Using Patient-reported Experience Measures to Evaluate a Community-based Chiropractic Outreach Programme in Rarotonga, Cook Islands

Abstract

Objective Community-based outreach placements provide authentic clinical learning environments yet are rarely evaluated using community-derived feedback. This study assessed an intern-led chiropractic outreach placement in Rarotonga using patient-reported experience measures (PREMs) and routinely collected case-mix data as complementary evaluative indicators. PREMs capture patients’ experience of the process of care and differ from patient-reported outcome measures (PROMs), which assess clinical or symptomatic outcomes. Methods Attending adults were invited to complete a post-visit PREM survey (n=252). Survey responses were compared with intern-recorded case-mix data (n=640; 2,453 encounters). Descriptive statistics and exploratory ordinal logistic regression examined patterns in patient experience, demographic predictors, and similarity between patient- and intern-reported information. Results Patient experience ratings were consistently high, particularly for relational domains (communication and personal manner). Tāne/male gender and symptom chronicity were associated with lower reported comfort and satisfaction. Patient- and intern-reported data showed closely similar patterns overall, suggesting good alignment in documentation practices. Conclusion PREMs data provided meaningful insight into relational aspects of care and, when combined with routine case-mix records, supported pragmatic evaluation of a community-based outreach placement. Findings highlight areas for targeted refinement in communication, expectations management, and documentation practices.