Table 5 Summary table of recommendations

1

An internationally uniform definition of competence for chiropractic education and assessment is required.

There is increasing global workforce movement and there is evidence of variations in international standards. Common standards would ensure and safeguard patient safety and care and be good for global workforce standardization

This may require agreement from all CCEs on the definition of common words and terms used in their documentation.

2

There should be separate definitions of competence at different stages of the course work; separating the undergraduate’s progress from readiness to graduate.

Chiropractic educators are better equipped to monitor and assess a student’s progress toward detailed graduating standards.

3

“Abilities” and “other categories” should be included in the definition of competence and their meanings clarified among CCEs.

This would create a clearer understanding of the required standards to be assessed and achieved by chiropractic educators.

Recommendations in relation to domains

4

A clarification of the use of the terms and words used to describe the domains of competency should be undertaken so there is an established understanding of their meaning among CCEs.

High levels of descriptions reduce the capacity for ambiguity as they clearly state the expected behaviours and standards of graduates.

5

Common domains of competency need to be created for chiropractic education. These domains should reflect not only practitioner behaviours but also qualities and roles. Consideration should be given to recent examples such as CanMEDS [46] and the ACGME [47]

Adoption of these structures would also improve the likelihood of mainstream integration.

6.

Appropriate descriptive statements should be found that adequately define the domains, sub-domains and their components. These should be sufficiently prescriptive and unambiguous to establish high standards of practice and reduce the possibility of undesirable practice profiles. E.g., radiology competencies, physical examination, and pathophysiology expectations.

CCEs should consider the evidence for a more prescriptive approach to component descriptive statements that would set clearly defined quality graduation standards for educators to achieve and CCEs to enforce.

7

The term “evidence-based” should be used for improved research and knowledge application, such as patient safety and treatment improvements from other mainstream medical disciplines. Further it would facilitate communication and integration within the broader health field. Content taught should be required to be done in the context of the evidence that underpins it.

The adoption of an evidence-based approach would help facilitate integration into mainstream health care.

8

Increased description of ethical and professional practice and practitioner behaviours which are consistent across all CCEs.

Clarity would ensure and safeguard high professional standards.

9

Imaging competencies need to include contemporary modalities such as MRI, CT and diagnostic ultrasound

Health care technology is constantly changing and chiropractic education should keep pace with these changes, so that patients benefit from access to these emerging imaging technologies.

10

CCEs should guide and fund research into accreditation matters: suggested areas include, but not limited to;

This will develop, inform and improve regulatory standards

10 (a).

A study comparing CCEs’ levels of enforcement of competency standards.

Identifying the opportunities for improving enforcement of standards may result in a uniform quality international standard of patient care and safety of practice.

10 (b).

A study of factors that may be at odds with competency standards.

Identification of these factors may provide opportunities and mechanisms for chiropractic educators to improve competency levels.

10 (c).

A study trialling interventions targeted at improving identified unwanted practitioner profiles which may alter practice behaviours.

This would improve the quality of patient care and safety