Evaluation of chiropractic students' knowledge and attitudes following pain interventions: A randomized educational trial at 2 institutions.

Objective: To examine chiropractic students' attitudes regarding knowledge of pain neuroscience, chronic pain, and patient-centered care before and after educational interventions. Secondarily, this study aimed to compare measures of these skills between cohorts at different timepoints throughout training programs.

Methods: Using stratified randomization, 281 Year 3 chiropractic students at 2 institutions were allocated into 1 of 3 educational interventions and served as active-control comparison groups: pain neuroscience education, chronic pain education, or patient-centered care. Participants completed validated surveys regarding their experience with the education interventions immediately pre- and post-lecture and 12 weeks after completion. For further comparison, surveys were also completed by 160 Year 1 students and 118 Year 2 students at 1 of the institutions. Independent sample t tests and 1-way analysis of variance were used for data analysis.

Results: All Year 3 lecture groups showed immediate improvements (pain neuroscience education: 3.99 + 3.09/100, p = .18 [95% CI: 10.10 to -1.77]; chronic pain education: 0.42 + 0.74/7, p = .02 [95% CI: 0.72 to 0.07]; patient-centered care: 0.25 + 0.12/6, p = .05 [95% CI: 0.12-0.51]), but these were not sustained at the 12-week follow-up (pain neuroscience education: -6.25 + 4.36/100, p = .15 [95% CI: 14.93 to -2.42]; chronic pain education: 0.33 + 0.16/7, p = .19 [95% CI, 0.66 to 0.01]; patient-centered care: 0.13 + 0.13/6, p = .30 [95% CI: 0.41 to -0.13]). Compared to active controls, only the patient-centered care group showed an immediate statistically significant difference.

Conclusions: While this study found that immediate improvement in targeted competencies is possible with focused interventions, they were not sustained long term.