Message from Principal Investigator of the R25 Grant

Dear Colleagues:

Cyndy Long, PhDI want to let you know about an upcoming opportunity for Palmer faculty. As part of our collaboration with the R25 program at Northwestern Health Sciences University, we will have access to the series of e-learning modules they developed called “Foundations of Evidence-Informed Practice.” There are currently 3 courses consisting of 7-8 modules each. Those of you who have attended the EBCP workshops at the University of Iowa over the past 2 years have already completed the first course: “Overview.” The second course is “Types of Research” and the third course is “Using Evidence in Practice.” Each module is estimated to take 30 minutes to complete.

We will make these available to you in mid-May, so be on the lookout for an e-mail from Katie Hoyt that will have instructions for you to register. You will be given a code so that there is no cost to you. The e-learning modules are accredited for chiropractic CEUs for both Iowa and Illinois. California will allow you to have 6 of 12 hours of online CEUs. Unfortunately, Florida does not accept online CEUs at this time. There are a total of 10 CEUs available for the whole series. 

These e-learning modules will be available to you for the remaining 3.5 years of our R25 grant. We also anticipate being able to offer other e-learning opportunities to you in the future. 

Cynthia R. Long, PhD 

Evidence in Action

My REEL Experience
Melissa Ferranti, DC - Florida Campus

Melissa Ferranti, DC Attending the REEL workshop at the University of Iowa campus in November of 2012 provided me with an amazing experience to grow as a chiropractic physician as well as an educator. I learned the importance of evidence based clinical practice (EBCP) and how to develop, search, critically appraise, and apply the best evidence based practice literature. Although I thought it would be a daunting task it turned out to be easy, quick, and surprisingly fun! Attending the REEL workshop has helped me develop good clinical questions, search the proper resources, and critically appraise the literature.

Beyond understanding how to use EBCP in my own practice, I learned some amazing tools to convey the message to my student interns. I work in the Florida campus clinic and have implemented what I learned immediately upon my return. My interns are learning the importance of patient preference, clinical experience, and using the best research to provide care to patients in our community. It has given me a sense of satisfaction watching my student interns develop the most important clinical questions. Then, I help them with the formation of clinical queries on our databases, guide them in searching for answers, and show them how to apply the best information to shape their patient care decisions. Palmer is at the cutting edge of chiropractic and it is exciting! I highly recommend everyone take the opportunity to attend an EBCP training workshop so that we may develop the most advanced and relevant chiropractic physicians at Palmer and continue to be The Trusted Leader in Chiropractic Education.

My EBCP Journey
Mike Tunning, DC, ATC - Davenport Campus

Mike Tunning, DC If ever a quote can perfectly describe a situation, “The journey is the destination” certainly does in regards to my involvement with learning and teaching evidence-based clinical practice (EBCP). I have always enjoyed reading journal articles and learning new advances in patient management, but never approached it in a systematic way that would allow me to fully understand the study. As many of us believe when we read an article, I thought I could read a few pieces, get the main message and then take the authors’ conclusion as it was stated. I never fully appreciated what a good research study was until learning the basic fundamentals of critical appraisal. Previously, every article carried the same weight to me, yet many of them had differing conclusions. How could one study show that O’Brien’s test for a SLAP tear is almost perfect in its ability to find the pathology when another study shows it is a terrible test for finding pathology? These questions were answered in my first experience learning EBCP. Dr. Mark Wilson, an extremely gifted educator at the University of Iowa, helped us learn how to interpret a variety of statistical measures commonly seen in different types of research articles. We worked together in small groups sharing frustrations and successes, but all the while improving our skills as teachers and clinicians. We were able to get to know faculty from other colleges who expressed similar challenges as educators and who shared a our vision to improve the classroom experience for students.

The next year I continued on my EBCP journey as a workshop tutor-trainee. In this capacity I had a little more responsibility to help organize the Iowa City EBCP workshop and facilitate small group discussions helping others begin their own EBCP journey. As the tutor-trainee I was not completely confident in my skills to teach EBCP, but I knew the only way to improve was to keep chipping away and continuing to learn. It was exciting when I began to realize that while I was explaining EBCP concepts to colleagues, they became much clearer in my own mind. I started to identify my own struggles and roadblocks to learning and used that to help others find their own. The workshop was fantastic, and by the end I noticed continued improvement in my own skills teaching as well a greater understand of EBCP concepts from the participants I worked with.

The following year I was asked to step into the role of workshop tutor. This brought the workshop to a whole new challenging level for me! I wanted to allow the tutor-trainees to find their own way of teaching and interacting with the participants just as I was able to achieve my clear understanding of EBCP concepts through the previous tutors empowering me to learn for myself. Taking more of a hands-off approach and providing feedback to the tutor-trainees actually proved to require even better understanding of the concepts. Instead of simply identifying the sensitivity of an article, I had to formulate and evaluate the sensitivity in a hypothetical case to help others learn. It was fascinating to recognize some of the roadblocks I struggled with in past years in the newcomers to the workshop. However the feeling of success was greater when the roadblocks were pushed aside in favor of learning. Positive responses from the participants was my greatest measure of success; I had done my job if they were learning and building confidence in their new abilities.

After participating in the EBCP workshop as a participant, tutor-trainee, and tutor, I would recommend to any and all instructors interested in improving skills both as an educator and in EBCP to volunteer and get involved. Don’t let the intimidation of learning something new or other roadblocks keep you away. Remember that when it comes to learning EBCP, the journey IS the destination. I am still on mine and enjoying every minute of it! 

The REEL Truth
Karol Donaubauer, DC, CCSP - Davenport Campus

Donaubauer_Karol Do you want to know the ‘REEL’ (Research, Evidence, Education and Life-long Learning) truth about the EBCP Workshop held in Iowa City November 15-16, 2012? Well, here it is: It was extremely educational, interesting, and fun; not necessarily in that order.

We learned about many different EBCP tools to use in the clinic with students and patients. We critically appraised articles together to assess whether or not we’d want to use it in practice. We learned how to use appropriate databases and what to search for different types of research studies. We also learned how to determine what the right question is to ask in order to get the results or answers needed for a particular clinical question: PICO (patient, intervention, comparison, outcome). PICO helps refine a question in order to find the best results in scientific databases. Finally, we learned about the 6 As Cycle: Assess, Ask, Acquire, Appraise, Apply and Assess. I have used both PICO and the 6 As in my recent work. Learning how to use these tools has proven extremely useful.

What also made the workshop engaging and fun was that all of the presenters were extremely qualified in their specific presentation and were passionate about transferring their knowledge to the workshop participants. They were interesting and made their presentations easy to understand and interactive. I was satisfied with both the presenters and the material presented. If I were asked to rate this workshop, I would give it a 5 on a 5 point scale.

JACA Evidence in Action Articles

Article Series a Success
Dana Lawrence, DC, MMedEd, MA

Dana Lawrence, DC, MMedEd, MA As part of our R25 initiative, one of the desires we had was to demonstrate how to use evidence, in the form of information available to readers in scientific articles, as a means to resolve clinical scenarios. Dr. Christine Goertz and I had, initially sort of unknown to each other, been in conversation with leadership in the American Chiropractic Association to provide articles for the Journal of the American Chiropractic Association. We hoped to raise the profile of Palmer College faculty members while at the same time providing ACA members with information they could apply in practice. From this the idea of the Evidence in Action column was born.

In brief, we invited faculty from all three campuses to write short articles in which the author initially sets out a clinical scenario- often drawn from a real case, sometimes from a “created’ scenario- and then show how a piece of literature was then used to provide guidance in managing the patient. By doing so, we could begin to introduce the reader to core concepts in evidence-based practice: sensitivity and specificity, likelihood ratios, odds and risk ratios, and so on. Each article concentrated on a single core concept, so that this was done slowly and sensitively. And in each article, we highlighted the skills and knowledge of individual Palmer faculty.

According to the editor of JACA, this column has been one of the most well-received changes of the past few years. It has generated positive press and numerous compliments. We have committed to continuing this for the future, and at present have at least 3 new columns in preparation. To date, we have provided 18 such columns to the journal. This newsletter will link to past articles, and as new ones come on line, we will add them as well.

We hope that you find these articles interesting and informative and that you also take pride in the work of your fellow faculty members. And we invite you to consider preparing one as well. If you are interested, please contact me at dana.lawrence@palmer.edu and I will help you get started.

Enjoy!

JACA Evidence in Action Articles – 2013
  • January/February 2013: Your Patient has Wrist/hand Pain and Paresthesias – Does She Have Carpal Tunnel Syndrome? -Robert M. Rowell, DC, MS 
JACA Evidence in Action Articles – 2012
  • January/February 2012: A patient brings her 11-year-old son to your clinic with mid thoracic back pain -Makani Lew, BS, DC  
  • March/April 2012: My Patient Has Fibromyalgia Syndrome (FS)—What Can I Do? -Michael Tunning, DC, ATC; and Casey Crisp, DC, MS  
  • May/June 2012: My Patient Has Facial Pain – What Can I Do to Help? -Tammi Clark, DC; and Robert D. Vining, DC  
  • July/August 2012: Does Therapeutic Ultrasound Provide an Effective Treatment Outcome for Carpal Tunnel Syndrome? -Theresa L. Whitney, BEd, DC  
  • September/October 2012: 78-Year-Old Female with a Compression Fracture -John Stites, DC, DACBR, FACO  
  • November/December 2012: Is There an Efficient Tool to Help Identify Neuropathic Pain? -Robert D. Vining, DC 
JACA Evidence in Action Articles – 2011
  • January/February 2011: Are You Influenced by the Medical Information Your Patients Bring You? -Dana J. Lawrence, DC, MMedEd, MA  
  • March 2011: My patient has chest pain. How should I proceed? -Charles N.R. Henderson, DC, PhD  
  • April 2011: My patient has recurrent knee pain—How can I prevent future episodes -Michael Tunning, DC, ATC; and Robert D. Vining, DC  
  • May/June 2011: A Patient Comes in With a Twisted Ankle -John Stites, DC, DACBR; and Ron Boesch, DC, DACNB  
  • July 2011: My patient has hip pain—Are my assessment procedures effective? -Robert D. Vining, DC; and Nancy Kime, DC  
  • August 2011: A Parent Seeks Information About His Overweight Son’s Recurrent and Constant Headaches -Dana J. Lawrence, DC, MMedEd, MA  
  • September/October 2011: Chronic LBP Management -Michelle Barber, MSW, DC: and Barbara Mansholt, BA, DC  
  • November/December 2011: Diagnostic Imaging Evaluation in Suspected Pediatric Lumbar Spondylolysis -Matthew D. Richardson, DC, DACBR; and Ian D. McLean, DC, DACBR