As chiropractors, we have a responsibility to meet state requirements for continuing education (CE) hours throughout the year. To some degree, states vary on their continuing education requirements, but we all must meet certain standards to stay current with the latest practice trends and procedures, state regulations, and the latest research that affects our decision-making in the delivery of the care we provide.
How we learn and how this information is delivered has changed, especially since the COVID-19 pandemic hit the country in March 2020. It has impacted our ability to learn and how we adapt to this changing landscape. Our chiropractic colleges, CE departments, state and national organizations, and various CE-providing companies have had to work with new delivery models and platforms. It hasn’t been easy.
Continuing education inspires chiropractors to improve our practice and stay legal. Chiropractic boards in each state require hours of continuing education before license renewal. The numbers range from 10 hours a year in New Hampshire to 50 in Illinois. Required topics vary ranging from adjustive technique, professional boundaries, X-ray diagnosis, documentation and in some cases, medical marijuana.
When it comes to online CE, the story is the same. Some states allow all CE to be taken online, while others allow none. When COVID-19 hit the U.S. in early 2020, chiropractic continuing education was turned upside down. Two years later, we can see the enormous and lasting impact on chiropractors and the chiropractic profession across the country.
The Before Times
Chiropractic CE has historically lagged behind other professions when it comes to online learning. Before COVID-19, a fair number of chiropractors were already familiar with online CE. Many chiropractic colleges offered robust online learning options. Several private CE providers provided online courses too.
Some online courses resembled correspondence courses with nothing more than articles to read. However, the majority of them were higher-quality experiences with videos, slides, and more in-depth, engaging content. An example would be a study that proves how foot stabilization reduces lower back pain by 34.5%.1
Little by little, barriers to online learning were breaking down. Boards were expanding online hours. Providers were increasing their online course catalogs. Chiropractors were taking more online courses. We were beginning to catch up to other professions.
How We Learn
Some still say that chiropractors should not be learning online at all. After all, we are the epitome of a hands-on profession. Others assert that technique can be better learned online than in person, given the right approach, but let’s set adjustive technique to the side for now.
“From an educational standpoint, online learning is perfectly capable of outperforming traditional classroom learning.”...
Instead, consider ethics, law, billing, coding, documentation, anatomy, foot function, the kinetic chain, spinal pelvic stabilization through custom orthotics, neurology, diagnosis, imaging, etc. The question for these topics is not whether to teach online. The question is, what is the most effective way for doctors to learn about these topics?
Let us turn briefly to adult learning theory. Licensed chiropractors arrive at the classroom with fully formed professional identities and deep knowledge. We have the opportunity to apply new content to our practices in short order, but how do we learn?
To integrate new information, adults are better off taking an active role. In many live classroom settings, the spotlight shines on the teacher as the information broadcaster. Students sit passively taking notes, in many instances distracted by their phones and computers.
Shine that spotlight instead on the chiropractors in the room. Active learners should engage with the materials throughout the learning experience. Group activities, speaking, doing exercises, asking, and answering questions, giving presentations. Those are ways adults take ownership over their own learning. Learners take action.
Online platforms offer simple tools for active learning, and in fact, many boards require it. Periodic quizzes and challenge questions jolt learners into action. Pre and post-tests assess learning in ways that rarely appear in brick-and-mortar classrooms. Sophisticated online learning experiences have advanced exercises or homework that take learning a step further. Live online webinars allow individual demonstrations and inquires. Email question-and-answer sessions with the instructor allow unlimited time for learners to formulate and ask questions.
From an educational standpoint, online learning is perfectly capable of outperforming traditional classroom learning. Classroom learning will always have a place, and personal presence and live interaction are invaluable. But let’s always keep the goal in mind — better learning.
2022 and Beyond
Many U.S. chiropractic boards made temporary changes to their regulations in 2020 and 2021, allowing online CE for the first time, more online learning, or new kinds of online learning. It was an unprecedented period of regulatory urgency and flexibility. Online learning is now nearly ubiquitous in the U.S.
Chiropractors who formerly had to travel long distances to access live seminars welcomed this change, as did those of us limited by pandemic restrictions. Course evaluations and personal stories attest to the success of these expanded programs.
However, many temporary regulations are expiring, and online learning expansions are being reversed. In many cases, boards are going back only because the rules dictate that they must. Changing CE regulations is no easy matter. A simple proposal can take years to go into effect. Happily, nearly all boards are considering long-term changes to permanently allow online CE to meet their state requirements.
Private companies, such as Foot Levelers, have adapted and met these new expectations, both by the regulators and the end-user — the doctor. On an annual basis, we provide CE to thousands of doctors, not so different from other private organizations. We have had to adapt and provide quality, easy-to-navigate information to doctors that is easily accessible and understood. From a company that has historically provided CE through face-to-face interaction, we changed delivery models to now include virtual online learning and presentations to meet the needs of our profession. This has also impacted speakers and how they deliver this information in a productive, engaging, and easy-to-understand manner. Imagine having to deliver 12 hours of technique through a virtual format and the challenges that provides. We have collectively bridged these challenges with innovation and adaptive styles. Why? Because we must.
"I Laurie Isenberg is the director of postgraduate and continuing education at Life Chiropractic College West in Hayward, California. She holds a master's I degree in information and library sciences from the University of Michigan and a bachelor's degree in natural resources from Cornell University.
Dr. Mark Zeigler is the vice president of education at Foot Levelers, Inc. He is a graduate of Northwestern College of Chiropractic. He previously served as vice president of institutional advancement at Life Chiropractic College West and president of Northwestern Health Sciences University. During his 26 years in private practice, he served as president of the South Dakota Chiropractors Association and as mayor of Sturgis, South Dakota.
To see the latest schedule of Foot Levelers in-person and virtual learning opportunities, visit footlevelers.com/seminars.
Reference
1. Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial. Jerrilyn A. Camhron, DC, MPH, PhD, a JenniferM. Dexheimer, BS, LMT, aManuel Duarte, DC, MSAc, DABCO, DACBSP, hSally Freels, MS, PhD c From the aDepartment of Research, National University of Health Sciences, Lombard, IL; bDepartment of Clinical Practice, National University of Health Sciences, Lombard, IL; and cSchool of Public Health, Division of Epidemiology and Biostatistics, University of Illinois, Chicago, IL.
