The knowledge, attitudes, and practice of registered Masters Chiropractic students of dry needling during their clinical practicum

Abstract

Background Dry needling (DN) is an effective treatment protocol commonly used by chiropractors and chiropractic students for patients presenting with myofascial trigger points (MFTPs). The efficacy of DN is majorly advantageous in its use in clinical practice, but it is not without risk. As an invasive procedure, requiring the penetration of skin, DN has the potential to cause infection, as well as other adverse events. These range from undesirable short-term side effects to more serious harm that can result in fatality. As such, a practitioner is expected to be well versed in the modality and confident in performing the procedure on patients. This requires a strong educational background in DN, both theoretically and practically, to ensure the safe and effective practice of DN. Despite the call for more research-based investigation into chiropractic education, the literature in this regard is still lacking. Various authors have demonstrated the beneficial nature of the student perspective and in this case, as the involved party, the student experience would best address the successes and shortcomings of the teaching and learning of DN at the Durban University of Technology (DUT). Aim To describe the knowledge, attitudes, and practice of registered Master of Technology in Chiropractic students on the usage of dry needling during their clinical practicum at the DUT Chiropractic Day Clinic (CDC). Method A qualitative approach was used with an exploratory and descriptive design, within an interpretive paradigm. The eight participants chosen were selected by means of purposeful sampling. Their experiences of DN were recorded electronically during semi-structured, individual interviews and were later transcribed verbatim. The researcher then used thematic analysis to interpret the data and discuss the findings. Results One main theme prevailed. Dry needling is an important modality in the treatment of myofascial trigger points and is a clinical skill that is learnt through observation and practice to prevent patient harm. A total of five sub-themes emerged from the data, which categorised the different components discussed in this study. These included: trigger point treatment, pre-clinic teaching and preparedness for dry needling, appraisal of dry needling during the clinical practicum, choice of dry needling practice style, and dry needling high-risk muscles. The participants reported their dissatisfaction with the pre-clinic DN education and their dislike for the rule that prohibits the DN of high-risk muscles (HRM). They indicated that the pre-clinic DN education required more practical exposure and direct supervision. Participants commented on the need for examinations and testing to be more practical in nature. Despite the negative aspects shared by participants, the DN education at DUT left students feeling prepared and confident to DN in clinical practice. They attributed their development of knowledge, skills and confidence to a year of clinical experience and the clinicians’ input during the clinical practicum. This study highlighted the DN knowledge and attitudes of master’s chiropractic students and described their practice of the modality.