title: Relationship between chiropractic teaching institutions and practice characteristics among Canadian doctors of chiropractic: a random sample survey.
abstract: OBJECTIVE
  The objectives of this study were to determine if faction membership among Canadian doctors of chiropractic (DCs) is associated with differences in educational program characteristics among English-speaking Canadian and United States chiropractic colleges and to determine if those differences are expressed in terms of surveyed attitudes and behaviors regarding treatment efficacy, radiographic imaging, vaccinations, and interprofessional referrals. This study also aims to identify if educational programs may be a potential source of multiple professional identities.
  
  
  METHODS
  A randomly selected sample of Canadian DCs, stratified across the English-speaking provinces, was surveyed by mail. Survey items included school of graduation, self-categorization by chiropractic subgroup, perceptions of condition-specific treatment efficacy, use of plain film radiographic imaging, vaccination attitudes/behaviors, and patient referral patterns. Self-categorization by chiropractic subgroup included: the unorthodox faction (associates the chiropractic subluxation as an encumbrance to the expression of health) and the orthodox perspective (associates with musculoskeletal joint dysfunction, public health, and lifestyle concerns). For data analysis, chiropractic schools were divided into 2 groups according to location: English-speaking Canada and the US. The US was further clustered into liberal ("interested in mixing elements of modern and alternative therapies into the practice of chiropractic") and conservative categories ("chiropractors who believe in continuing the traditions of chiropractic").
  
  
  RESULTS
  Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. χ(2) Testing revealed significant differences in self-categorized faction membership associated with the clustering of colleges based on ideological viewpoints (χ(2) = 27.06; P = .000). Descriptive results revealed a relationship between school of origin and perceived treatment efficacy, use of radiographic imaging, and vaccination attitudes. No significant differences were found relative to interprofessional referral patterns.
  
  
  CONCLUSIONS
  Chiropractic program attended is a significant predictor of orthodox vs unorthodox faction membership and professional practice characteristics for Canadian DCs. This suggests that the current chiropractic education system may contribute to multiple professional identities.
authors.affiliation: Chiropractor (Private Practice), Able Body Health Clinic, Lethbridge, AB, Canada.
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Puhl
authors.affiliation: Chiropractor (Private Practice), Able Body Health Clinic, Lethbridge, AB, Canada.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Reinhart
authors.affiliation: Associate Professor, Department of Kinesiology and Physical Education, University of Lethbridge, Lethbridge, AB, Canada.
authors.forename: Jon B
authors.initials: JB
authors.lastname: Doan
authors.affiliation: Director of Education, Year II, Professor, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors.forename: Marion
authors.initials: M
authors.lastname: McGregor
authors.affiliation: Chair, Department of Pathology and Microbiology, Professor, Canadian Memorial Chiropractic College, Toronto, ON, Canada.. Electronic address: SInjeyan@cmcc.ca.
authors.forename: H Stephen
authors.initials: HS
authors.lastname: Injeyan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D002684:Chiropractic / Q000193:education*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004517:Education, Professional / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D017063:Outcome Assessment, Health Care; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D014481:United States
keywords: Attitude of Health Personnel; Chiropractic; Interprofessional Relations; Professional Education