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2002 Education Conference


Clinical Education

October 26-29, 2002, Sao Paulo, Brazil


Consensus Statements

Introductory Matters

1. This is an era of significant change in health sciences education, both in the content and methods of education. Reasons for this include:

  1. Evidence that a variety of newer teaching methods may be more effective than traditional teaching programs which place emphasis upon lectures in separate subject areas and upon a division between pre-clinical and clinical education.
  2. The growth of knowledge and the evolution of health care systems is occurring at such a speed that the acquisition of effective learning skills is now as important as the teaching of content.
  3. More highly educated students with higher expectations necessitate more effective learning and assessment methods.
  4. Changes in consumer awareness with respect to health care issues, and changes in the balance of power in the doctor/patient relationship.

2. To respond to this need for change in an effective manner, and to enhance the quality of chiropractic education, chiropractic educational institutions should:

  1. Be conversant with the field of health sciences education in general, learning from and contributing to its development.
  2. Collaborate more fully with one another.
  3. Consult with other stakeholders in chiropractic education, including professional associations, and accrediting, examining and licensing bodies.  These other stakeholders should act to facilitate and encourage the necessary innovations and changes in regulations and standards affecting chiropractic education.

3. A major goal of chiropractic education, of importance to the clinical and professional competencies required of chiropractors in the more complex health care environment of today and tomorrow, should be the development of sound critical thinking, problem-solving and independent learning abilities.

Content of Clinical Education

4. With respect to patient examination, assessment and diagnosis, there is a wide variance in methods taught and practised, and there would be value in a conference of a similar nature to the current one seeking a consensus that would promote greater consistency in chiropractic education and practice in this area.

5. With respect to modes of care:

  1. Programs should reflect the continuing central role of adjustment techniques in chiropractic education and practice.
  2. Curriculum content should include other modes of care and clinical competencies that are evidence-based and meet the primary needs of patients using chiropractic services. Examples referred to at this conference include rehabilitative exercises, occupational health as it relates to the prevention and management of neuromusculoskeletal disorders, and sports chiropractic.

6. With respect to research, students should learn to perform, interpret and apply research, in part through involvement in original research projects.

7. There should be course content that prepares students for the more complex and diversified environments in which chiropractors may practice, including an understanding of the roles of other health professionals and third party stakeholders, and how to communicate with them effectively.

Methods of Clinical Education

8. Chiropractic programs should focus more attention on developing an integrated curriculum, particularly through the early introduction of clinical content, and through presenting basic science instruction in a way that emphasizes the content and concepts necessary for clinical decisions that are common in chiropractic practice.

9. Clinical education should be initiated very early in the curriculum, with opportunities to observe and participate as appropriate in patient care.

10. There should be early development of psychomotor skills.

11. Instructional and active learning strategies for improving clinical education that were discussed at this conference include case studies, interdisciplinary patient care, and modular curriculum structure.

12. Enhancing the critical thinking and clinical decision-making of students are important elements of clinical education, and an appreciation of clinical epidemiology can enhance this set of clinical skills.

13. Upon graduation students are now entering many different practice environments and they must leave our programs and institutions more informed about the realities of developing and maintaining successful practices in these varied environments.

14. Several papers presented at this conference focused attention on the importance of creating opportunities for students to work with clinical faculty in community practice settings.  The advantages of such external clinical experience include:

  1. Opportunities to become more informed about the realities of managing a chiropractic practice.
  2. Experience working with health care professionals from other disciplines.
  3. Contact with patients having a wide range of clinical problems.


15. An extended period of structured supervised clinical experience either as part of the degree requirements or prior to unsupervised clinical practice should be encouraged.

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