An Assessment of Musculoskeletal Medicine Deficiencies in Chiropractic Education: a Survey of Chiropractic Clinical Clerks



Journal Title

Journal ISSN

Volume Title



Multiple medical disciplines receive inadequate education in musculoskeletal medicine throughout their training. The purpose of this study was to investigate whether chiropractic clinical clerks in their clinical clerkship year of training, exhibit any particular area of educational deficiencies in musculoskeletal medicine using a validated questionnaire by Freedman and Bernstein (1998). This observational study examined a convenience sample of chiropractic clinical clerks in the south central part of Texas. Statistical analyses were computed using PASW Statistics 23 software (v. 23 SPSS Inc. Chicago, IL, USA). Descriptive statistics and a two-sample t-test were used to identify the demographics of the study population and the 25 item open-ended questionnaire. Sixty-seven clinical clerks participated in the study with 57% being male. According to the standard basic competency benchmark mean score of 73% suggested by the program chairs of orthopedic residency departments, 94% of chiropractic clinical clerks failed to demonstrate basic competency in musculoskeletal medicine. Only four clinical clerks met the standardized basic competency benchmark in musculoskeletal medicine, however most were deficient in upper and lower extremity diagnosis, low back examination and diagnosis, pediatrics examination, bone joint conditions and common malignancies. Using a t-test, the aggregate scores between trimester seven and trimester ten clinical clerks revealed no statistical significance on the 25-item questionnaire. To our knowledge, this is the first study assessing chiropractic clinical clerks basic competency in musculoskeletal medicine using the Freedman and Bernstein questionnaire. The deficient questionnaire items in pediatrics, spinal/extremity diagnosis and special imaging with a mean less than 73% will be shared with the curriculum committee and further investigation is warranted to fully assess the current training provided by chiropractic colleges in musculoskeletal medicine



Assessments, Musculoskeletal medicine, Freedman and Bernstein, Musculoskeletal deficiencies, Muscles, Chiropractic education