Review of Clinical Competencies Required by CCEs

WORLD FEDERATION OF CHIROPRACTIC CONSORTIUM OF EUROPEAN CHIROPRACTIC EDUCATORS ASSOCIATION OF CHIROPRACTIC COLLEGES

EDUCATION CONFERENCE

Royal University Center Maria Cristina, San Lorenzo, Madrid, Spain October 14, 2010

Joseph Brimhall, D.C.

President, University of Western States President, Councils on Chiropractic Education International

CCE International (CCEI)

•

Australasia – CCEA

•

Europe – ECCE

•

Canada – CFCREAB

•

United States - CCE

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CCE International

•

Not an accrediting agency

•

Association of accrediting agencies

•

Mutual endorsement and recognition based on equivalence of the accreditation standards

•

International Accreditation Standards

3

Role of Accrediting Bodies in Chiropractic Education

• Establish and promulgate high standards to assure quality in the education of chiropractors • Work with the educational programs to assist them in adhering to the established standards • Utilize a standard process to evaluate how well an educational program adheres to the standards • Public disclosure regarding those educational programs that undergo such evaluation 4

What is accreditation?

Certification of the quality of education by: • • • • • Development of valid criteria (Standards) Self-study and assessment (self analysis) Peer review evaluation (site-visit and report) Accreditation decisions On-going monitoring of compliance (interim reports, complaint process, data collection) 5

•

What is not accreditation?

Not scope

of practice (jurisdictional law) •

Not

the

philosophy

of chiropractic (trade organizations, schools, individual practitioners) •

Not

the

identity

of the profession (trade organizations) •

Not

the

definition

of chiropractic (jurisdictional law) •

Not proscriptive

—does not prohibit or restrict education 6

•

Outcome-based Accreditation

Less prescriptive—more autonomy for the educational program

•

Establishes expected results from the program, including the competencies of its graduates

•

“Begin with the end in mind”

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•

Outcome-based Chiropractic Accreditation

Relies on an understanding of practicing chiropractic as a

primary health care

provider:

o Primary contact (access, gate-keeper) o Primary ability to evaluate and diagnose o Primary ability to manage the patient’s health care (including direct care, recommendations, and/or referral) 8

Clinical Competencies

• • • Defines what the graduate should be able to do Attributes of an entry-level chiropractor Relies on input from: o Jurisdictional licensing authorities o Professional trade organizations o Accredited educational programs o Practitioners o Public 9

Clinical Competencies

•

Attitudes, awareness

•

Skills, abilities

•

Knowledge, understanding

•

Characteristics, attributes

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Clinical Competencies

1. Patient assessment or evaluation 2. Diagnosis, decision-making 3. Patient Management, planning 4. Implementation of care 5. Record keeping 6. Patient relationship 7. Public health – health advocacy – disease prevention 8. Information literacy 9. Ethics and professionalism

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• • • • • • •

Patient Assessment

History Physical examination Psychological/psychosocial assessment Radiology, imaging Laboratory, specialized tests Spinal examination Neuromusculoskeletal examination 12

•

Diagnosis

Consistent with history and examination • Working diagnosis • Differential diagnosis • Refer or collaborate as necessary for other expert opinions 13

Patient Management

• • • • Planning and implementation of care Coordination of care Lifestyle and healthy living Evaluates progress; manages accordingly • Referral, collaboration, co management 14

Chiropractic care

• • • • • Spinal manipulation/adjustment Extremity manipulation/adjustment Soft tissue therapy Physiotherapy modalities Nutritional therapy – dietary counseling • Exercise and rehabilitation 15

•

Record keeping

“Legible, accurate, complete and current” • Accepted procedures and protocols • Legal requirements, release and request • Coding • Electronic health records?

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•

Patient relationship

Maintain professional attitudes and behaviors • Partnership with patient • Appropriate boundaries, imbalance of power • Trust • Fiduciary duty to the patient 17

• • • • • • • • •

Public health – Wellness Disease Prevention

Health promotion; health screening Leading health indicators Community health issues, chiropractic role Environmental issues Social determinants of health Hygiene Disease prevention Immunization?

Maintenance care?

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Information Literacy

• Ability to access and critically appraise research information • • Research methods Life-long learning – continuing education • Integrate new information 19

• • • • • • • • •

Ethics and Professionalism

Integrity – personal and professional Jurisprudence Ethical standards and conduct Professional communication “Moral character” Licensure and regulation Substance abuse; addictive behaviors Financial dealings with patients Dual relationships 20

“In a time of drastic change, it is the learners who inherit the future. The learned usually find themselves equipped to live in a world that no longer exists.” -

Eric Hoffer

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The End

Thank you.