 minutes. We hope you are tempted.

No differences in grades or level of satisfaction in a flipped classroom for neuroanatomy.

Abstract: Objective: The intensive nature of a 5- or 6-week teaching block poses unique problems for adequate delivery of content. This study was designed to compare the delivery of a unit of undergraduate neuroanatomy in a short summer school period, as a traditionally taught unit, with a rendition given in the form of the “Flipped Classroom.” The aim was to evaluate the effectiveness of the flipped classroom in the intensive mode classroom. Methods: The flipped classroom encompassed the same learning outcomes, but students were responsible for covering the content at home in preparation for tutorials that applied their acquired knowledge to higher levels of thinking. The main outcome measures were the final course grades and the level of satisfaction with the course. Results: There were no significant differences between the 2 cohorts in final grades (p = .259), self-rated knowledge (p = .182), or overall satisfaction with the course (p = .892). Conclusion: This particular design of the flipped classroom did not ...

Peer review of teaching.

Abstract: This article provides an overview and description of peer review of teaching for faculty members and administrators who would like to implement a peer review program. This may include classroom and clinical settings. A brief overview, procedure, and a teaching competence evaluation rubric are provided.