Pertinent to Stakeholders
​in Chiropractic Regulation

NEW

​An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis
Bart N. Green, DC, MSEd, PhD; Claire D. Johnson, DC, MSEd, PhD; Richard Brown, DC, LLM; Charmaine Korporaal, MTech(Chiro); Doug Lawson, DC, MSc; Eric Russell, DC, MBA; Ricardo Fujikawa, MD, DC
J Chiropr Educ (2020) 34 (1): 15–30. 
https://doi.org/10.7899/JCE-19-22 
Excerpts from Abstract:
  • The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs.
  • Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies.

NEW

The Councils on Chiropractic Education International Mapping Project: Comparison of Member Organizations' Educational Standards to the Councils on Chiropractic Education International Framework Document
Cynthia K Peterson, Kristi Randhawa, Lynn Shaw, Michael Shobbrook, Jean Moss, Lenore V Edmunds, Drew Potter, Stefen Pallister, Mark Webster
J Chiropr Humanit. 2022 Jul 17;29:1-6.  
https://pubmed.ncbi.nlm.nih.gov/35874302/ 
Excerpts from Abstract:
  • The purpose of this project was to investigate how well each member agency's standards complied with the Councils on Chiropractic Education International (CCEI) framework standards.
  • This mapping project demonstrated the similarities of the CCEI member agency standards and that these standards focused on outcomes-based chiropractic education. This quality improvement project resulted in useful dialogue among the member agencies during this project, which clarified areas of difference.
Chiropractic program changes facilitated by the European Council on Chiropractic Education Accreditation reports: A mixed methods audit and thematic analysis
Cynthia K. Peterson, RN, DC, MMedEd,; Joyce Miller, DC, PhD; B. Kim Humphreys, DC, PhD; Ken Vall, DC, MEd
 J Chiropr Educ 2021; Published February 2021
doi: https://doi.org/10.7899/JCE-20-10​
Excerpt from Abstract:
The purpose of this study was to obtain feedback from program heads as to whether ECCE evaluation reports facilitated changes/improvements to their programs and to identify their reported changes.
COVID-19: how has a global pandemic changed manual therapy technique education in chiropractic programs around the world?
Katie de Luca, Marcus McDonald, Laura Montgomery, Stephen Sharp, Anika Young, Simon Vella, Michelle M. Holmes, Sasha Aspinall, Danica Brousseau, Chris Burrell, David Byfield, Dawn Dane, Philip Dewhurst, Aron Downie, Roger Engel, Brian Gleberzon, Dana Hollandsworth, Anne Molgaard Nielsen, Laura O’Connor, David Starmer, Michael Tunning, Paul Wanlass & Simon D French 
Chiropractic & Manual Therapies volume 29, Article number: 7 (2021) Published 1 February 2021 
https://rdcu.be/ce3fp
Excerpt from Abstract:
"​The aims of this study were to describe the immediate actions made by chiropractic programs to deliver education for manual therapy techniques and to summarise the experience of academics who teach manual therapy techniques during the initial outbreak of COVID-19 pandemic."
​The use of internet analytics by a Canadian provincial chiropractic regulator to monitor, evaluate and remediate misleading claims regarding specific health conditions, pregnancy, and COVID-19
Greg Kawchuk, Jan Hartvigsen, Stan Innes, J Keith Simpson, Brian Gushaty
Chiropractic & Manual Therapies volume 28, Article number: 24 (2020) Published 11 May 2020
https://chiromt.biomedcentral.com/articles?volume=28&articleCitationId=24&tab=citation
Excerpt from Abstract:
"Our study aimed to evaluate the novel use of internet analytics by a Canadian chiropractic regulator to determine their registrants compliance with three regulations related to specific health conditions, pregnancy conditions and most recently, claims of improved immunity during the COVID-19 crisis."
​At-risk advertising by Australian chiropractors and physiotherapists
by  J. Keith Simpson 
Chiropractic & Manual Therapies volume 27, Article number: 30 (2019)  Published 13 June 2019​
​https://chiromt.biomedcentral.com/articles/10.1186/s12998-019-0247-x
Excerpt from Abstract:
​​ “The aims of this research were to determine the frequency, type and nature of at-risk advertising by Australian chiropractors and physiotherapists and whether there is a correlation between professional association membership and advertising guideline compliance.”
Australian Report:
Chiropractic spinal manipulation of children under 12
 
This 228 page independent study was released October 30, 2019, and is available for download in PDF or WORD format.
DIRECT LINK TO DOWNLOAD: 
https://www.safercare.vic.gov.au/reports-and-publications/chiropractic-spinal-manipulation-of-children-under-12
Excerpts from the government website: ​
  • The report includes the findings and recommendations into a review of spinal manipulation on children performed by chiropractors.
  • On 8 March 2019, the Council of Australian Governments (COAG) Health Council (CHC) noted community concerns about the practice and agreed there was a need to consider whether public safety was at risk.
  • The Victorian Minister for Health, the Hon. Jenny Mikakos MP, instructed Safer Care Victoria (SCV) to undertake an independent review.
  • ​This report was provided to the Minister for reporting to the CHC in October 2019.
Health Practitioner Regulation: Has the National Law Produced National Outcomes in Serious Disciplinary Matters?
Jenni Millbank
Federal Law Review, Volume: 47 issue: 4, page(s): 631-654 Published September 13, 2019
https://journals.sagepub.com/doi/10.1177/0067205X19875028
Excerpt from Abstract:
Major disparities were identified in outcomes across the professions, with doctors being subject to less severe outcomes than other professions, in particular in comparison with nurses, even when the same main head of misconduct was in issue. Marked disparities were also identified between outcomes in different states and territories, suggesting that the National Law is not being applied in a uniform manner.
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Regulating Alternative Medicines: Disorder in the Borderlands 
Trebilcock, Michael & Mahadevia Ghimire, Kanksha.
Report from the C.D. Howe Institute, April 2019
https://www.researchgate.net/publication/332448772_Regulating_Alternative_Medicines_Disorder_in_the_Borderlands
Excerpts from Abstract:
  • The central challenge for regulation is how to allow for patients’ autonomy over their own treatment, while addressing the severe information asymmetries between practitioner and patient: a situation worsened when professionals misrepresent their skills or the benefits of their services.
  • Regulation of CAMs should be calibrated to the degree of risk entailed, especially when alternatives are promoted as substitutes for, rather than as complements to, biomedicine in treating potentially life-threatening health conditions.
The report recommends:
1. That regulatory responses should be calibrated to the degree of risk entailed for patients.
2. State-sanctioned forms of delegated self-regulation of certification regimes by practitioners themselves.
3. The creation by government of an overarching advisory body – an alternative medicine advisory council
4. Ensuring that persons responsible are held liable for fraudulent, false or misleading advertisements or claims, tortious liability for negligence or criminal liability for gross negligence.
Chiropractic students' perceptions of barriers and facilitators to joining a professional association
Innes SI, Stomski N, Theroux J.
Chiropr Man Therap. 2019 Nov 27;27:67. doi: 10.1186/s12998-019-0285-4. eCollection 2019
https://www.ncbi.nlm.nih.gov/pubmed/31788182
Excerpts from Abstract:
  • We sought to explore possible reasons by asking chiropractic students their perceptions of barriers and facilitators to joining a professional association.
  • Chiropractic organisations can probably most effectively increase membership numbers through raising awareness of their contribution to the development of the profession.
A failed review of CCE site inspection standards and processes
Innes SI, Leboeuf-Yde C, Walker BF
Chiropr Man Therap. 2019 Oct 30;27:49. doi: 10.1186/s12998-019-0270-y. eCollection 2019
www.ncbi.nlm.nih.gov/pubmed/31687129
Excerpts from Abstract:
  • sought to compare the various CCEs documented standards and processes for site inspection teams for similarities and differences with the intent of making recommendations to create uniform and high quality standards.
  • sought to compare a sample of CCEs site inspection team surveys / reports for commonly identified recommendations and quality improvements and determine if they are adequately described in their accreditation standards.
​The chiropractic workforce: a global review
by Mette Jensen Stochkendahl, Mana Rezai, Paola Torres, Deborah Sutton, Peter Tuchin, Richard Brown and Pierre Côté
Chiropractic & Manual Therapies volume 27, Article number: 36 (2019) Published 24 July 2019
https://chiromt.biomedcentral.com/track/pdf/10.1186/s12998-019-0255-x
Excerpt from Abstract:
 “The world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce.”
Identification of practitioners at high risk of complaints to health profession regulators
Matthew J. Spittal, Marie M. Bismark & David M. Studdert 
BMC Health Services Research volume 19, Article number: 380 (2019) Published: 13 June 2019
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4214-y
Excerpt from Abstract:
Some health practitioners pose substantial threats to patient safety, yet early identification of them is notoriously difficult. We aimed to develop an algorithm for use by regulators in prospectively identifying practitioners at high risk of attracting formal complaints about health, conduct or performance issues.
Learning and teaching of patient-centred communication skills in allied healthcare manual therapy students: A systematic review
Lee Muddle, Cindy J. O'Malley, Ieva Stupans
International Journal of Osteopathic Medicine, Volume 32, 21 - 27  June 2019 
https://www.journalofosteopathicmedicine.com/article/S1746-0689(19)30005-7/abstract
Excerpt from Abstract:
There is little evidence to indicate communication skills training is being provided to chiropractic and osteopathy students. However, communication skills training is being provided to physical therapists/physiotherapists and is varied in the types of teaching techniques used, the duration of teaching and the timing of teaching around clinical placements.
The development of a global chiropractic rehabilitation competency framework by the World Federation of Chiropractic. 
Côté, Pierre & Sutton, Deborah & Nicol, Richard & Brown, Richard & Mior, Silvano. (2019).
Chiropractic & Manual Therapies. 27. 10.1186/s12998-019-0249-8. 
https://www.researchgate.net/publication/333456324_The_development_of_a_global_chiropractic_rehabilitation_competency_framework_by_the_World_Federation_of_Chiropractic
Excerpt from Abstract:
​In this article, we [WFC] present the chiropractic rehabilitation competency framework that will contribute to the development of the global framework in support of WHO's strategic planning for rehabilitation. The goal of WHO's strategic planning is to improve the integration and support of multi-disciplinary rehabilitation and establishing opportunities for global networks and partnerships in rehabilitation.
Variables associated with successful performance on the National Board of Chiropractic Examiners Part IV examination
Himelfarb, Igor & Shotts, Bruce & Hyland, John & Gow, Andrew.
Journal of Chiropractic Education. 10.7899/JCE-18-28. ​(July 2019). 
www.researchgate.net/publication/334584363_Variables_associated_with_successful_performance_on_the_National_Board_of_Chiropractic_Examiners_Part_IV_examination
Excerpt from Abstract:
Performance on the National Board of Chiropractic Examiners Part IV examination is related to the performance in all other National Board of Chiropractic Examiners exams.
 perspective on Councils on Chiropractic Education accreditation standards and processes from the inside: a narrative description of expert opinion - 
Part 1: Themes and Part 2: Analyses of particular responses to research findings.
Innes, Stanley & Cope, Vicki & Leboeuf-Yde, Charlotte & Walker, Bruce. (2019).
Chiropractic & Manual Therapies. 27. 10.1186/s12998-019-0275-6. and s12998-019-0276-5. 
https://www.researchgate.net/publication/335773032_A_perspective_on_Chiropractic_Councils_on_Education_accreditation_standards_and_processes_from_the_inside_a_narrative_description_of_expert_opinion_Part_1_Themes
​​
https://www.researchgate.net/publication/335772883_A_perspective_on_Councils_on_Chiropractic_Education_accreditation_standards_and_processes_from_the_inside_a_narrative_description_of_expert_opinion_Part_2_Analyses_of_particular_responses_to_research_
Excerpts from Abstracts:
  • Recommendations are made including an adoption of an evidence-based approach to accreditation standards and processes and the use of expertise from other health professions. Further, the focus of attention should be moved away from professional interests and toward that of protection of the public and the patient.
  • Expert opinions lead us to conclude that CCEs should embrace and pursue the widely accepted mainstream healthcare standards of an evidence-based approach and place the interests of the patient above that of the profession. Recommendations are made to this end with the intent of improving CCE standards and processes of accreditation.
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