Claire Johnson

Background: This commentary describes perspectives from workshop attendees at a North American educational conference on the chiropractic profession and its relationship with whole health. Whole Health is a paradigm shift within healthcare settings and funding agencies in the United States that utilizes a systems framework to transform healthcare. Whole health frameworks emphasize biopsychosocial well-being as defined by individuals, families, and communities, and leverages interprofessional, team-based approaches to promote well-being, disease prevention, and restoration of health. Main body: Two separate, 60-minute workshop sessions were convened at the 2025 Association of Chiropractic Colleges Education Conference and Research Agenda Conference to discuss whole health and chiropractic. Attendees ( n = 105) included chiropractic academicians, researchers, practitioners, students, and organizational leaders from institutions largely based in the United States. Participants in 14 small groups discussed (1) ways the chiropractic profession aligns with whole health, and (2) how chiropractors can contribute to whole health in clinical practice and healthcare education. Notes taken by group scribes were collected from each workshop and generated 401 distinct comments. Thematic analysis with an inductive approach was used to group and define key topics that emerged from the data. Aspects of the chiropractic profession were described as historically being aligned with whole health for its foundational philosophy in innate healing and resilience, and for espousing person-centeredness and patient values. Themes describing the future contribution of chiropractic to whole health include evidence-based practice; communication and advocacy; integration into the broader healthcare system; and forward-facing education. There was overlap between past and future when considering holism; therapeutic alliance and patient empowerment for self-care; direct access; therapeutic conservatism; preventive health and lifestyle medicine; and longitudinal care. Conclusions: The whole health paradigm presents an opportunity for chiropractors to be recognized contributors within multidisciplinary teams, using their expertise to aid chronic disease prevention, patient empowerment, and health care delivery innovations. Continued education and training, policy changes, and further research are required for the chiropractic profession to best serve patients and provide value within a whole health framework.

Background: Accreditation of healthcare provider training programs ensures graduate competency and provides a means for programs to improve. Accreditation consistency assures the public that healthcare providers have similar basic training across world regions. Currently, it is unknown if chiropractic accrediting agencies have congruent standards globally. Therefore, the purpose of this study was to investigate similarities and differences in student competencies and program standards among four chiropractic accreditation agencies worldwide. Methods: A quantitative content analysis was performed on accreditation standards from regional international accreditation agencies responsible for accrediting the majority of the world’s chiropractic degree programs. Agencies included the Council on Chiropractic Education (United States), the European Council on Chiropractic Education (Europe, United Kingdom, South Africa), the Council on Chiropractic Education Australasia (Australia, New Zealand, Malaysia), and the Council on Chiropractic Education Canada (Canada). The contents of the accrediting standards were coded using a standardized coding list. A modified Delphi technique was used by 21 international experts from December 1, 2023, to April 18, 2024. After four rounds of consideration to achieve consensus, the contents were analyzed for frequency and congruence of coded items across the accrediting agencies’ standards. A two-way analysis of variance was conducted to identify if there were any differences among the accreditation agencies. Results: Neither student competencies [F(3,8) = 0.007, p > .05] nor program standards [F(3,4) = 0.002, p > .05] differed significantly across the accrediting agencies. The statistical relationships between accreditation agencies and coding frequencies remained stable across all coded items, with no single code exhibiting differential performance depending on the accrediting body. The overall model showed R ² = 0.96 for student competencies and R ² = 0.87 for program standards; thus, the models’ predictions align with the observed data. Conclusions: The study findings demonstrate congruence for student competencies and program standards among chiropractic accreditation agencies across multiple geographic regions. The patterns of content were stable and consistent across the four accrediting agencies, with no evidence of differential effects among the agencies. In addition, this study provides essential details and standardized codes for agencies’ documents, which may facilitate dialogue and comprehension among agencies, educators, regulators, governing officials, and other stakeholders in chiropractic education. Study registration: The study protocol was prospectively registered with Open Science Framework on November 30, 2023 https://doi.org/10.17605/OSF.IO/259WC.

Objective: This scoping review aimed to map the volume (number of studies) and nature (topics and designs) of chiropractic education research and scholarly publications on chiropractic learners and programs worldwide. Introduction: Despite the expansion of the chiropractic profession and its recognition by entities such as the World Health Organization, a gap exists in comprehending the international landscape of chiropractic education. No prior studies have systematically mapped the volume and nature of chiropractic education research and scholarly publications. A scoping review of chiropractic education research and scholarly publications is needed to guide future policy development, research agendas, and educational initiatives within the chiropractic profession. Inclusion criteria: Publications in the indexed literature on chiropractic students, graduates, academics, and programs in any chiropractic education setting were included. Studies focused on chiropractic programs and education for chiropractic students or chiropractors worldwide were considered for inclusion. All research designs, literature reviews, descriptive studies, and commentaries were included. Methods: This scoping review was conducted according to JBI methodology for scoping reviews and was reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases PubMed (NLM), Scopus, CINAHL via EBSCOhost, Index to Chiropractic Literature, Biblioteca Virtual em Saúde, and Educational Resources Information Center were searched from their inception to November 5 and 6, 2023, with no language limits. Data were extracted for primary topics, study designs, and regions of the included documents and entered in Covidence by paired independent reviewers. The findings were organized into figures and tables with a narrative description. Results: The search identified 7494 documents. After deduplication, 5041 were screened for relevance, of which 667 were selected for full-text review. From these, 598 were selected for data extraction. The chiropractic education topics included values/ethical competence (n=3), personal/behavioral competence (n=34), knowledge and cognitive competence (n=49), functional and clinical competence (n=93), and program-relevant research (n=419). Most designs were quantitative (n=391), followed by descriptive reports (n=91), qualitative (n=43), mixed methods (n=40), commentaries (n=22), and literature reviews (n=11). Chiropractic education was most studied in the United States (n=359), Australia (n=116), and Canada (n=106). Conclusions: This scoping review reports the volume and nature of indexed publications relating to chiropractic learners and programs worldwide. This body of literature contains learner competencies in knowledge, skills, and attitudes, as well as studies about chiropractic programs. The increasing number of publications and proportion of study designs over time show that chiropractic scholars and programs are engaged in collecting, analyzing, and distributing data relevant to education and training. The map of professional competencies in the chiropractic education literature shows that the profession possesses the fundamental traits needed to contribute to the global health care workforce. Review registration: Open Science Framework https://osf.io/9b3ap Supplemental digital content: French- [http://links.lww.com/SRX/A94], Spanish- [http://links.lww.com/SRX/A93] Mandarin- [http://links.lww.com/SRX/A87], Portuguese- [http://links.lww.com/SRX/A88], Malaysian- [http://links.lww.com/SRX/A90], and Welsh-language [http://links.lww.com/SRX/A89] translations of the abstract are available.

Objective: The objective of this scoping review is to map the volume and nature (topics, study designs, regions) of chiropractic education research relating to chiropractic learners and programs worldwide. Introduction: Education of the health workforce is critical to reach population health goals. Chiropractic educational programs are expanding globally; however, the state of chiropractic education research is not known. A better understanding of the volume and nature of chiropractic education research will inform education research priorities and development of chiropractic programs, and assist with preparing a stronger chiropractic workforce to address world health goals. Inclusion criteria: This scoping review will consider articles that study students, faculty, administration, staff, graduates, and programs in any chiropractic education setting, including graduate, clinical, postgraduate, and specialty training, in any country. Articles on non-educational topics or clinical research will be excluded. Methods: This review will follow the JBI scoping review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases to be searched include PubMed, Scopus, CINAHL, Index to Chiropractic Literature, Biblioteca Virtual em Saúde, and Educational Resources Information Center, from their inception. All languages will be considered. Two reviewers will independently screen records using predefined eligibility criteria and extract data using tables. Data extracted from eligible articles will include study design, participants, region, and topics. The results will be presented in a narrative summary, with data presented in tabular and diagrammatic formats. Review registration: Open Science Framework https://osf.io/9b3ap

This study aimed to (1) collect and analyze statements about how to celebrate chiropractic in the present and roles that chiropractors may fulfill in the future, (2) identify if there was congruence among the themes between present and future statements, and (3) offer a model about the chiropractic profession that captures its complex relationships that encompass its interactions within microsystem, mesosystem, exosystem, and macrosystem levels. For this qualitative analysis, we used pattern and grounded theory approaches. A purposive sample of thought leaders in the chiropractic profession were invited to answer the following 2 open-ended questions: (1) envision the chiropractor of the future, and (2) recommendations on how to celebrate chiropractic. Information was collected during April 2023 using Survey Monkey. The information was entered into a spreadsheet and analyzed for topic clusters, which resulted in matching concepts with social-ecological themes. The themes between the responses to the 2 questions were analyzed for congruence. We used the Standards for Reporting Qualitative Research to report our findings. Of the 54 experts invited, 32 (59%) participated. Authors represented 7 countries and have a median of 32 years of chiropractic experience, with a range of 5 to 51 years. Nineteen major topics in the future statements and 23 major topics in statements about celebrating chiropractic were combined in a model. The topics were presented using the 4 levels of the social-ecological framework. Individual (microsystem): chiropractors are competent, well-educated experts in spine and musculoskeletal care who apply evidence-based practices, which is a combination of the best available evidence, clinical expertise, and patient values. Interpersonal relationships (mesosystem): chiropractors serve the best interests of their patients, provide person-centered care, embrace diversity, equity, and inclusion, consider specific health needs and the health of the whole person. Community (exosystem): chiropractors provide care within integrated health care environments and in private practices, serve the best interests of the public through participation in their communities, participate through multidisciplinary collaboration with and within the health care system, and work together as a profession with a strong professional identity. Societal (macrosystem): chiropractors contribute to the greater good of society and participate on a global level in policy, leadership, and research. There was concordance between both the future envisioning statements and the present celebration recommendations, which suggest logical validity based on the congruence of these concepts. A sample of independent views, including the perceptions from a broad range of chiropractic thought leaders from various backgrounds, philosophies, diversity characteristics, and world regions, were assembled to create a comprehensive model of the chiropractic profession. The resulting model shows an array of intrinsic values and provides the roles that chiropractors may provide to serve patients and the public. This study offers insights into the roles that future chiropractors may fulfill and how these are congruent with present-day values. These core concepts and this novel model may have utility during dialogs about identity, applications regarding chiropractic in policy, practice, education, and research, and building positive relationships and collaborations.

Objective: The purpose of this report is to provide a summary of the methods used and feedback from reviewers about the peer review process for the 2023 Association of Chiropractic Colleges Educational Conference and Research Agenda Conference (ACC-RAC). Methods: After the peer review process was complete, the 2023 ACC-RAC peer review committee members were invited to provide feedback through an anonymous electronic form. The survey included a Likert scale to rate items about the peer review process and an option for open-ended comments. Results: Of the 166 peer reviewers, 77 (46%) completed the survey. The reviewers represented 9 countries, with the greatest number from North America. The majority (95%) of respondents rated the process of peer review in topic groups as good to excellent, and the majority (92%) of respondents rated the overall 2023 peer review process as good to excellent. The critical comments that were submitted are addressed in this report. Conclusion: Overall, peer reviewer satisfaction with the process used for the 2023 ACC-RAC was high. We will include information from this report as part of the continuous quality improvement of peer review process, an important part of improving chiropractic education, research, and scholarly activities.

The purpose of this article is to provide an overview of the growth of chiropractic education globally and a chronological list of current training programs. Another purpose is to provide exemplars of enduring programs and offer suggestions for how chiropractic practitioners may celebrate education on Chiropractic Day, which is September 18. Chiropractic education has transformed considerably over the past 125 years, and there are now 52 programs globally. We consider the 5 longest-existing chiropractic programs and propose hypotheses for what may have contributed to their durability. In addition, we offer ideas and opportunities for how chiropractic practitioners may focus on chiropractic education when celebrating the founding of the profession. Since its inception, chiropractic education has expanded around the world and continues to develop. Recognized accreditation agencies and testing organizations are ensuring that standards of education are established and maintained internationally. With innovation, international collaboration, and a commitment to continuous professional development, the future of chiropractic education is bright. We urge chiropractic practitioners from all over the world to celebrate these accomplishments on Chiropractic Day.

The purpose of this article is to describe the contents of an education descriptive report and to provide a useful publication format for educators in the health professions. The education descriptive report is a pragmatic, empirical study that can contribute to the literature. Education descriptive reports describe an event or situation in an education setting, the resulting outcomes, and what new information can be learned. These reports may use quantitative, qualitative, or mixed methods and may be from organizational, academic, instructional, programmatic, or other educational perspectives. The education descriptive report gives educators in the health professions a mechanism to introduce their scholarly efforts and observations in education environments in a manner that is consistent with the academic literature. This article describes the structure of an education descriptive report and includes a helpful template for academic authors to develop their own report so they may publish observational, reflective, and hypothesis-generating articles.

This is the third paper in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to provide a brief review of the history of the growth of chiropractic, its public relations campaigns, and infighting that contributed to the events surrounding the Wilk v AMA lawsuit. This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the third of the series that explores the growth the chiropractic profession. By the 1930s, the AMA was already under investigation for violation of antitrust laws and the National Chiropractic Association was suggesting that the AMA was establishing a health care monopoly. Chiropractic schools grew and the number of graduates rose quickly. Public relations campaigns and publications in the popular press attempted to educate the public about chiropractic. Factions within the profession polarized around differing views of how they thought that chiropractic should be practiced and portrayed to the public. The AMA leaders noted the infighting and used it to their advantage to subvert chiropractic. Chiropractic grew rapidly and established its presence with the American public through public relations campaigns and popular press. However, infighting would give the AMA material to further its efforts to contain and eliminate the chiropractic profession.

This paper is the eighth in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to discuss the possible impact that the final decision in favor of the plaintiffs may have had on the chiropractic profession. This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the eighth of the series that discusses how the trial decision may have influenced the chiropractic that we know today in the United States. Chiropractic practice, education, and research have changed since before the lawsuit was filed. There are several areas in which we propose that the trial decision may have had an impact on the chiropractic profession. The lawsuit removed the barriers that were implemented by organized medicine against the chiropractic profession. The quality of chiropractic practice, education, and research continues to improve and the profession continues to meet its most fundamental mission: to improve the lives of patients. Chiropractors practicing in the United States today are allowed to collaborate freely with other health professionals. Today, patients have the option to access chiropractic care because of the dedicated efforts of many people to reduce the previous barriers. It is up to the present-day members of the medical and chiropractic professions to look back and to remember what happened. By recalling the events surrounding the lawsuit, we may have a better understanding about our professions today. This information may help to facilitate interactions between medicine and chiropractic and to develop more respectful partnerships focused on creating a better future for the health of the public. The future of the chiropractic profession rests in the heads, hearts, and hands of its current members to do what is right.