The following position statement on chiropractic was recently formulated as a collaborative effort among several European chiropractic institutions in an effort to provide a cohesive idea of how evidence-informed chiropractic operates. These include: The University of Southern Denmark, University of Zurich, and Bournemouth University, among others. These points would apply to the majority of chiropractors in Canada as well.
Clinical and Professional Chiropractic Education: a Position Statement
Whereas, the welfare of the patient is paramount; and
Whereas, chiropractic education should be of the highest quality and be founded on the principles of evidence-based care; and
Whereas, curricula should be responsive to changing patient, societal and community needs and expectations within a modern health care system;
We, the undersigned chiropractic educational institutions, state as follows:
1. Chiropractic education and training must adhere to the biopsychosocial model of health care and be underpinned by biologically plausible theory and peer-reviewed research. It should embrace the value of clinical experience, shared decision-making and a patient-centered approach to care.
2. Upon graduation, chiropractic students should be equipped to work effectively and collaboratively to deliver improved quality of life outcomes for patients with musculoskeletal disorders. This will, of necessity, incorporate:
a. An evidence-based approach to the case history, physical examination, diagnostic imaging, report of findings and management plan that may include a range of clinical interventions
b. Effective communication in a language that is clearly understood by all stakeholders in healthcare, thereby facilitating interprofessional practice and promoting effective collaboration between health care teams
c. Knowledge of preventative measures including but not limited to musculoskeletal care, encompassing wider public health and health promotion initiatives
3. Wherever possible, chiropractic educational programs should form or develop affiliations with established public and private universities preferably within a medical or health science faculty. Such links may develop opportunities for interprofessional education and collaborative practice.
4. Chiropractic educational institutions should support their faculties in the provision of innovative models for the development of knowledge, learning and skills. These should focus on facilitating scholarly activity including research, interprofessional education and teaching within the context of emerging health care models.
5. The teaching of vertebral subluxation complex as a vitalistic construct that claims that it is the cause of disease is unsupported by evidence. Its inclusion in a modern chiropractic curriculum in anything other than an historical context is therefore inappropriate and unnecessary.
6. Chiropractic education should reflect ethical practice and professional standards throughout the curriculum. Upon graduation, students must understand their responsibilities to their patients, their communities and to the profession.
7. Practice styles promoting preset ‘high volume’ chiropractic care models as wellness care, which may contribute to inappropriate patient dependence, compromise patient confidentiality or require repeated exposure to ionising radiation are not part of an undergraduate chiropractic curriculum. Students should be taught to recognise that such approaches are not acceptable in terms of the best interests of patients or the chiropractic profession.
Dr. Mark Strudwick is a third-generation chiropractor in Victoria, B.C.