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Chiropractic Journal of Australia : CJA December 2013
138 Chiropractic Journal of Australia Volume 43 Number 4 December 2013 We believe this to be due to the importance of neuroanatomy in providing the necessary foundation for clinical neurology in the chiropractic profession, and hence the emphasis that is placed upon it in teaching and in applying what is learnt to real life situations a chiropractor would encounter in practice. An understanding of the nervous system and neurology is important in chiropractic because of the work done on the musculoskeletal system and the close link to the nervous system and the tissues it supplies. METHOD Participants This study consisted of 166 initial respondents in two cohorts; students in the frst year of the Masters of Chiropractic program (4th year), and students in the third year of the Bachelor of Chiropractic Science. The 4th year students had completed the neuroanatomy unit HLTH 308 in 2011 and the 3rd year bachelor students completed HTLH 214 in 2011. HLTH308 and HLTH214 were identical units that were run simultaneously in 2011 as the old unit (HLTH308, a third year unit) gave way to the new unit (HLTH214, a second year unit). This unusual circumstance occurred because the undergraduate chiropractic degree was reorganised in 2011 and the third year unit was converted into a second year unit. Both units covered the same material and had the same learning outcomes. The material was taught in the traditional rather than problem based mode, with structured lectures, practicals based on identifcation of structures on models, prosections and the living body, and tutorials based on case studies. Both of these units were also run by the same unit convenor and lecturer, and the same tutors were teaching in the same practicals and tutorials, so there was a consistency that allowed comparison of the two groups one year after the material was learnt. Students were considered eligible to participate if they had completed either of these units in 2011 successfully. Participants were considered ineligible if they were enrolled in the Masters Qualifer’s program (an alternate entry into the masters' course) or had completed HLTH 308 prior to 2011. Participants were also considered ineligible if they crossed over in units (i.e. they completed the HLTH214 in 2011 and then did the 4th year unit in 2012, or they did HLTH308 in 2011 and then did the 3rd year unit in 2012). This study was approved by the Macquarie University ethics committee (reference number: 5201200332). The study was entirely voluntary and there were no incentives offered to the participants. Questionnaire All eligible participants had completed the same fnal exam in 2011. To assess their knowledge retention one year later, we randomly extracted 15 multiple choice questions from the 2011 fnal exam by selecting the frst and last question and every third question in that exam. Consent forms, the questionnaire with these questions, and demographic questions, were distributed during a tutorial at a time that suited the unit convenors. Participants were not given prior warning that the study was to take place, so that no study or preparation could occur. Outcome Measures Results from the questionnaire were compared to the results of the multiple choice section of the fnal neuroanatomy exam given to these students the year before. Statistical Methods Demographic questionnaire responses and multiple choice question (MCQ) test scores were tabulated, and proportions or means with standard deviations were calculated. The Pearson's Chi-squared test with Yates' continuity correction was used to check for group differences in dichotomous variables (i.e. gender, native English speaker / English as second language, mature age student / non-mature age student), while the Welch Two Sample t-test was used to check for group differences in continuous variables (i.e. MCQ test scores) and within group differences on pre-post scores (i.e. frst MCQ test score versus second MCQ test score). All statistical analyses were performed using R statistical package, version 2.15.2 (R Foundation for Statistical Computing, Vienna, Austria). RESULTS There was a response rate of 98.2% (166 of an original 170 students) for the combined cohorts. Forty-fve participants were considered ineligible because they didn’t fll out the demographic questions properly, crossed over in units or they had completed the unit before 2011. This left a total of 121 out of the 167 original participants (72.5% eligible participants): a total of 76.6% (59 of an original 77) of the third year students and 68.9% (62 of an original 90) of the masters' students. The demographics of the two cohorts were similar (Table 1). The mean attained score for the multiple choice section of the original exam (2011) for the combined cohorts was 54.5 ± 15.8%; broken down, the HLTH 214 students attained 58.9 ± 12.3% and the HLTH308 students attained 49.9 ± 17.8%. The HLTH 214 students did signifcantly better than the HLTH308 students in 2011 (p=0.005) (Table 1). NEUROANATOMY RETENTION McCOY et al Figure 1
CJA September 2013