Innes Stanley I, Leboeuf-Yde Charlotte, Walker Bruce F
1School of Health Professions, Murdoch University, Murdoch, Australia.
Institut Franco-Européen de Chiropraxie, Ivry sur Seine, France.
Chiropr Man Therap. 2018 Aug 15;26:25. doi: 10.1186/s12998-018-0196-9. eCollection 2018.
Chiropractic programs are accredited and monitored by regional Councils on Chiropractic Education (CCE). The CCE-International has historically been a federation of regional CCEs charged with harmonising world standards to produce quality chiropractic educational programs. The standards for accreditation periodically undergo revision. We conducted a comparison of the CCE-International 2016 Accreditation Standards with the previous version, looking for similarities and differences, expecting to see some improvements.
The CCE-International current (2016) and previous versions (2010) were located and downloaded. Word counts were conducted for words thought to reflect content and differences between standards. These were tabulated to identify similarities and differences. Interpretation was made independently followed by discussion between two researchers.
The 2016 standards were nearly 3 times larger than the previous standards. The 2016 standards were created by mapping and selection of common themes from member CCEs' accreditation standards and not through an evidence-based approach to the development and trialling of accreditation standards before implementation. In 2010 chiropractors were expected to provide attention to the relationship between the structural and neurological aspects of the body in health and disease. In 2016 they should manage mechanical disorders of the musculoskeletal system. Many similarities between the old and the new standards were found. Additions in 2016 included a hybrid model of accreditation founded on outcomes-based assessment of education and quality improvement. Both include comprehensive competencies for a broader role in public health. Omissions included minimal faculty qualifications and the requirement that students should be able to critically appraise scientific and clinical knowledge. Another omission was the requirement for chiropractic programs to be part of a not-for-profit educational entity. There was no mention of evidence-based practice in either standards but the word 'evidence-informed' appeared once in the 2016 standards.
Some positive changes have taken place, such as having bravely moved towards the musculoskeletal model, but on the negative side, the requirement to produce graduates skilled at dealing with scientific texts has been removed. A more robust development approach including better transparency is needed before implementation of CCE standards and evidence-based concepts should be integrated in the programs. The CCE-International should consider the creation of a recognition of excellence in educational programs and not merely propose minimal standards.
整脊疗法项目由地区整脊疗法教育委员会（CCE）进行认证和监管。国际CCE历来是一个地区CCE的联盟，负责协调全球标准，以制定高质量的整脊疗法教育项目。认证标准会定期修订。我们对国际CCE 2016年认证标准与上一版本进行了比较，寻找异同点，期望能看到一些改进。
找到并下载了国际CCE的当前版本（2016年）和上一版本（2010年）。对被认为能反映标准内容和差异的词汇进行了字数统计。将这些统计结果制成表格以确定异同点。先由两位研究人员独立进行解读，然后进行讨论。
2016年的标准篇幅几乎是上一版的3倍。2016年的标准是通过从成员CCE的认证标准中梳理和选取共同主题而制定的，并非通过在实施前对认证标准进行基于证据的开发和试验的方法制定。2010年时，整脊疗法从业者需要关注身体在健康和疾病状态下结构与神经方面的关系。2016年则要求他们管理肌肉骨骼系统的机械性紊乱。新旧标准之间存在许多相似之处。2016年新增的内容包括一种基于教育成果评估和质量改进的混合认证模式。两者都包含在公共卫生领域发挥更广泛作用所需的综合能力。遗漏的内容包括对教师最低资质的要求以及学生应能够批判性评估科学和临床知识的要求。另一个遗漏是整脊疗法项目需成为非营利性教育实体一部分的要求。两个标准中均未提及循证实践，但“循证知情”一词在2016年的标准中出现了一次。
已经发生了一些积极的变化，比如勇敢地朝着肌肉骨骼模型迈进，但负面的是，培养能熟练处理科学文本的毕业生的要求被取消了。在实施CCE标准之前，需要一种更稳健的发展方式，包括提高透明度，并且循证概念应融入项目中。国际CCE应考虑设立对卓越教育项目的认可，而不仅仅是提出最低标准。
