Nathan Hutting

Background: Musculoskeletal (MSK) conditions remain a leading source of global disability, and manual therapy (MT) features in multimodal guideline concordant care; however, teaching in clinical programs that involve MT often remains technique-centric and insufficiently aligned with contemporary, person-centred teaching and practice. The present paper synthesizes literature and recent professional discourse to advance an educational framework that operationalizes modern clinical teaching across professions. Objective: To present a review-informed, consensus-driven, student centred framework for clinical education involving MT, designed to cultivate safe, effective, culturally responsive, and evidence-based graduates. Methods: Elements supporting a positive, student-centred learning experience were developed inductively by the lead author, then a narrative review of the literature was conducted on the elements, or pillars as they were designated. This was followed by iterative process to refine and further develop the ideas with a group of international educators, clinicians, and researchers across multiple professions. Consensus was achievedon the core elements of a modern clinical education framework. Results: The framework is anchored in basic sciences and clinical skills, and articulated through six teachable pillars: self-awareness, communication, cultural respect, epistemic humility, intellectual curiosity, and professional identity, delivered via high engagement, student-centred teaching. It provides practical curriculum guidance (crossyear learning outcomes, assessment strategies, and implementation vignettes) to embed person-centred communication, bias mitigation, cultural safety, evidence-based practice competencies, lifestyle medicine integration, and interprofessional collaboration. Together, the six pillars offer a novel approach to student-centred learning. Conclusions: A six-pillar, multi-profession approach offers actionable guidance for modern clinical education involving MT and supports the development of graduates prepared for contemporary MSK care: technically competent, evidence-based communicators who are culturally responsive and collaborative across healthcare teams.

To achieve international consensus on communication and education competencies and associated graduation milestones for Orthopedic Manual Physical Therapy (OMPT) fellowship training. A modified three-round Delphi process was conducted. This study was part of a larger project aimed at reaching consensus on competencies and graduation milestones across seven domains of expertise. A panel of content experts developed and approved proposed competencies in Round I. Rounds II and III involved stakeholders, identified as members of IFOMPT member organizations, who selected domains to rank and voted using a four-point Likert scale. Consensus was established beforehand at 80% agreement. Experts identified four competencies and 18 milestones for communication, and four competencies with nine milestones for education. In subsequent rounds, 124 participants from 12 countries evaluated communication competencies, and 135 participants from 15 countries evaluated education competencies. All competencies achieved consensus. Strong support was observed for person-centered communication, cultural humility, feedback and reflection, clinical teaching, and learner assessment. No significant differences were found between the ratings of Rounds II and III. This study provides the first internationally agreed-upon framework for communication and education competencies in OMPT fellowship training. These findings offer a foundation for curriculum design, assessment, and global standardization. Future research should validate assessment tools and expand consensus to additional domains.