| Clinical Guidelines for Chiropractic Practice in Canada
Chapter 15 - Continuing Education and Professional Development
Chapter Outline
I OVERVIEW
This chapter review the reasons for continuing professional development, comments on current continuing education programs in Canada, and then makes recommendations with respect to postgraduate and continuing education.
II DEFINITIONS
For definitions see the Glossary at the end of this publication.
Continuing Education
Graduate Education
Post-Graduate Education
Provincial Divisions
III. LIST OF SUB-TOPICS
A. Continuing Education
B. Post-Graduate Education
C. Graduate Education
D. Professional Organization
E. Ethics/Standards of Conduct
F. Research
IV LITERATURE REVIEW AND DISCUSSION
Historically the chiropractic profession developed continuing education programs on a voluntary basis. Thus, for example, the Canadian Council on Chiropractic Roentgenology was established in the 1940s for the express purpose of providing continuing education in the field of radiology. Its regular programs were well attended from that time, but on a voluntary basis only.
Since the 1960s provincial chiropractic licensing bodies, sometimes of their own volition and sometimes in accordance with government policy, have increasingly developed mandatory continuing education programs. Today these vary from province to province. All are currently based on the requirement of a minimum number of continuing education hours over a one to three year period. Some programs admit any topic, as long as the program has been approved by the provincial regulatory body. Some specify topics that must be included, such as radiology.
Continuing education programs have a number of purposes which include:
1. To help practitioners maintain their knowledge base and clinical skills.
2. To help them become current concerning new knowledge and clinical skills.
3. To provide an opportunity to meet with and learn from colleagues in health care, both within the chiropractic profession and from related disciplines.
4. To maintain and improve levels of professional competency and the quality of chiropractic care, individually and throughout the profession.
Continuing education also includes graduate education, for the purposes of obtaining a formal graduate degree, and postgraduate education, leading to specialty or certification status. Whereas continuing education programs for the purposes of maintaining registration or licensure are administered by provincial regulatory bodies, graduate and postgraduate education are the responsibility of chiropractic colleges and their accrediting agencies or, when the graduate degree is in a different discipline, other colleges or universities.
Most Canadian chiropractors receive their undergraduate professional education in chiropractic colleges in Canada or the United States. All must have graduated from a college accredited by the Council on Chiropractic Education (CCE). The CCE in the United States was established in 1971, and autonomous but affiliated CCEs have been established in Canada, Australasia and Europe since that time, in Canada in 1975 (Haldeman 1992). Presently all applicants to chiropractic colleges in Canada and the United States must have completed a minimum of two years successful university study in qualifying subjects. At Canada's one chiropractic college, the Canadian Memorial Chiropractic College in Toronto, applicants require a minimum of three years university and from this September will require a university baccalaureate degree for admission. A second school of chiropractic commences at the University of Quebec, Trois Rivières in September 1993.
Following admission to chiropractic college, students complete a minimum four year full-time undergraduate program. Chiropractic colleges in Canada and the United States provide a number of graduate and postgraduate education programs in fields such as neurology, orthopaedics, radiology and chiropractic sports sciences.
Readers should consult the references given in this chapter for more detailed discussion of models of continuing education (McLaughlin and Donaldson 1991, Harden and Laidlaw 1992, Bunnell and Ketal 1991, Weary 1988). There is wide dissatisfaction with current models of continuing education for health care and other professionals. All methods of continuing education have significant flaws and a search for better methods and outcomes is underway.
V. ASSESSMENT CRITERIA
Rating Systems 2 assessment criteria are used in this chapter. For an explanation of this system see the Introduction and Guide to Use (p. xxiii).
VI. RECOMMENDATIONS (GUIDELINES)
A. Continuing education
15.1 Every practitioner should participate in continuing education programs.
Rating: Necessary
Evidence: Class I
Consensus level: 1
15.2 Provincial divisions should require suitable hours of continuing education for the practitioner each year.
Rating: Recommended
Evidence: Class I, II, III
Consensus level: 1
15.3 Provincial divisions should offer sufficient seminars to allow practitioners to complete the hours required within the province.
Rating: Recommended
Evidence: Class II, III
Consensus level: 1
15.4 Continuing education hours should be allowed by the provincial division for appropriate research and other scholarly activities.
Rating: Discretionary
Evidence: Class II, III
Consensus level: 1
15.5 Approval of seminars by the provincial divisions should be based on the content of the material presented.
Rating: Recommended
Evidence: Class II, III
Consensus level: 2
15.6 Continuing education credits should only be awarded for activities and programs which are relevant to competence and quality in clinical practice.
Rating: Necessary
Evidence: Class I, II, III
Consensus level: 1
15.7 Provincial divisions should provide self-evaluation forms and procedures to assist practitioners in assessing their clinical strengths and weaknesses.
Rating: Recommended
Evidence: Class II, III
Consensus level: 1
15.8 Continuing education credit programs should be directed by the provincial divisions to meet practitioner needs. They are not intended to replace the practitioner's responsibility for self-study.
Rating: Recommended
Evidence: Class II
Consensus level: 1
15.9 Proprietary chiropractic science programmes should be encouraged to affiliate with accredited educational institutions for the purposes of better development, evaluation and implementation of such programmes.
Rating: Necessary
Evidence: Class II, III
Consensus level: 1
15.10. Proprietary chiropractic management programs which are offered for continuing education credit should comply with suitable guidelines as established by the Canadian Chiropractic Association and/or provincial divisions.
Rating: Necessary
Evidence: Class III
Consensus level: 2
B. Postgraduate education
15.11 All educational institutions are encouraged to provide residency programmes for the purpose of advanced research, education, clinical practice, and specialty status.
Rating: Recommended
Evidence: Class II, III
Consensus level: 1
15.12 Colleges and certified specialty groups should provide opportunities for part time/weekend postgraduate programmes for professional development.
Rating: Recommended
Evidence: Class II, III
Consensus level: 1
15.13 Practitioners are encouraged to participate in certification or specialty education programmes.
Rating: Discretionary
Evidence: Class II, III
Consensus level: 1
C. Graduate education
15.14 Practitioners are encouraged to participate in programmes providing graduate education (e.g. masters or doctorate level) offered by accredited educational institutions.
Rating: Discretionary
Evidence: Class II, III
Consensus level: 1
D. Professional organizations
15.15 Practitioners should be members of one or more recognized professional organization. Practitioners should be encouraged to participate in the administration and election process of those organizations.
Rating: Recommended
Evidence: Class II, III
Consensus level: 1
E. Ethics/standards of conduct
15.16 Practitioners should conduct themselves in a manner consistent with the codes of ethics of the Canadian Chiropractic Association and provincial divisions.
Rating: Necessary
Evidence: Class I, II, III
Consensus level: 1
15.17 Provincial divisions should have peer review programs to ensure that practitioners are practising ethically and maintaining suitable standards.
Rating: Necessary
Evidence: Class I, II, III
Consensus level: 1
15.18 Practitioners who advertise should do so in a responsible and professional manner, consistent with provincial division statutes and these guidelines (see chapter 19).
Rating: Necessary
Evidence: Class I, II, III
Consensus level: 1
F. Research
15.19 Practitioners are encouraged to participate in research and support institutions/organizations conducting research, for the purposes of professional development and improved patient care. Valid research requires appropriate research protocols as approved by recognized institutional review boards.
Rating: Recommended
Evidence: Class I, II, III
Consensus level: 1
15.20 The practitioner should remain current on developments in chiropractic and related health care issues.
Rating: Recommended
Evidence: Class III
Consensus level: 1
VII. COMMENTS, SUMMARY OR CONCLUSION
VIII. REFERENCES
Bunnell, Ketal. Development of a model for personalized continuing medical education. J Continuing Education in the Health Professions 1991; II:19-27.
Coulter ID. Chiropractic and medical education: a contrast in models of health and illness. J Can Chiropr Assoc 1983; 27(4):151-158.
Coulter ID. Professional graduate studies in chiropractic. J Can Chiropr Assoc 1986; 30(4):177-181.
Coulter ID. Chiropractic physicians for the twenty-first century? J Can Chiropr Assoc 1986; 30(3):127-131.
Haldeman S, ed. Principles and practice of chiropractic. 2nd ed. Norwalk: Appleton & Lange, 1992.
Harden R, Laidlaw JM. Effective continuing education and the crisis criteria. Medical Education 1992; 26:408-422.
Lathrop FD: Continuing medical education: who needs it? Laryngoscope 1990; 18:1975-1980.
McLaughlin P, Donaldson J. Evaluation of continuing medical education programs. J Continuing Education In Health Professions. 1991; II:65-84.
Pallister S. Continuing education for chiropractors in Canada. J Can Chiropr Assoc 1989; 33(3):121-122.
Vear HJ, ed. Chiropractic standards of practice and quality of care. Gaithersberg: Aspen Publication Inc, 1992.
Vear HJ. Commentary standards of chiropractic practice. J Manipulative Physiol Ther 1985; 81:33-43.
Wardell WI. Chiropractors: challengers of medical domination. Res Soc Health Care 1981; 2:207-250.
Weary PE. Time-limited certification. J American Academy of Dermatology 1988; 18(5, Part I): 1130-1134.
IX. MINORITY OPINIONS |