• Nim C
• Smith N
• Starmer D
• Wang S
• Choi G
• Alayed A
• AlShareef J
• Gnjatic A
• Sloan K
• Wong K
• Funabashi M

• Affiliation / Canadian Memorial Chiropractic College (CMCC)
• Affiliation / Parker University. Research Center
• Affiliation / Université du Québec à Trois-Rivières (UQTR). Département de chiropratique
• Affiliation / University Hospital of Southern Denmark. Spine Centre of Southern Denmark
• Affiliation / University of Southern Denmark. Department of Regional Health Research
• Affiliation / University of Southern Denmark. Department of Sports Science and Clinical Biomechanics
• Manipulation, Spinal
• Open Access Document
• Students, Chiropractic
• Variable Force Technique

Background: Although distinct, confidence and competence play a valuable role in healthcare education. For chiropractic students, both may be important in mastering motor skills required to perform spinal manipulative therapy (SMT). However, little is known about how individual factors influence students' confidence and competence. Better understanding of these associations would enable the development of tailored training. Therefore, this study aimed to investigate associations between demographics, anthropometrics, and prior SMT experience and confidence and competence in performing SMT with specific force–time characteristics in chiropractic students.

Methods: This secondary analysis of a cross-sectional study involved 149 chiropractic students who performed SMT targeting specific peak thrust forces (200 N, 400 N, 800 N). Students were assessed for competence in force–time characteristics (preload, peak thrust force, time to peak force) using the force-sensing table technology, and self-reported their confidence in performing each characteristic. Demographics, anthropometrics, and SMT experience were collected and multivariable linear and logistic regressions were used to assess associations.

Results: Confidence was higher in male students, students in later years of study, and those with more SMT experience. Competence in time to peak force was higher among males and third-year students, whereas males and taller students were more likely to reach the 800 N peak thrust force. No other associations were found for competencies.

Conclusions: While certain demographic and experiential factors are associated with increased confidence, these do not consistently translate to competence in SMT force–time characteristics. Targeted training approaches that account for individual student factors to better support them in developing their SMT motor skills are needed.

Author keywords: Spinal manipulation - Force-sensing table - Confidence - Teaching - Feedback

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