To compare virtual and in-person physical examination (PE) learning among chiropractic students.


Preexisting assessment data from 69 students enrolled in a Head and Neck PE course were analyzed for this study. The course comprised three 50-minute labs and one 50-minute lecture each week. Students had the option to attend the lab class in person or online. The virtual classroom was broadcasted simultaneously with the in-person class. Relevant class materials, including slides and videos, were available to all students on the learning management system. Student performance was evaluated through 8 weekly quizzes and 2 objective structured clinical examinations (OSCEs). Data for after-school practice and learning for each topic were also collected.


Our results indicated that OSCE and weekly quiz scores were positively correlated with in-person class attendance (p = .000, r = .619 and p = .000, r = .488, respectively). Participants were broken down into 2 groups: (1) higher than 50% attendance rates and (2) 50% or lower attendance rates. The mean OSCE (p = .000) and quiz scores (p = .001) for group 1 (49.41 ± .72 and 22.48 ± 1.06) were significantly higher than those for group 2 (48.13 ± 1.30 and 21.22 ± 1.29). By contrast, the mean number of videos watched was lower for group 1 compared with group 2 (3.23 ± 2.61 vs 5.70 ± 3.35, p = .011). There were no significant differences in the number of practices between the 2 groups (p = .18).


Students who participated in in-person PE learning outperformed those in virtual learning in this study.

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Author notes

Xiaohua He is a professor in the department of Life Sciences and Foundations at Palmer College of Chiropractic, Florida (4777 City Center Parkway, Port Orange, FL 32129; shawn.he@palmer.edu).

Concept development: NZ, XH. Design: NZ, XH. Supervision: NZ, XH. Data collection/processing: NZ, XH. Analysis/interpretation: NZ, XH. Literature search: NZ, XH. Writing: NZ, XH. Critical review: NZ, XH.