Entry-to-Practice Competency Profile
for Chiropractors in Canada

The Doctor of Chiropractic Programs in Canada are accredited by the Council on Chiropractic Education
Canada, of the Federation of Canadian Chiropractic

1|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Introduction and the Context of Chiropractic
A Doctor of Chiropractic is a primary contact health professional whose purpose is to help meet thehealth needs of the public, giving particular attention to the structural and neuromusculoskeletal related
aspects of the body. The Chiropractic application and development of scientific knowledge focuses on
the relationship between; structure, function, the nervous system, and the body’s inherent ability toheal itself, as these relationships affect the restoration and preservation of health.
The purpose of chiropractic professional education is to provide the Doctor of Chiropractic candidate
with a core of knowledge and skills in the basic and clinical sciences and related health topics required
for the Doctor of Chiropractic to perform the professional obligations of a primary contact health care
professional.
The Doctor of Chiropractic's responsibilities include health assessment, use of imaging modalities,
diagnosis, and the management and coordination of the patient's health care needs in health anddisease. When appropriate the Doctor of Chiropractic co-manages or refers to other members of thehealth care team.
The Doctor of Chiropractic Programs are accredited by the Council on Chiropractic Education Canada of
the Federation of Canadian Chiropractic and are dedicated to educating students to becomechiropractors who have the knowledge, skills, attitudes and values needed to provide high quality
patient care.
This Entry-to-practice Competency Profile for Chiropractors in Canada is a guide to ensure that theresources needed by the program to deliver the Doctor of Chiropractic program are in place and that theabilities required by a graduate ready to begin practice, are demonstrated by every graduate. Graduate
competencies describe abilities expected of a new graduate chiropractor based upon the health careneeds of society. The Entry-to-practice Competency Profile for Chiropractors in Canada is the guide forDoctor of Chiropractic Programs to develop curriculum to support educational programs in developing
student competencies for entry-to-practice.

2|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Entry-to-Practice Competency Profile for Chiropractors in CanadaThis Entry-to-practice Competency Profile for Chiropractors in Canada describes the key expectedabilities of a chiropractor at entry to the profession in Canada. The profile that follows is organized byroles, key competencies and enabling competencies.
The competency profile is founded on a ‘role’ framework. The roles in the CanMEDS (2015) approachwere adopted for Chiropractors in Canada. There are seven roles: Neuromusculoskeletal (NMS) Expert,
Communicator, Collaborator, Health Advocate, Scholar, Professional, and, Leader. A competentchiropractor integrates the competencies of all seven roles.
Competency is an observable and measurable behaviour that integrates multiple components such as
knowledge, skills, attitudes and values. They are multidimensional, dynamic and evolve over time.
Competence may be assessed to ensure acquisition. In this document, two levels of competencies aredescribed: key competencies and enabling competencies. Key competencies are the important outcomeof the objectives (i.e. what is to be achieved or performed). The action verb in the key competency iscentral to the objective. Enabling competencies are the sub-objectives, or the ingredients to achieving
the key competencies. They are shown in this document, each with its own paragraph.
The competency profile for entry-to-practice represents the endpoint of the formal involvement ofprogram accreditors and educators and will serve the needs of regulators. The profile will support
quality assurance, continuing professional development and specialization. Entry-to-practice is the point
where learners become clinicians without direct supervision.
The Entry-to-practice Competency Profile for Chiropractors in Canada is intended to provide guidance ininforming curriculum content of DCP programs, identifies the expected graduate entry-to-practicecompetencies for a chiropractor, sets accreditation standards and support, and, establishes a baseline
for specialization.
The Doctor of Chiropractic educational programs use the Entry-to-practice Competency Profile for
Chiropractors in Canada to guide the development of curriculum, establish outcome measures of how
the program achieves and prepares learners to successfully integrate the competencies to be a clinician,and their readiness to enter into practice.
Details on accreditation are contained in Program Standards for the Doctor of Chiropractic Degree
Program – Canada (2018 Pending). The role of accreditation is to accredit the program. The program
must demonstrate how students reach the level of competencies included in the Entry-to-practicecompetency profile for Chiropractors in Canada.
NB. All of the colour highlights (hyperlinks) are described or defined in tabular form at the end of thisdocument.

3|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Key Competencies, enabling competencies
1. Neuromusculoskeletal (NMS) Expert
The role of the NMS expert is to:
1.1

Demonstrate proficiency in determining a differential diagnosis of the patient.
1.1.1 Demonstrate proficiency in conducting a history
1.1.2 Demonstrate proficiency in performing an examination
1.1.3 Demonstrate proficiency in determining the need for and selection of or referral for
appropriate imaging modalities and laboratory analysis to order to arrive at an
appropriate differential diagnosis.
1.1.4 Demonstrate proficiency in interpretation of results of diagnostic testing
1.1.5 Demonstrate clinical reasoning by considering the relative influence of all determinantsin the formulation of a differential diagnosis

1.2

Develop and manage an appropriate plan of patient care.
1.2.1 Prioritize issues that need to be addressed
1.2.2 Consider risk management strategies that address patient safety
1.2.3 Obtain informed consent
1.2.4 Implement measurable and effective patient-centered management that supports
ongoing care, follow up investigations, response to treatment and further consultation
1.2.5 Adapt to unanticipated clinical findings.

1.3

Demonstrate the proficient delivery of therapeutic interventions
1.3.1 Implement safe and effective interventions consistent with the established differential
diagnosis and treatment goals and expectations
1.3.2 Recognize and respond to adverse events
1.3.3 Provide evidence informed conservative care for NMS conditions

1.4

Deliver appropriate chiropractic adjustments/manipulations as identified in the treatment plan
1.4.1 Identify segmental dysfunction of the spine and/or other articulations
1.4.2 Analyze and interpret findings indicating the need for chiropractic adjustment /manipulation
1.4.3 Identify indications, contraindications, and risk factors for the chiropractic adjustment /manipulation, explain the anticipated benefits, potential complications and effects topatients
1.4.4 Apply chiropractic adjustment/manipulation to patients while ensuring patient safety
1.4.5 Identify the effects following the chiropractic adjustment / manipulation

4|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

2. Communicator
The role of the communicator is to:
2.1

Establish rapport and trust with patients, their families and/or caregivers and/or support
persons, colleagues and other health professionals:
2.1.1 Engage in responsive, non-judgmental and culturally respectful dialogue, during written(including electronic) communication, verbal, and non-verbal communication
2.1.2 Facilitate an environment which optimizes patient comfort, safety, confidentiality andprivacy
2.1.3 Share information in an empathic manner that respects patient privacy andconfidentiality
2.1.4 Recognize the physical and psychosocial needs of patients
2.1.5 Identify barriers and adapt communication approaches that enable shared decisionmaking and promote patient engagement in their care.

2.2

Synthesize relevant information and perspective of patients and families and/or caregivers
and/or support persons, colleagues and other health professionals.
2.2.1 Gather and document relevant information and perspectives of patients and families,
colleagues and other professionals
2.2.2 Document clinical information and encounters in an accurate, readable, complete,timely and accessible manner in compliance with regulatory and legal requirements

2.3

Communicate in a collaborative, responsive and responsible manner that is meaningful to therecipient.
2.3.1. Recognize when values, biases, or perspectives of patients, chiropractors or other healthcare professionals may have an impact on quality of care, and modify the approach tothe patient accordingly
2.3.2 Participate in a continuing dialogue (with patient and/or referrer) while maintaining
informed consent as part of the evolving process of patient engagement
2.3.3 Assist patients, their families and/or caregivers and/or support persons to identify,
access and make use of information and communication technologies to support theircare and manage their health2.3.4 Utilize communication skills and strategies that help the public to practically apply
evidence-informed health information
2.3.5 Manage conflicts, misunderstandings and sensitive conversations in a professionalmanner
2.3.6 Address challenging communication issues effectively, such as obtaining informed
consent and addressing anger, confusion and misunderstanding
2.3.7 Provide clear and accurate explanation about the plan of care, recommendations andprognosis for the goals of proposed interventions, as well as the risks and benefits ofproposed interventions within a structured report of findings.

2.4

Demonstrate appropriate and responsible use of technology for communication
2.4.1 Implement steps to comply with relevant regulation and acts that relates to security,
confidentiality and privacy issues with the use of electronic communication and datacollection

5|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

3. Collaborator
As collaborators, chiropractors work with others to deliver intra- and inter-professional care.
3.1

Demonstrate an understanding of the chiropractic scope of practice and those of other healthprofessions
3.1.1 Demonstrate knowledge of relevant provider’s scopes of practice in order to best
address the patients’ needs and health goals
3.1.2 Co-manage and/or refer to the appropriate health professionals when applicable

3.2

Value and engage the patient/family/support persons in patient care.
3.2.1 Actively engages patient/family/support persons as team members in planning patientcare
3.2.2 Demonstrate respect for patient, family and community cultural and social values in theprovision of clinical care
3.2.3 Adapt to a variety of patient types and populations

3.3

Work effectively with chiropractors and other health professionals.
3.3.1 Engage in respectful shared decision making with chiropractors and others healthprofessionals when required or when applicable
3.3.2 Negotiate overlapping and shared responsibilities with chiropractors and other healthprofessions when required or when applicable
3.3.3 Implement strategies to promote understanding, manage differences, and resolve
conflicts in a manner that supports a collaborative culture
3.3.4 Utilize both verbal and/or written communication in situations of referrals and comanagement
3.3.5 Support and assist colleagues and other health professionals through constructive
feedback and knowledge transfer when required or when applicable

6|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

4. Health Advocate
The role of a health advocate is to:
4.1

Advocate for health, healthy lifestyle at home/work/recreation, injury prevention, and quality oflife for individual patients and communities within and beyond the clinical environment.
4.1.1 Explore relevant personal and social determinants of health with the patient
4.1.2 Encourage patients and their families to adopt healthy behaviours
4.1.3 Recognize, support and assist in implementing evidence-informed public healthpractices and initiatives
4.1.4 Identify and address barriers and facilitators to adopting healthy behaviours
4.1.5 Use opportunities to communicate the role and benefits of chiropractic to enhance
individual and community health

5. Scholar
The role of a scholar is to:
5.1

Demonstrate skills as a knowledge broker that includes contribution to the creation, criticalappraisal, dissemination, application and/or translation of health care knowledge into practice.
5.1.1 Demonstrate an understanding of the scientific principles of research and evidenceinformed practice for health care
5.1.2 Demonstrate the ability to identify and retrieve relevant scientific literature, and tocritically appraise and evaluate the applicability of health related literature and research
5.1.3 Summarize and communicate to professional and lay audiences the findings of relevant
research and/or scholarly evidence
5.1.4 Identify ethical principles for research and incorporate them into obtaining informed
consent, considering potential harms and benefits, and considering vulnerable
populations
5.1.5 Identify and develop strategies to address knowledge gaps in clinical care
5.1.6 Demonstrate attributes of a lifelong learner including strategies to integrate new
evidence-informed knowledge into practice
5.1.7 Educate colleagues, other health professionals and students in evidence-informed
chiropractic practice

5.2

Establish and maintain evidence informed clinical knowledge, skills, and attitudes,
appropriate for the practice of chiropractic.
5.2.1 Demonstrate the application of knowledge of the clinical and biomedical sciences
5.2.2 Execute the practice of chiropractic in an evidence-informed manner considering best
current evidence, patient preference and clinician expertise

7|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

6. Professional
The role of a professional is to:
6.1

Demonstrate a commitment to the patient, profession and society through ethical behaviour.
6.1.1 Exhibit appropriate professional behaviours and relationships with colleagues, mentors,
and other health professionals
6.1.2 Respond appropriately to ethical issues and conflicts of interest
6.1.3 Adhere to professional codes of ethics, standards of practice, and professional
regulations

6.2

Identify and describe the elements of appropriate, ethical and healthy business practices that
could help develop and sustain a successful chiropractic practice.
6.2.1 Identify and describe the elements of how to manage and balance personal andprofessional demands
6.2.3 Understand ethical business skills and practices
6.2.4 Understand relevant advertising and marketing practices that comply with legislation
and/or regulation
6.2.5 Understand quality improvement processes for business practices.

6.3

Demonstrate elements of reflective practice.
6.3.1 Demonstrate an ongoing ability for critical self-appraisal, including an examination of
one’s own strengths, weaknesses and biases
6.3.2 Implement appropriate learning opportunities and/or remediation strategies
6.3.3 Demonstrate the ability to ask for assistance or mentorship

7. Leader
The role of a leader is to:
7.1

Identify and describe the elements of leadership in professional practice.
7.1.1 Understand the roles and governance structures of regulatory and professionalorganizations relevant to the chiropractic profession
7.1.2 Identify capacity to contribute to the profession through strategic alignment between
areas of interest, strengths and professional opportunities
7.1.3 Demonstrate engagement through community, professional, volunteer or otheractivities
7.1.4 Understand how to contribute to the improvement of health care delivery in teams,
organizations and systems

8|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

References:
Albanese M A, Mejicano G, Mullan P, Kokotailo P, Gruppen L. Defining characteristics of educational
competencies. Medical Education. 2008;42: 248-55.
http://www.royalcollege.ca/portal/page/portal/rc/canmeds/frameworkFrank JR, Mungroo R, Ahmad Y, Wang M, de Rossi S, Horsley T. Toward a definition of competencybased education in medicine: a systematic review of published definitions. Med Teacher. 2010;32: 6317.
Frank JR, Snell L, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al. Competency- based medical
education: theory to practice. Med Teacher. 2010;32: 638-45. 73
Gruppen Larry D, Mangrulkar Rajesh S, Kolars Joseph C. Competency-based education in the healthprofessions: Implications for improving global health
http://Deepblue.lib.umich.edu/bitstream/2027.42/85362/1/CompBasedEd.pdf
http://www.health.gov.on.ca/en/pro/programs/fht/

9|PageEntry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Term
I.

Description of key terms
Expert(NMS) expert

As Neuromusculoskeletal (NMS) Experts, chiropractors
integrate all of the key competencies, applying
chiropractic knowledge, clinical skills, and professional
values in their provision of high-quality and safe patientcentred care. NMS Expert is the central chiropractic key
competency and defines the chiropractor’s clinical scopeof practice.

Evidence informed

Evidence-informed practice integrates best available
evidence with client context and the personal knowledge
and experience of the chiropractor to inform clinicalproblem solving and decision-making.
Note: Practice-based evidence is evidence collected fromroutine clinical practice and it forms part of evidenceinformed practice.
References:
Sackett, DL; Straus, SC; Richardson, WS; Rosenbert, W;
Harnes, RB. (2000). Evidence Based Medicine: How topractice and teach EBM. (2nd ed). Edinburgh: Churchill
Livingston.
Woodburt, MG; Kuhnke, JL. Evidence-based Practice vs.
Evidence-informed Practice: What’s the Difference?
Wound Care Canada. Vol 12, No 1, Spring 2014. 18-21
The chiropractor identifies the area(s) of complaint and thenature of the NMS condition by asking questions regarding theonset and pattern of the symptoms (location, duration,
frequency, intensity, character, radiation), aggravating andrelieving factors, and associated signs and symptoms. The history
enquires about different areas of the patient's health including:o Family history
o Dietary habits and general lifestyleo Past history of other treatments (chiropractic, physiotherapy,
medical and other)o Occupational history
o Psychosocial historyo Other areas to probe, often based on responses to above
questions.

History

10 | P a g e

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Physical examination

The chiropractor performs physical tests, taking into
account the patient’s presenting history and symptoms,
with the intent of establishing a diagnosis and devising atreatment plan.
The examination may include observation, postural
evaluation, as well as biomechanical, neurological andorthopedic tests, and assessment of joint motion andmuscle function and palpation.

Imaging modalities*

Laboratory analysis*

Differential diagnosis

Clinical reasoning

The chiropractor also performs a basic evaluation of allbody systems with the intent of screening for conditions
that need to be considered in the differential diagnosis
process or that require a referral to another healthprofessional.
Imaging modalities refer to techniques and processes
which create visual representations of the interior of abody for clinical analysis and intervention. Depending on
the jurisdiction, chiropractors may have the right toprescribe, perform and interpret diagnostic ultrasound, xray, computed Tomography (CT), magnetic resonanceimaging (MRI)*regulations vary and are controlled by jurisdiction
The testing of human samples of tissues, blood, urine,
and feces, for the purposes of refining a differential
diagnosis.
*regulations vary and are controlled by jurisdiction
The process of differentiating between two or morediagnostic possibilities that share similar signs or
symptoms, using results of history, physical exam, and/or
laboratory tests, imaging and/or referral as needed torule in or rule out different diagnostic possibilities.
“The Process in which the clinician, interacting with thepatient and significant others structures meaning, goals,
diagnosis and health management strategies based uponclinical data, client choices and professional judgement
and knowledge. It is thinking and decision-making
associated with clinical practice that enables clinicians totake the best-judged action for individual patients. In thissense, clinical reasoning is the means to ‘wise’ action.”
Jones, M. and Rivett, D. ( Clinical Reasoning for manual
therapists, 2004) Butterworth-Heinemann ISBN: 978-07506-3906-4

11 | P a g e

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Referral

The directing of a patient to another health professional
for consultation, review, or further action, from one
clinician or clinic to another by request.

Plan of patient care

Note: the term health professional is used in the broadest
sense to including referral to health professionals as wellas community services and psychosocial supports needed
to manage healthThe plan of management for the patient and theircondition. The care plan generally includes goals, as wellas treatment modalities, frequency and duration.
Short-term goals may include pain reduction andrestoration of normal joint function and muscle balance
Care plans may also include long-term goals such as
restoring functional independence and/or tolerance tonormal activities of daily living.
For chiropractors, the care plan may include some or all of
the following:• Joint manipulation (adjustments) and mobilizations,both manual and mechanically-assisted to areas ofjoint dysfunction, including the spine and the
peripheral joints• Established therapeutic modalities to improve soft
tissue healing and pain control• Exercises to improve muscle balance, flexibility,
strength, and coordination• Patient education to improve posture and motor
control, as well as possibly reduce anxiety• Other treatments such as massage, heat/cold
application, and education on ergonomics andnutrition.
The plan should specify the expected frequency and durationof care and include periodical re-evaluations.
https://www.spine-health.com/treatment/chiropractic/chiropractictreatment-plan

Patient safety

12 | P a g e

The World Health Organization (WHO) defines patient
safety as:

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

“the absence of preventable harm to a patient during theprocess of health care and reduction of risk of
unnecessary harm associated with health care to an
acceptable minimum. “
Acceptable minimum: “refers to the collective notions ofgiven current knowledge, resources available and thecontext in which care was delivered weighed against therisk of non-treatment or other treatment” and expects
co-morbidities and contra-indications to be taken into
account when establishing a plan of care.
http://www.who.int/patientsafety/en/
WHO notes that older and sicker patients often present
with significant co-morbidities “requiring more and moredifficult decisions as to health care priorities. Increasing
economic pressure on health systems often leads tooverloaded health care environments.”
http://www.euro.who.int/en/health-topics/Healthsystems/patient-safety
Adverse event

An untoward or undesirable occurrence in the healthcare
process

Patient centered care“the practice of caring for patients (and their families) inways that are meaningful and valuable to the individual
patient. It includes listening to, informing and involving
patients in their care.”Eight principles of patient centered-care:
1. Respect for patients’ values, preferences andexpressed needs
2. Coordination and integration of care
3. Information and education
4. Physical comfort
5. Emotional support and alleviation of fear and anxiety
6. Involvement of family and friends
7. Continuity and transition
8. Access to carehttps://www.oneviewhealthcare.com/the-eightprinciples-of-patient-centered-care/

13 | P a g e

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Conservative care
Adjustment/manipulation

Therapeutic interventions

Therapeutic skill

Type of treatment defined by the avoidance of invasive
measures such as surgery or other invasive procedures,
usually with the intent to preserve function or body parts
Doctors of chiropractic employ adjustment/manipulation toaddress joint and neurophysiologic dysfunction. The
adjustment/manipulation is a precise procedure requiring thediscrimination and identification of dysfunction,interpretation and application of clinical knowledge; and theuse of cognitive and psychomotor skills.
A treatment or intervention delivered with the intent ofmodifying the outcome of a patient’s health. In
chiropractic, an intervention is usually undertaken to help
treat or cure a condition.
The ability of a clinician to deliver a therapeuticintervention in a way that is effective while minimizing
risk to the patient.
e.g. as a therapeutic skill used by most chiropractors,
spinal manipulation requires the ability to accurately
control the speed, force, depth and distance of theadjustive thrust. It also requires the ability to modify
these parameters to suit different types of patients andconditions, including the recognition of risk factors andcontraindications.

Co-morbidity

Chronic conditions

One or more additional conditions that co-exist alongside
the patient’s primary complaint, and may require comanagement of the patient’s care and/or modification of
the treatment approach e.g. osteoporosis, Parkinson’s,
lupus, etc.
Pre-existing health conditions which need to be comanaged alongside the NMS conditions e.g. lupus,
metabolic syndrome, COPD, multiple sclerosis, etc.

II.
Communicator
Health professional
Both regulated and non-regulated professions involved inpatient management e.g. doctors, physiotherapists, social
workers, kinesiologists, personal support workers, casemanagers, etc.
Culturally respectful
Finding a way to communicate effectively that also
communication
respects and accepts cultural differences in ways ofcommunicating
Barriers to communication Obstacles which interfere with a message being
understood.
Examples of barriers:
14 | P a g e

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

•Use of jargon. Over-complicated, unfamiliar and/or
technical terms.
•Emotional barriers and taboos. Some people may find it
difficult to express their emotions; some topics may becompletely 'off-limits' or taboo. Taboo or difficult topics
may include, politics, religion, disabilities (mental andphysical), sexuality and sex, racism and any opinion that
may be seen as unpopular.
•Lack of attention, interest, distractions, or irrelevance to thereceiver.
•Differences in perception and viewpoint.
•Physical disabilities such as hearing problems or speechdifficulties.
•Physical barriers to non-verbal communication. E.g. notbeing able to see the non-verbal cues, gestures, postureand general body language can make communication lesseffective.
•Language differences and the difficulty in understanding
unfamiliar accents.
•Expectations and prejudices which may lead to false
assumptions or stereotyping. People often hear what they
expect to hear rather than what is actually said and jump toincorrect conclusions.
•Cultural differences. Differences in the norms of social
interaction differ between cultures, including the way
in which emotions are expressed. E.g. the concept of
personal space is different for different cultures andbetween different social settings.
(Reference: https://www.skillsyouneed.com/ips/barriers-communication.html )15 | P a g e

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Readable

Able to be read or deciphered; legible. Legible, easy toread, decipherable, clear, intelligible, comprehensible,
reader-friendly e.g. "the inscription is perfectly readable"

Communication approaches Broadly encompasses all forms of communication (e.g.
verbal, written, non-verbal, including assistive devices(hearing aids, augmented communication devices,interpreters))
The approach used for communication will depend onwhether the goal is to gather information, provide
support, share insights, etc.
ConflictElectronic communication
Assistive/augmented
communication
devices

Actual or perceived difference between two or morebeliefs, ideas or interests; Note: conflict can beconstructive and its resolution can lead to growth
All forms of electronic communication including email,texts, data bases, websites, social media“communication methods and technologies used tosupplement or replace speech or writing for those with
impairments in the production or comprehension of
spoken or written language.”
Fossett, B; Mirenda, P. (2009). Augmentative andAlternative Communication. In Odom, SL; Horner, RH;
Snell, ME. Handbook of Developmental Disabilities.
Guilford Press. 330–366.

III.
Collaborator
Intra-professional careInter-professional careIV.

Intra-professional care refers to care provided throughcollaboration between two or more chiropractors
Inter-professional care refers to care provided throughcollaboration between chiropractors and other healthprofessionals
Note: inter-professional adopts an inclusive view of“professional” to include all those who provide, care/service as well as patients/ clients, families andcommunities who are integral components of the patientcare process

Health Advocate

Determinants of health

Conditions in which people are born, grow, live, work andage.
The WHO states that the determinants of health include:
the social and economic environment,

16 | P a g e

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Facilitators of health
Barriers to healthV.

the physical environment, andthe person’s individual characteristics and behaviours.
Personal, environmental, financial and social resources
which improve the ability to make and implement
positive health choices
Personal, environmental, financial and social resourcesthat limit the ability to make and implement positive
health choices

Scholar

Knowledge broker

Knowledge brokers (KBs) work collaboratively with key
stakeholders to facilitate the transfer and exchange of
information in a given context
https://doi.org/10.1186/s13012-015-0351-9

Vulnerable populations

Scholarly evidence

Evidence

Lifelong learner

VI.
Professional
Ethical business practices

17 | P a g e

Vulnerable populations are groups and communities at ahigher risk for poor health as a result of the barriers theyexperience to social, economic, political andenvironmental resources, as well as limitations due toillness or disability.
http://nccdh.ca/glossary/entry/vulnerable-populations“Scholarly sources (also referred to as academic, peerreviewed, or refereed sources) are written by experts in aparticular field and serve to keep others interested inthat field up to date on the most recent research,findings, and news.”
https://www.library.illinois.edu/ugl/howdoi/scholarly/
More broadly defined then scholarly evidence; may
include consensus based guidelines, systematic andnarrative reviews includes original research, systematic
reviews, clinical practice guidelines, etc.
Lifelong learning is the "ongoing, voluntary, and selfmotivated"[1] pursuit of knowledge for either personal or
professional reasons.
Department of Education and Science (2000). Learning
for Life: Paper on Adult Education. Dublin: Stationery
Office.

Using values and morals to guide your business decisions,evidence-informed care plan, includes recognizing andadhering to contractual obligations, and ethical tax
practices

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018

Healthy business practices

Quality improvement

VII.
Engagement

18 | P a g e

A healthy workplace is one in which workers and managers
collaborate to use a continual improvement process toprotect and promote the health, safety and well-being of all
workers and the sustainability of the workplace(WHO)
Using data from your practice to improve your practicemanagement e.g. monitoring and addressing long wait
lists, lack of follow-up, etc…

LeaderParticipation in community and professional activities or
events e.g. sitting on student council, boards ofvulnerable groups and/or charities, volunteering, running
events; coaching sports teams

Entry-to-Practice Competency Profile for
Chiropractors in Canada
November 2018