Barry Draper

Towards a 21st century paradigm of chiropractic: Stage 1, redesigning clinical learning

OBJECTIVE To describe a formal process designed to determine the nature and extent of change that may enhance the depth of student learning in the pre-professional, clinical chiropractic environment. METHODS Project teams in the Royal Melbourne Institute of Technology (RMIT) School of Health Sciences and the Division of Chiropractic explored questions of clinical assessment in several health care disciplines of the School and the issue of implementing change in a manner that would be embraced by the clinicians who supervise student-learning in the clinical environment. The teams applied to RMIT for grant funding within the Learning and Teaching Investment Fund to support two proposed studies. RESULTS Both research proposals were fully funded and are in process. DISCUSSION The genesis of this work is the discovery that the predominant management plan in the chiropractic teaching clinics is based on diagnostic reductionism. It is felt this is counter-productive to the holistic dimensions of chiropractic practice taught in the classroom and non-supportive of chiropractics paradigm shift towards wellness. A need is seen to improve processes around student assessment in the contemporary work-integrated learning that is a prime element of learning within the clinical disciplines of the School of Health Sciences, including chiropractic. CONCLUSION Any improvements in the manner of clinical assessment within the chiropractic discipline will need to be accompanied by improvement in the training and development of the clinicians responsible for managing the provision of quality patient care by Registered Chiropractic Students.

Prescription medication use in a chiropractic training clinic: Cause for vigilance.

PURPOSE The concurrent use of CAM therapies with traditional allopathic medical practice is increasing. This study investigates the concurrent use of prescription medication in patients attending a chiropractic student teaching clinic for the first time. The need for practitioners to be aware of the side effects of prescribed medication patients are using is discussed. METHODS Cross-sectional study of 1008 new patient consultations at a university chiropractic teaching clinic. RESULTS 549 prescription medications being used by 330 patients were included in the analysis. A total of 104 individual medications were identified of which 69 listed headache as a potential side effect of their use. 57 of 116 (49%) of patients seeking care for the treatment of headache were concurrently using these medications. CONCLUSIONS Patients presenting to the university chiropractic teaching clinic may be seeking care for symptoms attributed to prescription medication. The requirement that practitioners be aware of the side effects of prescribed medication patients are using is raised.

Fleas, ruby and the power of chiropractic.

This essay details my experience with a woman who believed her profound incapacity was due to her failure to respect what she termed the power of chiropractic. Whilst the clinical setting may be a fertile locale for the analysis of power the essay seeks not to allocate supplementary relations or uncover unspoken truths by privileging none but a remarkable womans interpretation of that power.