Evaluation of chiropractic students' perspectives on back pain management following one of three clinical evidence-based educational training interventions: a cluster-randomized trial.

Objective: To assess the effectiveness of educational interventions' impact on chiropractic students' attitudes toward patient-centered care and low back pain (LBP) using knowledge about pain science and stratified LBP management with the MAINTAIN instrument. Methods: From January-August 2022, students were cluster randomized into three groups (information-only, focused-lecture, workshop series) with the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and the Patient-Practitioner Orientation Scale (PPOS) measured at baseline, 4-months, and 8-months. Data were analyzed with descriptive statistics and repeated-measures ANOVA. Results: Of 264 students, response rates declined by 8-months (16.7-31.3%). No significant within- or between-group differences were found across timepoints. A small but statistically significant shift toward doctor-centered attitudes in the instrument-only group (p=0.024) was not clinically meaningful. Conclusions: Educational interventions did not significantly change student attitudes. Contributing factors may include focus on attitudinal change, limited research culture, implementation barriers, and student burnout.