There has been an emphasis on moving from an input-based system to an outcomes-based system regarding continuing education. That is, proposals to modify existing continuing education offerings in the chiropractic profession to reflect adult learning models. Up to the present, continuing education has emphasized passive learning approaches that have as their chief outcome measure some sort of documentation that the doctor sat through a particular number of hours in the subject. This tells the licensing body nothing about what was learned or what competency was achieved. Likewise, it drives the practitioner’s focus not toward mastery or applicability to day-to- day practice, but rather toward satisfying a numerical requirement. None of the recent literature reviewed discussed using periodic examinations of licensed practitioners as a way to ensure continued professional development and competence, although some of the chiropractic news press has reported that this is a looming possibility.
To be more specific, the literature on this subject reports that the driving factors in ongoing professional development include increasing levels of public scrutiny, an increased marketplace emphasis on quality assurance and the growing popularity of evidence-based practice models. We have moved into an information age, and it is clear that keeping up with the discipline requires regular engagement with a variety of materials. Professional development based upon these motivations should ultimately benefit the patients under the care of chiropractic practitioners.
Because the dominant model of chiropractic continuing education has been centered upon verification of attendance rather than demonstrable change in knowledge, skills or attitudes that will improve patient care or enhance professional competencies, chiropractors may find transition to a new model challenging.
Suggested approaches to this type of professional development include portfolio-based and experiential models. Whereas traditional lecture-based formats have the teacher as the deliverer of content, in these formats the teacher functions as a facilitator. A major challenge for regulatory bodies that wish to implement these models relates to adequate assessment and documentation – regulatory boards must certify to the public that practitioners are maintaining an appropriate level of training and are keeping up with new developments in their field to ensure quality care. So, while a shift from documenting attendance to tracking learning goals in a portfolio makes sense for adult learners, it creates difficulties for those who must evaluate the work done by practitioners to stay current or acquire new knowledge or skills. It is difficult to come up with valid and reliable criteria upon which someone’s learning plan or portfolio will be judged. Further, such a protocol would require training evaluators.
There is also a shift in the location of continuing educational programs. With the proposed moves to adult learning models, the practitioner not only develops a set of learning goals and a plan for achieving them, but also takes responsibility for creating learning opportunities and experiences – often in the setting of his/her own practice. Again, verification that work is actually being done becomes a question for regulatory bodies. This question also arises when more traditional continuing education programs are delivered via distance education.
_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision