Development of preliminary integrated health care clinical competencies for United States Doctor of Chiropractic programs: A modified Delphi consensus process

Clinton J. Daniels, Rehabilitation Care Services, VA Puget Sound Health Care System, Tacoma, WA, USA.
Zachary A. Cupler, Physical Medicine and Rehabilitation Services, Butler VA Health Care, Butler PA, USA.
Jason G. Napuli, Primary Care Services-Whole Health, VA St. Louis Health Care System, St. Louis, MO, USA.
Robert W. Walsh, Integrated Primary Care Service, VA Palo Alto Health Care System, Palo Alto, CA, USA.
Anna-Marie L. Ziegler, Primary Care Services-Whole Health, VA St. Louis Health Care System, St. Louis, MO, USA.
Kevin W. Meyer, Rehabilitation Care Services, VA Puget Sound Health Care System, Tacoma, WA, USA.
Matthew J. Knieper, Primary Care Services-Whole Health, VA St. Louis Health Care System, St. Louis, MO, USA.
Sheryl A. Walters, Library, Logan University, Chesterfield, MO, USA.
Stacie A. Salsbury, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA.
Robert J. Trager, Connor Whole Health, University Hospitals, Cleveland, OH, USA.
Jordan A. Gliedt, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Morgan D. Young, Washington State Department of Labor and Industries, Olympia, WA, USA.
Kristian R. Anderson, Spectra Community Health Center, Grand Forks, ND, USA.
Eric J. Kirk, Advocate Health - MidwestFollow
Scott A. Mooring, Northwestern University Health Sciences, Bloomington, MN, USA.
Patrick J. Battaglia, Community-Based Clinical Education, University of Western States, Portland, OR, USA.
David J. Paris, Physical Medicine and Rehabilitation, VA Northern California Health Care, Redding, CA, USA.
Amanda G. Brown, Center for Integrative Medicine, Henry Ford Health, Detroit, MI, USA.
Justin M. Goehl, Family Medicine, Dartmouth Health, Dartmouth, Lebanon, NH, USA.
Cheryl Hawk, Texas Chiropractic College, Pasadena, TX, USA.

Abstract

Background:There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training.

Objective:The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education.

Methods:A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies.

Results:Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration.

Conclusion:We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment.

Type

Article

PubMed ID

39157778

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