J Can Chiropr Assoc 2000 (Sep); 44 (3): 157–168 ~ FULL TEXT
Brian J. Gleberzon, DC
Canadian Memorial Chiropractic College,
1900 Bayview Avenue,
Toronto, Ontario, Canada M4G 3E6.
Since its establishment in 1945, the Canadian Memorial
Chiropractic College (CMCC) has predominately
adhered to a Diversified model of chiropractic technique
in the core curriculum; however, many students and
graduates have voiced a desire for greater exposure to
chiropractic techniques other than Diversified at CMCC.
A course structure is presented that both exposes
students to a plethora of different “Name techniques”
and provides students with a forum to appraise them
critically. The results of a student survey suggested that
both of these learning objectives have been successfully
met. In addition, an assignment was designed that
enabled students to recommend which, if any, “Name
techniques” should be included in the curriculum of the
College. The recommendations from these assignments
were compiled since the 1996/97 academic year. The
results indicated an overwhelming demand for the
inclusion of Thompson Terminal Point, Gonstead,
Activator Methods, Palmer HIO and Active Release
Therapy techniques either as part of the core curriculum
or in an elective program. These recommendations
parallel the practice activities of Canadian
From the Full-Text Article:
Since its establishment in 1945, the Canadian Memorial
Chiropractic College (CMCC) has predominately adhered
to a Diversified model of chiropractic care in the core
curriculum. Students, however, have consistently voiced
their desire for increased exposure to, and instruction in,
other chiropractic technique systems, such as Gonstead
and Thompson Terminal Point techniques. Taken together,
this group of chiropractic technique systems is
commonly referred to as “Brand Named” techniques or
simply “Name” techniques due to the fact that their origins
can be traced back to individual developers. A review of
the Applied Chiropractic Department at CMCC (which is
responsible for instruction in the psycho-motor skills of
Diversified technique) was conducted in 1998.  This review
involved faculty, clinicians and students and consisted
of survey instruments, interviews and focus groups.
The review revealed that 87% of students (N = 385) expressed
a desire for increased exposure to Name techniques
other than Diversified. 
Currently, the primary exposure to Name techniques in
the core curriculum at CMCC is during a course titled
Integrated Chiropractic Practice and Principles. This
course provides an opportunity for guest lecturers (typically
field practitioners) who utilize a particular Name
technique to present the technique to students. Lecturers
provides an historical account, description of the philosophical
model or approach (mechanistic, postural, reflexive,
tonal) and a demonstration of the diagnostic and
therapeutic methods utilized by each technique. Some
“hands-on” exposure to each technique is provided in the
psycho-motor skills labs. During the 1999/2000 academic
year, 15 guest lecturers presented 12 different Name techniques
Although this course is offered to fourth-year students
during their internship, clinic treatment policies prohibit
students from utilizing any technique other than Diversified
with their patients. [2-4] The policy on “Alternate Therapies”
for the CMCC outpatient clinics states:
“Patients admitted to the CMCC clinics will be treated by chiropractic
methods as instructed in the CMCC curriculum.” 
policy results from concerns that clinical faculty, who may
not be familiar with the protocols of a particular technique,
cannot provide appropriate intern supervision. Other concerns
involve allocation of human resources and scheduling
conflicts.2 However, in some cases, a clinician may
have sufficient training in a particular technique to provide
adequate supervision, and may allow an intern who wishes
to employ a particular Name technique to do so, provided
he or she follow specific clinical guidelines. 
Topics presented to the fourth year students in the 1999/2000 academic year during the Integrated Chiropractic Practice and Principles course
1 Active Release Therapy
2 Activator Methods Chiropractic Technique
3 Alexander/ Mitzva Technique
4 Applied Kinesiology
7 Logan Basic
8 Network Spinal Analysis
9 Palmer HIO
10 SacroOccipital Technique
11 Thompson Terminal Point Technique
12 Torque Release Technique
1 Applied Behavioral Analysis and an Interdisciplinary Approach to the Care Of the Autistic Child|
With the implementation of the new curriculum at
CMCC in the 1999/2000 academic year, the Integrated
Chiropractic Practice and Principles course will be provided
to students at the beginning of their second year. At
this time, however, there is neither an elective program offering
students instruction in Name techniques nor is instruction
in Name techniques offered through the continuing
education department. Therefore, there is to some degree a
“gap” between the CMCC undergraduate Chiropractic programme
and reported professional practice activities.
In order to provide students with the opportunity to explore
Name techniques further, and to identify those particular
Name techniques that students wished to learn in
greater depth, the author (who is the coordinator of the
course) increased the number of guest lecturers, developed
a problem-based learning forum and designed an investigative
assignment. The objectives of the re-structuring of
the course and the investigative assignment were to
broaden student exposure to a variety of Name techniques
of varying philosophical, diagnostic and therapeutic approaches
while, concurrently, encouraging students to appraise
As an additional learning objective, the investigative
assignments required students to determine if any particular
Name technique warranted inclusion in the curriculum
of the college. The recommendations from these assignments
have been compiled since the 1996/1997 academic
year. The preference for certain Name techniques became
apparent, and these preferences parallel the current practice
activities of Canadian chiropractors.
At the beginning of the course, the class of 150 students
was randomly assigned to groups of 16. Each group of
students then divided themselves into working pairs. Each
pair of students was responsible for the investigation of
one particular Name technique. The allocation of responsibilities
was decided by the students. Each pair of students
conducted an investigation of the chosen technique. Investigation
criteria included an historical account of the developer
of the technique, the philosophical approach of the
technique, a description of the diagnostic and therapeutic
protocols of the technique, outcome measures, and an assessment
of any relevant research regarding the efficacy of
Students were permitted to chose their own topics. The
rationale behind this approach was that a student with an
interest in a technique may have in his or her possession
information that would be difficult to obtain from standard
investigative sources. For example, a student may possess
seminar notes and may be aware of pertinent research in
non-indexed peer reviewed journals. A student may also
have first-hand experience with a particular technique.
This student would therefore be in a position to provide a
much more extensive and detailed review.
Each pair of students presented their findings to the
large group of 16 students in a faculty-facilitated, problem-
based learning (PBL) environment. The facilitators
were chiropractors, most of whom were tutors in the psycho-
motor skills labs and all of whom were in private clinical
practice. After the presentation, the group debated the
merits of each technique, considering its strengths and
weaknesses. The students then voted as to their recommendation
on whether to include the technique in the core
curriculum, to develop an elective program, or to continue
to exclude the technique from the current curriculum. In
this manner, even if a pair of students had a passionate
interest in a particular technique and provided a charismatic
presentation, the larger group could still vote for the
technique’s exclusion from the curriculum.
The investigations and recommendations were combined
into a report submitted for evaluation. The author
has compiled the recommendations gathered from a four
year period (1996 to 1999). In order to avoid any potential
bias, the results from previous years are not disclosed to
students prior to the submission of their reports.
Assessment of satisfaction with the course format
A course survey of fourth year students was conducted in
the fall of 1999 (Table 2). The survey revealed that 86.4%
of respondents (N = 125) agreed or strongly agreed with
the statement that the guest lecturers provided an opportunity
for students to ask questions during their presentations.
Furthermore, 91.2% of respondents agreed or
strongly agreed with the statement that the PBL groups
provided the students with an opportunity to express their
opinions about Name techniques. Also, 76% of the students
agreed or strongly agreed with the statement that the
course enhanced their abilities to analyze Name techniques
critically, with 15.2% of students undecided. The
survey also revealed that 92.8% of respondents agreed or
strongly agreed with the statement that the course gave
them a better understanding of different Name techniques.
Lastly, 76% of students agreed or strongly agreed with the
statement indicating that they were satisfied with the
course overall, with 11.2% of students undecided. The results
of this survey suggested that the primary learning
objectives of the course were successfully met.
Evaluation of Integrative Chiropractic Practice and Principles by 1999/2000 fourth year students (N = 125)
Please refer to FULL TEXT article
Recommendations from student investigative reports
Over the past four years, a total of 42 student investigative
reports have been submitted for evaluation. Each report
contained between 6 to 10 research assignments on a particular
technique. A total of 302 research assignments on
21 different Name techniques have been submitted. If an
assignment did not provide a definite recommendation
(N = 25), or if a technique was researched by fewer than 3
groups over the four year period (N = 14), that assignment
was excluded from the summation. The results of the remaining
263 investigative assignments from each academic
year have been tabulated (Table 3, Figure 1).
Compilation of Results from Student Investigative Reports (1996–1999) (N = 263)
Please refer to FULL TEXT article
Graphic Depiction of Results of Student Investigative Reports
Please refer to FULL TEXT article
Examination of the results reveal distinct trends. Specifically,
students independently and yet consistently recommend
inclusion in the curriculum of Thompson
Terminal Point (100%), Gonstead (97%), Activator Methods
(94%), Palmer HIO (93%) and Active Release Therapy (84%) techniques. Students appear to be less interested
in Torque Release (65%), Logan Basic (62%),
Sacro-Occipital Technique (60%), Cranio-Sacral Therapy
(52%), Applied Kinesiology (42%), Network Spinal Analysis (40%) and Chiropractic Biophysics (33%).
Name techniques at CMCC
One need look no further than the proliferation of “Technique
Clubs” at CMCC to conclude that students have a
tremendous interest in Name techniques. Currently, there
are 8 techniques offered by “technique clubs’ under the
purview of the Student Administrative Council, with 1 more
proposed for the 2000/2001 academic year (Table 4). 
List of “Technique Clubs” at CMCC 
1. Technique Clubs active at CMCC as of 1999/2000 academic year|
Active Release Technique
Motion Palpation Institute (MPI)
Thompson Terminal Point
2. Technique Club(s) Applying for 2000/2001 academic year
Utilization of name techniques by Canadian chiropractors
A review of the literature reveals that a significant proportion
of Canadian chiropractors utilize Name techniques in
clinical practice. For example, in 1993, the National Board
of Chiropractic Examiners released their findings of a job
analysis of chiropractors in Canada.  This analysis indicated
that, although 87.3% of respondents utilized Diversified
technique, 44.2% utilized Sacro-Occipital Technique,
43.6% Activator, 37.7% Meric, 35.0% Gonstead, 32.4
NIMMO/tonus receptor, 31.0% Applied Kinesiolgoy,
30.0% Thompson, 25.9% Logan Basic, 22.4% Cox/
Flexion-Distraction, 22.3% Palmer HIO, 22.2% “Cranial”
and 15.5% “other” techniques. 
Kopansky-Giles and Papadopoulos conducted a practice
pattern survey of Canadian chiropractors in 1995. 
Two findings are of particular relevance here. The first is
that 72.7% of respondents (N = 2,587) reported that they
utilized Diversified techniques for 76% to 100% of their
patients, indicating that one out of four chiropractors
utilized a technique other than Diversified for 76% to
100% of their patients. In addition, the respondents also
indicated that, for 1% to 25% of their patients, they utilized
Activator (31.4%), Sacro-Occipital Technique (18.8%),
Thompson (14.3%), Gonstead (10.9%), Cranio-Sacral
Therapy (8.3%) and Palmer HIO (6.9%) techniques.  This
preference in the utilization of Diversified technique undoubtedly
reflects the fact that, as of 1995, the vast majority
of respondents (over 90%) had been educated at
CMCC  and may preferentially utilize the only technique
(Diversified) that they were taught.
Secondly, this survey predicted that the number of Canadian
chiropractors would increase from 5,000 to 10,000
by the year 2005.  CMCC graduates approximately 150
students a year. Over a ten year period, therefore, 1,500
new chiropractors will have graduated from CMCC. The
remaining 3,500 new Canadian chiropractors must therefore
be graduates of colleges other than CMCC.
According to the Canadian Chiropractic Examining
Board (CCEB), 608 candidates sat for the Canadian Board
Examinations in 1999, as compared to only 186 in 1992. 
Between 1995 and 1999, a total of 1,812 candidates
sat for the Canadian Board examinations. Only 40%
(N = 730) were graduates of CMCC. The other candidates
were graduates of Western States (N = 194), National College
(N = 155), Palmer College West (N = 150), North-western College (N = 102), Palmer College (N = 100) and
other chiropractic colleges (N = 381). 
Many other chiropractic colleges provide extensive exposure
to a wide variety of Name techniques either in the
core curriculum or within an elective program. With such a
large influx of chiropractors into Canada from different
chiropractic colleges, it can be predicted with confidence
that the utilization rates of Name techniques by Canadian
chiropractors will rise dramatically over the next few
A survey of CMCC students and graduates by Watkins
and Saranchuk, completed in July 1999, sought to compare
professional practice activities with the educational
programming at CMCC.  This survey gathered information
pertaining to the techniques primarily and regularly
utilized by CMCC graduates between 1993/4 and 1997/8
(N = 325) as well as techniques fourth year students
(N = 95) thought they would primarily or regularly utilize
after graduation. The survey revealed 84.5 % of students
thought they would primarily utilize Diversified technique.
However, the same group of students thought
they would regularly utilize Activator (21.6%), Applied
Kinesiology (15.5%), Cranio-Sacral Therapy (14.4%),
Thompson Terminal Point (12.4%), Motion Palpation Institute
(MPI) (11.3%), Gonstead (11.3%), and “other”
techniques (13.6%) once they were in private practice. 
Watkins and Saranchuk reported that utilization rates of
Name techniques among CMCC alumni were even higher
than those predicted by students.  While 86.7% of graduates
primarily utilize Diversified technique, 33.3% reported
regularly using Activator, 22% MPI, 20.7%
Thompson Terminal Point, 11.3% Gonstead, 9.7%
CranioSacral, 9.1% Palmer HIO and 13.6% reported utilizing
“other” Techniques. It must be emphasized that
these relatively high rates of “regular” Name technique
utilization were gathered from CMCC graduates who received
only a preliminary introduction, and thus no formal
training, in any technique other than Diversified from the
The high rates of “regular” utilization of Name techniques
by CMCC graduates may be related to the finding
in the same survey that only 32.7% of CMCC graduates
(and 30.9% of CMCC students) obtained their continuing
education from CMCC. In contrast, 64.4% of graduates
and 69.1% of students sought their continuing education
from sources other than CMCC.  It is possible that a majority
of the continuing education sought from outside
sources is for instruction in different Name techniques. For
example, when certain seminars are offered in Toronto
(notably Active Release Therapy), student attendance in
CMCC classes noticeably declines, despite the hefty cost
of some of these outside presentations. (A weekend instructional
seminar in Active Release Therapy costs a student
approximately $1,000 US.)
Student appraisals of name techniques
Within the investigative assignments, students were reluctant
to recommend certain Name techniques for inclusion
in the curriculum at CMCC for a variety of different reasons.
Many students concluded that, while a particular
Name technique may provide positive therapeutic outcomes,
the philosophy of the technique would integrate
poorly with the paradigm of the Diversified technique
model. This was often the argument against recommending
such tonal techniques as Network Spinal Analysis
(NSA) and Torque Release Technique (TRT). Some students
were unsure if a particular technique should even fall
under the label of “chiropractic care”; this was the case
often made against Cranio-Sacral Therapy. Students also
correctly identified that the incorporation of certain techniques
would be complicated by trademark or copyright
protection laws. An example of this situation is Active
Some students felt that the research into a particular
Name technique was currently inadequate or inconclusive.
A study by Blanks et al.  of patients under Network care
illustrates this point. The study involved a large group of
patients (N = 2,818) who reported significant benefits
while under Network care (measured as improvements in
their “wellness coefficient”). However, because the study
was retrospective, the researchers were unable to question
those patients who discontinued care, possibly because of
lack of satisfaction or benefit. This could skew the results.
Also, assessing a patient’s perceived improvements after a
lengthy (and costly) treatment regimen may influence patient
responses. Patients may wish to validate their time
and money commitments and report disproportionally
more favorable results than may have actually been
Irrespective of such problems with research methods on
Name techniques, it should be noted that studies into the
efficacy of Diversified technique for clinical conditions
other than certain types of headaches and acute and
chronic low back pain are generally few and far between.
In addition, while studies may indicate the poor inter-examiner
reliability of diagnostic tests such as prone leg
length analysis, a test ubiquitous to many Name techniques
and not endorsed by Diversified technique, many
studies assessing the inter-examiner reliability of motion
palpation, a core Diversified diagnostic test, fare as poorly.
A few representative examples are provided in the references.
An argument can be made that only those techniques
that are “evidence-based” should be offered in chiropractic
curricula; however, good quality research comprising
this evidence is sparse for every technique, Diversified
included. Furthermore, Sackett, an expert on evidence-based
medicine, recently commented that “evidence-based
medicine means integrating individual clinical expertise
with the best available external clinical evidence from systematic
research ... especially from patient-centered clinical
research”.  This emphasizes the importance of studies such
as the one by Blank et al, notwithstanding its methodological
Meeker recently identified many theoretical challenges
facing chiropractic science in order to develop evidence
of chiropractic “success”, not the least of which is developing
definitions of health that can be measured.  As
Cooperstein and Schneider opine, “colleges today are confronting
the challenges of charting a path between the
Scylla of an initially disappointing run at technology assessment
and the Charybdis of an anachronistic faith in
chiropractic procedures.” 
Students did not recommend abandoning the curricular
commitment to a Diversified model of chiropractic care.
Rather, students recommended the addition of Name techniques
to their armamentarium of diagnostic and therapeutic
skills that may be of benefit to patients with specific
clinical conditions. For example, the use of an adjusting
instrument (Activator or Integrator, used in Torque
Release) or low force techniques (Logan Basic, Sacro-
Occipital Technique) may be of benefit for treating children,
patients with advanced osteopenic disorders, patients
with severe pain upon palpation and for those patients who
do not like manual adjustments with audible releases.
Similarly, comprehensive knowledge of adjusting techniques
that utilize tables with drop piece capabilities (such
as Thompson Terminal Point) may be helpful if there is a
significant discrepancy in size between a large patient and
a diminutive doctor.
Other issues germane to name technique use
Other techniques, such as Gonstead, Thompson and
Palmer HIO, offer methods of cervical adjusting that are
non-rotatory. [24-26] Cervical rotation has been identified
as the position that places a patient at a relatively higher
risk of injury (notably stroke) as compared to non-rotatory
positions,  although this cannot be concluded with certainty.
 Instrument adjusting may also minimize the risk
of cerebral vascular accidents during cervical adjusting,
although a few injuries have recently been reported. 
Lastly, some practitioners may be attracted to techniques
that support a vitalistic paradigm of chiropractic care,
such as Palmer HIO, Torque Release or Network Spinal
Some critics of Name techniques point to the “cookbook”
approach of many of the techniques, accusing some
practitioners of abandoning avenues of individual clinical
reasoning. While it is possible some practitioners may be
over-reliant on the algorhythmic simplicity inherent in
some Name techniques, it is the author’s experience that
practitioners who utilize Name techniques continue to
meet the level of clinical competence required of a “reasonable”
chiropractor. In addition, were Name techniques
to become part of the curriculum at CMCC, there would
continue to be an emphasis on palpatory, orthopedic and
neurological examination skills for purposes of both diagnosis
and the monitoring of therapeutic outcomes.
Chiropractic and allopathic clinical practices are
fraught with uncertainty. [30, 31] As O’Malley observed,
many practitioners can relate anecdotal examples of a
seemingly capricious patient’s body responding to treatment
at variance with text-book expected outcomes of
predefined syndromes.  For those practitioners (and patients)
uncomfortable with this clinical uncertainty, those
Name techniques embracing a vitalistic paradigm offer a
degree of reassurance.
The antithesis of a dogmatic, vitalistic paradigm of
chiropractic care – a central pillar to many Name techniques
– may be a reliance on the “hard sciences” of physiology,
physics and engineering as it may apply to the
human body (biomechanics), a reliance which Cooperstein
describes as less religious but more pious.  This
“hard science” approach has been implemented in many
courses at CMCC, including those in the Applied Chiropractic
Department. Oftentimes these hard sciences are
used to refute aspects of the Diversified model which are
simultaneously being taught to students. [23, 30] However,
Cooperstein has cautioned the chiropractic profession that
the over-reliance on the “hard sciences” in chiropractic
pedagogy may be what Hayek (an economist) termed
“scientism” – the overly ambitious attempt to emulate the
methods of mathematical physics in an inappropriate
field.  Such fields include the healing arts, sociology, economics,
sociocultural anthropology – in short, any field
that studies or considers humans as social beings.
Cooperstein warns that “scientifically-based educators
have no choice but to de-fetishize the standard chiropractic
totems, but they should not deconsecrate such religious
totems without attempting to erect a secular model of
equal interest.”  In the absence of such new models,
student frustration and confusion may mount.
The author is unaware of any protocols that exist in
Diversified technique that guide a practitioner for the optimal
sequencing of adjustments to be delivered to a patient,
in the event the patient requires adjustments of various
regions of the spine. For example, if a patient requires
adjustments to the cervical spine, thoracic spine and to the
pelvis, Diversified technique offers no guidance as to
which adjustment to preferentially perform first. While the
sequencing of adjustments may not be clinically important,
if a practitioner believes that there is an optimal sequence
of adjustments that should be delivered, he or she
must adopt protocols from other Name techniques that
allow for this determination, such as Activator or
Thompson Terminal Point.
Diversified technique can be considered an eclectic
group of diagnostic and therapeutic methods adopted from
other, more established Name techniques. It is thought by
some to be a representation of the best aspects of many
other techniques, while others consider it a stand-alone
technique.  (It is for this reason that a capital “D” has been
used throughout this article when denoting Diversified
technique.) Diversified is arguably the least dogmatic of
all the chiropractic techniques, with some historians suggesting
it was developed as a response to the rigidity and
dominance of BJ Palmer during the 1940s.  However,
others consider Diversified technique to be a amalgam of
many of the Name techniques, a technique that adopts the
procedures of other techniques, divorced from their founding
principles. The dichotomy that may exist between educational
programming in the Chiropractic Principles Program
at CMCC and student perceptions (concerns) of the
importance and extent of emphasizing chiropractic principles
in the curriculum have been investigated.  For example,
Waalen, Watkins and Saranchuk reported that
students indicated that philosophy was a very important
part of their chiropractic education and they felt their
needs were not being met by the present program. 
Moreover, students perceived that faculty were unappreciative
of philosophy, although a survey of faculty was
found to be at odds with the student’s perceptions. 
It is appealing to believe that Diversified technique is
the linear culmination of a natural evolution of chiropractic
techniques, analogous to the evolution of Homo sapiens
(Austropithicines begat Homo habilus begat Homo erectus
and so on). The problem with this thinking is that anthropologists
now know evolution is not linear, but rather a
meandering experiment through time. [35, 36] Moreover, the
principle of “ontogeny recapitulates phylogeny” may apply
as equally to human evolution as to chiropractic evolution:
To paraphrase Einstein, in order for chiropractic to
see further, it should stand on the shoulders of its giants.
Nevertheless, Diversified technique has an inherent
plasticity to its structure which is often lacking in other
Name techniques, the protocols of which are considered
immutable. This plasticity of curricular structure in Diversified
technique is apparent from an historical review of
the Applied Chiropractic department of CMCC. While instruction
in Diversified technique has always been taught
in the core curriculum, examination of course calenders
reveals that instruction has also been provided in
Gonstead, Palmer HIO, Logan Basic and Sacro-Occipital
Technique (Table 5). [37-39]
Historical Examples of Technique Curricula of CMCC [37-39]
1. Techniques Taught in Applied Chiropractic department, 1951|
McLaren’s Precision Technique
2. Techniques Taught in Applied Chiropractic department, 1961
3. Techniques Taught in Applied Chiropractic department, 1971
Author’s Note: Meric Technique is a predecessor
to Diversified Technique.
According to various CMCC faculty members, CMCC
instructed students in Gonstead, Sacro-Occipital Technique
and Palmer HIO in the core curriculum as recently as
1973. (Schut B, King R, personal communication). Clinical
protocols at that time involved use of a “synchotherm”,
a descendant of the neurocalimeter used by Gonstead practitioners,
and a “posturometer.”  Moreover, an examination
of the current adjustments taught in the Applied
Chiropractic Department testifies to the strong influence
of Gonstead technique. With all this in mind, the integration
into the curriculum of those techniques of a similar
paradigm to a Diversified model would seem to be both
feasible and not without historical precedent.
On the other hand, the inclusion of Name techniques in
the core curriculum may be unfeasible (due to time constraints
caused by the introduction of the new “integrative
curriculum”) or even undesirable, and the development of
an elective program may cause tension with the clinical
administration. However, Name techniques could be offered
through the Continuing Education (CE) program.
For example, acupuncture is offered by the CE program
but is no where to be found in the core curriculum of
CMCC. Offering these courses within the CE program
would ensure high standards in content and presentation.
Such a bold direction would require a deviation from the
ethnocentrism which may exist in some educational institutions.
The CMCC has embarked on the development of a new,
integrated curricular model, which began in the 1999/2000
academic year for students entering the program. The
three central components were that the curriculum was to
be (i) competency-based, (ii) integrated and (iii) practice-related.
The inclusion of Name techniques would specifically
comply with the third component.
When considering curricular integration of Name techniques,
it is possible for CMCC to be responsive to student
desires, which cannot be ignored when one remembers
that college revenues are so highly tuition dependent. 
This should not be interpreted as a suggestion to pander to
student’s every whim. However, a curriculum that reflects
current practice activities of Canadian chiropractors (including
CMCC graduates) may ultimately have a positive
influence on alumni membership.
Recommendations and conclusions
Innovative course structure and assignments, such as those
utilized for the Integrated Chiropractic Practice and Principles
course discussed here, can achieve high levels of
student satisfaction while fulfilling specific learning objectives
important to chiropractic pedagogy.
Practice pattern studies suggest the landscape of the chiropractic
profession in Canada will undergo a tremendous
upheaval over the next few years. Combining the results of
demographic trends, student and alumni surveys, and the
results obtained from student recommendations reported
here, can enable CMCC to be responsive to predictable
changes. Name techniques are part of chiropractic reality
in Canada now, and are likely to play an even greater role
in the future. Technique system entrepreneurs have had an
unfair advantage over colleges because they can make virtually
any unsubstantiated claim they want without fear of
professional censure.  By contrast, a college is accountable
to many different stakeholders, not the least of which
are third party payers, public health agencies, the scientific
community, alumni, students and its own faculty.  It is
therefore the responsibility of CMCC, as an educational
institution, to provide students with a better education in
these areas, especially if it is to meet its own mandate of a
practice-based integrated curriculum, while simultaneously
struggling to prevent the more outlandish techniques
from taking hold among students through exploitation of
The college should therefore consider including those
Name techniques (or significant components thereof),
identified by students and utilized by field practitioners,
that are most compatible with a Diversified model of
chiropractic care into (1) the core curriculum, (2) an elective
program or (3) an extension of the CE program.
The author would like to express his appreciation to Dr.
Dave Waalen, Dr. Ayla Azad, Dr. Lisa Caputo, Joe
Piccininni MSc, CAT(C), Carol Hagino MSc and Ron
Saranchuk PhD for their assistance in this article, and to
the many students and faculty members of the Canadian
Memorial Chiropractic College, without whose participation
this study would not have been possible.
Waalen D, Gleberzon B, Saranchuk R. Review of Applied
Chiropractic Department (in press). Presented at the
Association of Chiropractic Colleges, Orlando, Florida,
CMCC Division of Clinical Education, Internal
Memorandum, dated November 30, 1998.
CMCC Division of Clinical Education, Internal
Memorandum, dated April 1, 1999.
CMCC Division of Clinical Education, Internal
Memorandum, dated July 6, 1999.
Student Administration Council, 1999/2000.
National Board of Chiropractic Examiners. Job analysis of
chiropractors in Canada. Greely, Colorado, 1993:84.
Kopansky-Giles D, Papadopoulos C. Canadian
Chiropractic Resource Databank (CCRD): A profile of
J Can Chiropr Assoc 1997; 41(3):155–191.
McEwen M. Chairmen, Canadian Council of Examining
Board. Personal Communication.
Watkins T, Saranchuk R. Analysis of the Relationship
between Educational Programming at the Canadian
Memorial Chiropractic College, and the Professional
Practices of its Graduates. In Press.
Blanks R, Schuster T, Dobson M. A respective assessment
of Network Care using a survey of self-rated health,
wellness and quality of life.
J Vertebral Subluxation Research 1997; 1(4):15–31.
DeBoer K, Harmon R, Savoie S, Tuttle C. Inter- and
intra-examiner reliability of leg-length differential
measurement: a preliminary study.
J Manipulative Physiol Ther 1983; 6(2):61–66.
Rhudy TR, Burk JM. Inter-examiner reliability of
functional leg-length assessment.
Am J Chiro Med 1990; 3(2):63–66.
Rhode DW et al. Comparison of leg length inequality
measurements methods as estimators of the femur head
height differences on standing x-ray.
J Manipulative Physiol Ther 1995; 18(7):448–452.
Meijne W, van Neerbos K, Aufdemkampe G, van der
Wurff P. Intraexaminer and interexaminer reliability of the
J Manipulative Physiol Ther 1999; 22(1):4–9.
Carmichael JP. Inter- and intraexaminer reliability of
palpation for sacro-iliac joint dysfunction.
J Manipulative Physiol Ther 1987; 10:164–171.
Herzog W, Read LJ, Conway PJW, Shaw LD, McEwen
MC. Reliability of motion palpation procedures to detect
sacro-iliac joint fixations.
J Can Chiropr Assoc 1980; 24:59–69.
Mior S, King R, McGregor M, Bernard M. Intra and
interexaminer reliability of motion palpation in the
J Can Chiropr Assoc 1985; 29(4):195–198.
Haas MH, Raphael R, Panzer D, Paterson D. Reliability of
manual end play palpation of the thoracic spine.
Chiropractic Technique 1995; 7:120–124.
Ross JK, Bereznick DE, McGill S. Atlas-axis facet
asymmetry: implications in manual palpation.
Spine 1999; 24:1203–1209.
Sackett D. Evidence-Based Medicine.
Spine 1998; 23(10):1085–1086.
Meeker WC. Concepts germane to an evidence-based
application of chiropractic theory.
Topics in Clinical Chiropractic 2000; 7(1):67–73.
Cooperstein R, Schneider MS. Assessment of chiropractic
techniques and procedures.
Topics in Clinical Chiropractic 1996; 3(1):44–51.
Fuhr A, Colloca C, Green J, Keller T. Activator Methods
Chiropractic Technique Mosby-Year Book Inc. USA 1997:
Coelho L. Applied Chiropractic. Share International II.
Fort Worth, Texas, USA. 1997: 159–186, 187–220.
Plaugher G. Textbook of Clinical Chiropractic. A Specific
Biomechanical Approach. Baltimore: Williams and
Terrett A. Vertebral basilar stroke following manipulation.
National Chiropractic Mutual Ins. Co. W. Des Moines,
Iowa, USA. 1996.
Haldeman S, Kohlbeck F, McGregor M. Risk factors and
precipitating neck movements causing vertebrobasilar
artery dissection after cervical trauma and spinal
Spine 1999; 24(8):785–794.
Nykoliation J, Mierau D. Adverse effects potentially
associated with the use of mechanical adjusting devices:
a report of three cases.
J Can Chiropr Assoc 1999; 43(3):161–167.
Cooperstein R. Brand-Name techniques and the confidence gap.
J Chiropr Ed 1990; 4(3):89–93.
Quill T, Suchman A. Uncertainty and control: learning to
live with medicine’s limitations.
Human Medicine 1993; 9(2):109–120.
O’Malley J. Toward a reconstruction of the philosophy
J Manipulative Physiol Ther 1993; 16(2):35–41.
Cooperstein R. On Diversified technique.
J Chiropractic Humanities 1995; 5(1):50–55.
Waalen D, Watkins T, Saranchuk R. The philosophy of
chiropractic: an action research model of curricular review.
J Can Chiropr Assoc 1999; 43(3):149–160.
Tattersall I, Matternes D. Once we were not alone.
Scientific America. Jan 2000; 282(1):56–62.
Havilland W. Anthropology. 8th. Ed. Harcourt Brace
College Publishers. USA 1997.
CMCC Course Calendar, c1951.
CMCC Course Calendar, c1961.
CMCC Course Calendar, c1971.
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