Chiropractic and osteopathic graduates’ unreadiness for practice

Have you ever wondered how good or bad the education of chiropractors and osteopaths is? Well, I have – and this new paper promises to provide an answer.

The aim ofthis study was to explore Australian chiropractic and osteopathic new graduates’ readiness for transition to practice concerning their clinical skills, professional behaviors, and interprofessional abilities. Phase 1 explored final-year students’ self-perceptions, and this part uncovered their opinions after 6 months or more in practice.

Interviews were conducted with a self-selecting sample of phase 1 participant graduates from 2 Australian chiropractic and 2 osteopathic programs. Results of the thematic content analysis of responses were compared to the Australian Chiropractic Standards and Osteopathic Capabilities, the authority documents at the time of the study.

Interviews from graduates of 2 chiropractic courses (n = 6) and 2 osteopathic courses (n = 8) revealed that the majority had positive comments about their readiness for practice. Most were satisfied with their level of clinical skills, verbal communication skills, and manual therapy skills. Gaps in competence were identified in written communications such as case notes and referrals to enable interprofessional practice, understanding of professional behaviors, and business skills. These identified gaps suggest that these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.

The authors concluded that this small study into clinical training for chiropractic and osteopathy suggests that graduates lack some necessary skills and that it is possible that the ideals and goals for clinical education, to prepare for the transition to practice, may not be fully realized or deliver all the desired prerequisites for graduate practice.

Their conclusions in the actual paper finish with these sentences, in the main, graduate participants and the final year students were unable to articulate what professional behaviors were expected of them. The identified gaps suggest these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.

In several ways, this is a remarkable paper – remarkably poor, I hasten to add. Apart from the fact that its sample size was tiny and the response rate was low, it has many further limitations. Most notably, the clinical skills, professional behaviors, and interprofessional abilities were not assessed. All the researchers did was ask the participants how good or bad they were at these skills. Is this method going to generate reliable evidence? I very much doubt it!

Imagine, these guys have just paid tidy sums for their ‘education’ and they have no experience to speak of. Are they going to be in a good position to critically evaluate their abilities? No, I fear not!

Considering these flaws and the fact that chiropractors and osteopaths are not exactly known for their skills of critical thinking, I find it amazing that important deficits in their abilities nevertheless emerge. If I had to formulate a conclusion from all this, I might therefore suggest this:

A dismal study seems to suggest that chiropractic and osteopathic schooling is dismal. 

Come to think of it, there might be another fitting option:

Yet another team of chiro- and osteos demonstrate that they don’t know how to do science.