Perceived level of knowledge and skills about clinical management of adolescent idiopathic scoliosis among undergraduate chiropractic students and clinical faculty at a Canadian chiropractic program: cross–sectional study

Background

The prevalence of adolescent idiopathic scoliosis (AIS) ranges from 0.93 to 5.2%. Among these individuals ,27% will consult primary care providers for back pain, including chiropractors. Undergraduate chiropractic curriculum include training on the management of AIS. Recent studies however suggest such training may be sub-optimal to ensure sufficient clinical competency. To address this, a four session training educational workshop was provided to a group of chiropractic interns and clinical faculty members at l’Université du Québec à Trois-Rivières (UQTR).

Aim

To determine the current level of knowledge and skills about AIS management among junior, senior interns and the clinical faculty members at the Outpatient clinic at UQTR.

Design and methods

A cross-sectional online survey was administered to 112 interns and clinical faculty members at UQTR outpatient clinic to assess self-reported levels of knowledge and skills about AIS. The survey questionnaire was pilot tested prior to distribution. Three groups of respondents (juniors, seniors interns and clinicians) completed 15 closed-ended questions on AIS clinical presentation, risks factors and management. Responses were compared between groups using the Fisher’s exact test.

Results

A response rate of 43% (n=48/112) was obtained from 14 juniors and 19 seniors interns and 15 clinical faculty members. Among the three groups, 93% of clinicians considered having moderate to high level of knowledge on AIS, compared with 73% senior interns and 21% junior interns (p=0.0001). The proportion of interns and clinicians exposed to an educational training intervention significantly differed between groups ( p≤0.0201) with fewer juniors interns 57% and clinicians 73% attending than seniors interns 95%. The level of awareness on the existence of practice guidelines on the management of AIS varied similarly across groups (p≤0.0138), with less awareness among junior interns 29% and clinicians 50% than senior interns 79%.

Conclusion

Study results suggest a persistent knowledge gap among interns and clinical faculty members for the management of AIS in a chiropractic teaching institution. Guideline dissemination and implementation strategies are needed to fulfill these gaps to improve patient care in this setting.