Abstract
Background: In the 20th century, chiropractic evolved from a traditional, vitalistic approach to an evidence-based one. Initially, chiropractic relied on spinal adjustments and the belief that spinal misalignments caused many illnesses, leading to a broad, unscientific scope of practice. This view was met with skepticism by the medical community. A critical shift occurred later in the century as chiropractors embraced scientific research and evidence-based procedures. This change was driven by advancements in medical research, the demand for healthcare accountability, and the need for chiropractic to align with mainstream medical standards.
Aim: The research aimed to determine if there was a relationship between intolerance of uncertainty, chiropractic conservatism, and a limitless scope of practice among chiropractic students at the University of Johannesburg.
Method: This study used a cross-sectional, exploratory, and quantitative approach with a questionnaire previously used by Innes et al. (2022) on Australian chiropractic students. A minimum of 70 participants was required for statistical viability, but 166 participated. Data was collected through an online questionnaire, including Section A (demographic data) and Section B (intolerance of uncertainty, chiropractic conservatism, limitless scope of practice). The questionnaire's content and face validity were assessed, adjusted, and approved by STATKON. It took 10-20 minutes to complete. Data analysis included frequencies, descriptive statistics, reliabilities (Cronbach’s alpha), normality (Kolmogorov-Smirnov), and correlations (Pearson). The questionnaire was distributed via WhatsApp using an online link without collecting email addresses or names to ensure anonymity. Participants read an information letter and consented before answering.
Results: The online survey was distributed to 255 registered chiropractic students at the University of Johannesburg, yielding a response rate of 65.35% (n=166). Among the participants, 73.3% (n=121) were female, and 26.7% (n=44) were male, with one participant not indicating their sex. The majority of respondents were aged 21-23 years (45.1%, n=74). Regarding their year of study, 18.8% (n=31) were 2nd-year MHSc students, making up the largest group. The overall mean score for intolerance of uncertainty was 32.50 (SD±9.02), indicating neutral levels. Chiropractic conservatism scored a mean of 6.25 (SD±2.06), reflecting a traditional approach, while the limitless scope of practice scored 0.55 (SD±0.72), indicating a preference for a limited scope. This study showed that 56.15% of students had low to normal levels of uncertainty. When using the brackets from Innes et al. (2022) 67.8% of students exhibited low to normal levels of intolerance of uncertainty. In this study, 56.7%
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showed moderate to high chiropractic conservatism, and 57.85% preferred a limited scope of practice.
Conclusion: This study demonstrates a substantial shift in how chiropractic students in evidence-based programs think. Initially, students exhibited more vitalistic and conservative approaches, but as they advanced, these views significantly declined. Ultimately, they embraced an evidence-based perspective and aligned their methods with the most recent findings and recommendations. As a result, the likelihood of providing spinal manipulation for inappropriate situations decreased. These results suggest that the University of Johannesburg's chiropractic program adequately prepares students with evidence-based chiropractic care.