The prevalence of psychosocial related terminology in chiropractic program courses, chiropractic accreditation standards, and chiropractic examining board testing content in the United States

• Published in: Chiropractic & manual therapies Vol. 28; no. 1; p. 43
• Main Authors: Gliedt, Jordan A, Battaglia, Patrick J, Holmes, Benjamin D
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.08.2020; BioMed Central; BMC
• Subjects: Accreditation; Accreditation - standards; Biopsychosocial; Chiropractic - education; Chiropractic - standards; Chiropractic curriculum; Chiropractic medicine; Chiropractors; Colleges & universities; Curricula; Curriculum - standards; Humans; Jargon; Medical education; Mental health; Mind body relationship; Psychological aspects; Psychology; Social determinants of health; Standardized tests; Students; Terminology as Topic; Terms and phrases; United States; United States; United States > US; Chiropractic education; Social determinants of health; Biopsychosocial; Chiropractic curriculum
• ISSN: 2045-709X; 2045-709X
• DOI: 10.1186/s12998-020-00332-7

Spine related disorders entail biological (somatic), psychological, and social factors. Though biological factors are often emphasized, psychosocial considerations may not be receiving proper attention in the chiropractic field. Chiropractors treat spine complaints and therefore should be trained in the full spectrum of the biopsychosocial model. This study examines the use of psychosocial related terminology in United States doctor of chiropractic program (DCP) curricula, the Council on Chiropractic Education (CCE) standards, and the National Board of Chiropractic Examiners (NBCE) test plans. Nineteen academic course catalogs, CCE curricular standards and meta-competencies, and NBCE test plans were studied. Terms containing "psycho", "soci", "mental", "econom", "cultur", "emotion", "determinant", "public", "communit", "neighbor", "behav", or "cognitive" were identified in each document. Frequency of use, context of use, thematic categorization, and percentage of use compared to overall content were calculated and described. 'Public' is the most commonly used psychosocial related term in DCP curricula. 'Determinant' was used in 1 DCP curriculum. The number of courses with psychosocial related terminology in course titles and course descriptions ranged from 1 to 5 and 3 to 12, respectively. Most terms are found in clinical skills, special populations, and other miscellaneous courses, with fewer terms found in psychology and public health courses. Terminology use in course titles and descriptions compared to overall content ranges from 3.40 to 14.86%. CCE uses terminology 17 times across 5 (out of 8) total meta-competencies. NBCE includes terminology in test plans I and II, but not III or IV. Despite evidence suggesting the influential role of psychosocial factors in determinants of health and healthcare delivery, these factors are poorly reflected in United States DCP curricula. This underappreciation is further evidenced by the lack of representation of psychosocial terminology in NBCE parts III and IV test plans. The reasons for this are theoretical; lack of clarity or enforcement of CCE meta-competencies may contribute.