Abstract
BackgroundChiropractors see themselves as well positioned to provide safe, effective and economical care for the on-going financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world’s accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research.Main textWe reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs’ educational standards and processes. Areas included a lack of definitions for key terms such as, ‘chiropractic’, ‘diagnosis’, and ‘competency’, without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a “big tent” approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is “unique”, highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to ‘traditional’ thinking. This has implications for public safety and patient quality of care.ConclusionIf chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.
Highlights
We reviewed recent relevant studies, including our own, into the role and function of Council on chiropractic education (CCE) and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to critically review those making the standards (CCEs)’ educational standards and processes
There are many possible factors that could contribute to this complex issue, one important component is that chiropractic educational programs should be of quality and demonstrate basic professional homogeneous standards [10]
This indicates a need for scrutiny of international chiropractic educational and practice standards detailed by CCEs to identify facets that could be changed to enhance the quality and the reputation of chiropractic education
Summary
Examining known issues confronting CCE standards and processes We believe there are several issues that have implications for the CCE standards and processes. The absence of a common understanding has implications for the creation of an internationally homogeneous quality set of essential accreditation standards or measures of entry-level graduate competencies upon which CCEs can conduct reliable and valid assessments across all CPs. Prominent chiropractic researchers have called this an urgent task that must be undertaken for the profession to remain relevant in today’s evidence-based healthcare environment [74]. There can be no dichotomous mindset that takes a compromised position in the face of known evidence, especially when it has implications for patient quality of care and safety This can be accomplished by embracing and pursuing the scientific model and an evidence-based approach to clinical practice, in the same manner as other twenty-first century allied-health professions. The CCE-International could take the lead in exploring new and innovative dimensions of accreditation standards and processes and encouraging further integration into mainstream healthcare by encouraging the exploration of hospital placements for undergraduate student education
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