The development and introduction of entrustable professional activities at 2 community-based chiropractic student preceptorship sites in the United States.

OBJECTIVE: Entrustable professional activities (EPAs) have seen widespread adoption in medical education and other health professions education. EPAs aim to provide a bridge between competency-based education and clinical practice by translating competencies into fundamental profession-specific tasks associated with clinical practice. Despite the extensive use of EPAs in health professions education, EPAs have yet to be introduced into chiropractic education. The purpose of this paper is to describe the development and introduction of EPAs as part of 2 community-based chiropractic student preceptorship education programs in the United States. METHODS: EPAs were developed and introduced at 2 community-based chiropractic preceptorship sites in 5 distinct steps: (1) differentiating EPAs from competencies, learning objectives, and knowledge, skills, and attitudes; (2) identifying EPAs; (3) mapping EPAs to competencies and necessary experience, knowledge, and skills; (4) designing EPA assessment strategies; and (5) implementing the use of EPAs. RESULTS: A total of 13 individual EPAs were developed and mapped to Council on Chiropractic Education meta-competency outcomes and underlying experience, knowledge, and skills. Three assessment tools were created to evaluate student entrustability for EPAs and enhance student self-assessment. The EPAs and assessment tools were integrated into chiropractic student preceptorships at each site. CONCLUSION: This paper describes the development and introduction of EPAs at 2 community-based chiropractic preceptorship sites. Future research is needed to develop and standardize EPA use and assessment, and to evaluate outcomes associated with EPA use.

Designing a 21st century chiropractic educational program: A time for reflection, a time for action.

The first new doctor of chiropractic program in the United States since 2003 started in 2016 and offered an opportunity to incorporate medical educational innovations and design principles from the experience of those involved in starting new health care programs. Thus, while the goal of the new program was to create a curriculum focused on evidence-based health care practices, it was also possible to use best evidence in the design of the new curriculum. Many innovative and evidence-based curricular elements were incorporated in the new program, including early and sustained clinical experience, case-based clinical education, and integration of basic and clinical sciences.

Revised methodology for the examinations of the National Board of Chiropractic Examiners: Impact on institutions, faculty, and students.

For over 50 years, the National Board of Chiropractic Examiners (NBCE) has administered pre-licensure examinations to chiropractic students and graduates. During this time, the testing process has been continually refined and improved, consistent with the evolving science and practices of standardized testing. NBCE test results are provided to chiropractic program leaders who use these data to improve their curricula as part of their own ongoing efforts to refine and improve the academic programs. Finally, the Council on Chiropractic Education (CCE) requires accredited chiropractic programs to report their NBCE scores to ensure that benchmarks set by the CCE are met. With this symbiotic relationship between the NBCE, CCE, and chiropractic programs (as well as state licensing authorities), it is very important that these groups collaborate and communicate with transparency and diplomacy. In particular, the chiropractic program leaders-and their students as the end users-are vitally interested in monitoring changes at the NBCE and CCE levels that may impact their programs. Recent changes in testing methodology for the NBCE examinations need to be understood and monitored to ensure that they result in their intended outcome, which is greater validity of the testing process. This commentary reflects the views and concerns of 3 chiropractic educational leaders and is intended to facilitate further discussion among chiropractic program leaders toward strengthening the aforementioned symbiotic relationship.

A survey of geriatrics courses in north american chiropractic programs.

PURPOSE: There has been a growing interest in meeting the health care needs of the anticipated "age wave." In order to prepare for the current demographic trends, we sought to describe the status of geriatrics curricula in the 18 North American English-speaking chiropractic colleges by reviewing geriatric course syllabi. METHODS: A cross-sectional survey was conducted using syllabi and catalog information solicited from each English-speaking chiropractic college in North America, collected from January 1, 2007 through June 30, 2007. Information was then summarized. RESULTS: As of June 30, 2007, roughly 78% of colleges submitted their current geriatrics course syllabi. The remaining 4 colleges were estimated using online course catalog information. Sixty-one percent of colleges offered a course that was solely dedicated to the topic of geriatrics. Additionally, 37.5% of syllabi indicating credit load offer 4 or more credits to the course containing the geriatrics component. Also, 31.3% of courses include non-classroom clinical experience, while 50% require an independent study project that provides further geriatrics experience. Furthermore, 41.2% of reported courses classify the teaching strategies as lecture only. CONCLUSIONS: These results warrant a proposal for improved curricula in this specialty population. It is proposed that more time be dedicated for this topic, more experiential learning be required, and more clinical focus be given on the needs of this population. A restructure of curricula will provide more clinical experiences for students to better equip future doctors of chiropractic for the increase in geriatric health care needs.