Message from the Vice-Chancellor for Academic Affairs

Dear Colleagues:

Robert Percuoco, DC New knowledge in healthcare diagnosis, treatment and effectiveness has been exploding exponentially. It is estimated that more data will be generated in the next four years than in the history of the world and yet the human capacity to absorb and retain information remains limited. For healthcare practitioners, including chiropractors, access to clinical information has never been greater, but new skills are needed to mine, evaluate and apply the data. The available "evidence-based" research provides clinical information well beyond any single practitioner's own practice experience; information that may help improve outcomes in meeting patients' health needs. The evidence-based clinical practice (EBCP) initiative, started several years ago on the Davenport campus as a result of an R25 NIH grant, is finally reaching students in the classroom and clinic. A group of basic science, clinical science, and clinic faculty Early Adopters from the Doctor of Chiropractic program (DCP) was formally trained in EBCP principles and practices beginning in fall 2008 through monthly meetings with a facilitator, an annual University of Iowa workshop, and some training at the McMaster University weeklong immersion program "How to teach EBCP". They collaborated for two years to refine their skills and to help train other faculty. The fruits of their training are beginning to appear across the Davenport DCP curriculum. Beyond the obvious Information Literacy and Foundations of Evidence-Based Care courses in first trimester and Evidence-Based Chiropractic course in ninth trimester, learning outcomes directly applying EBCP knowledge and skills are now included in Biochemistry I, Toxicology, Nutrition, Active and Passive Care physiotherapy courses, and in Clinical Case Correlations, I and III. Several clinicians are also providing opportunities for their interns to apply EBCP practices to patient management scenarios in clinic. The successes in Davenport have provided a good model for EBCP faculty training on the West and Florida campuses. The faculty has gone beyond simply satisfying the requirements of a grant, to preparing students to negotiate the next wave of the healthcare revolution. Thank you, Early Adopters, for blazing new trails in chiropractic education and patient care!

Robert Percuoco, D.C.

EBCP Concepts

Intention to treat - John Stites, D.C., D.A.C.B.R., F.A.C.O., Davenport Campus

Dr. John Stites portrait In the critical appraisal of a randomized controlled trial (RCT) one question usually asked is, "Were patients analyzed in the groups to which they were randomized?" Another way of stating this question is "Was an Intention-to-Treat principle followed in the analysis?"

Why is this important? 

In a RCT randomization is essential. The purpose of randomization is to help ensure that there is prognostic balance between groups. If the groups are balanced you can have greater confidence that any difference detected between groups is due to the intervention.

Read more ...  

Evidence in Action

EBCP in Undergrad – Judy Bhatti, D.C., Davenport Campus

Dr. Judy Bhatti teaches Clinical Science to third trimester Associate of Science in Chiropractic Technology (ASCT) students. In this class, students are required to look up peer- reviewed articles and apply PICO (Patient, Intervention, Comparison and Outcome) to the articles. The students' reports include: Body Mass Index (BMI), blood pressure, radiology, and thyroid abnormalities. Although chiropractic technologists do not diagnose, they are an important support person to the doctor of chiropractic and the office team. Chiropractic Technologists can find articles on best practices for the work they do in the clinic and for the DC.

Assessing Older Patients with the Evidence in Mind - Lisa Z. Killinger, D.C., Davenport Campus

Lisa Killinger portrait All ninth trimester Davenport DC students now learn how to do an evidence-based comprehensive geriatric assessment on older patients. In an effort funded by the Iowa Geriatric Education Center (Health Resources and Services Administration), Dr. Lisa Killinger trains students in her Healthy Aging class to use standardized, valid and reliable assessment tools to evaluate older patients.

Read more… 

EBCP in Microbiology – Michelle Barber, M.S.W., D.C., Davenport Campus

Michelle Barber, D.C. Each trimester in Dr. Barber's microbiology class, students spend a week doing "Infectious Disease Scientific Poster Presentations." Each student is assigned a disease which they have to research and then develop a scientific poster regarding its causative agent, history, epidemiology, pathology, response & treatment, and fun facts.

During the class hour, a group of students is assigned to display and present their posters, while the rest of the class circulates and asks questions. The presentations are done in the skywalk so that other campus students, faculty, and employees can participate, if they are interested. The activity gives the students an opportunity to research the latest evidence regarding their assigned disease, as well as experience a simulated conference poster session. Overall feedback has been positive. The students state they enjoy the poster presentation project, both as presenters and as participants.

EBCP – Lia Nightingale, Ph.D., Davenport Campus

Dr. Lia Nightingale has incorporated EBCP skills into several courses in the Davenport Campus curriculum. During the second week of the trimester in Biochemistry I, she covers an introduction to EBCP, Relative Risk (RR), Absolute Risk (AR), Odds Ratio (OR) and Number Needed to Treat (NNT). This is followed by critical appraisal of a spinal manipulation article. The students are randomly assigned to a 3-4 person group and are given an article they must summarize, critically evaluate, and interpret. She uses a wiki as the collaborative tool for the groups writing the paper.

Read about the other courses… 

Learn More

Additional resources available:
Center for Teaching and Learning's Evidence-Based Practice Center.