The Power of Hands-On Learning in Chiropractic Education
Chiropractic, more so than many health professions, is fundamentally based on touch and feel. Using methods rooted in science and evidence, licensed chiropractors adjust patients' spines and joints—as well as their behaviors and lifestyles—to help them achieve optimal health and wellbeing.
"Touching is a learned skill," says Dr. Michael Zumpano, professor and director of Northeast College of Health Sciences' Anatomy Center. "It's about developing your sense of what a human muscle, bone, nerve, or artery feels like. Having that baseline knowledge is necessary for patient assessment: Is that a spasm I'm touching or a tight muscle? Does that feel like a cancerous lump or a benign tumor?"
Like any skill, touch can be honed and improved—with time and practice. For that reason, hands-on learning is essential to any top-notch chiropractic education today. At Northeast, that practical education begins during the very first trimester of our Doctor of Chiropractic degree program and is woven throughout the entire curriculum.
A full year of gross anatomy
When it comes to learning human anatomy, dissection of a donated human cadaver remains the gold standard in medical education today--including at Northeast.
"Less than .1 percent of the world's population has the privilege of being able to learn anatomy by touching and dissecting a human cadaver," says Zumpano. "In many ways, the cadaver is a student's first patient experience. What we do in the anatomy labs and lectures corresponds directly to their future work with patients."
Of late, some chiropractic programs have shifted to using the Anatomage Table or other technologies to help teach human anatomy through visualization. But visuals—even high-fidelity, 3D ones—can't teach you to differentiate what normal and abnormal anatomy feels like. "That kinesthetic knowledge and appreciation comes from years of extensive hands-on experience and practice, all of which builds on the foundational work done in gross anatomy," he says.
Chiropractic assessments, techniques and adjustments
When exactly a hands-on chiropractic education begins will vary by school.
"At Northeast, our students begin palpating in the first trimester," says Dr. Wendy Maneri, associate dean for chiropractic clinical education and health centers at Northeast. During palpation, students use their fingers and hands to conduct a physical examination of a person—usually a fellow student to start—locating and identifying various landmarks and layers in the body.
Then, as Northeast students progress through the Doctor of Chiropractic curriculum, they learn about and practice various evidence-based, manual manipulation techniques, such as diversified and activator.
"Those first few trimesters are foundational," says Maneri. "Along with the science coursework and lab experiences, you're adding in your patient assessment courses and treatment courses." Zumpano echoes Maneri: "They're learning the anatomy of the spine, seeing X-rays of the spine and pelvis. But they're also integrating that information in their other classes, where they're practicing proper grounding, palpation and adjustments," Zumpano says.
Of course, hands-on learning in chiropractic isn't just about physically touching a patient. It's also about learning how to connect with the person in order to take an accurate patient history, complete a differential diagnosis list, and ask for permission to perform a comprehensive evaluation.
For now, according to Maneri, remote chiropractic care can't replace evaluating a patient in person. "There are things you're simply not able to do—palpating a muscle, evaluating a spine—if you're not in a shared environment with someone. A chiropractic education needs to reflect that reality."
Extensive clinical work treating real patients
"A hands-on chiropractic education provides an opportunity for students to work in lab settings as well as in healthcare settings. Both are hands-on environments, with one building on the other," Maneri says.
At Northeast, the last three trimesters let students focus on their clinical experience, introducing them to an array of settings where they treat patients from all walks of life.
"I think we have one of the most diverse clinical programs. Our hands-on opportunities include remote clerkships, preceptorships—practical training supervised by private practitioners—in both the US and Canada, and professional clinical observations, where students can shadow a practicing chiropractor for four weeks," she says.
As a result, Northeast students hone their practical chiropractic skills while potentially rotating through a variety of healthcare settings. Of course, some of these opportunities have a competitive application process or are only available to honors-level students. But generally speaking, you'll find Northeast students training at:
- Campus and outpatient health centers, including Northeast's clinical hubs in Seneca Falls, the Buffalo area, and Long Island
- College-affiliated health centers, such as the student health centers at the University of Buffalo and SUNY Old Westbury
- Veteran Administration sites across the country
- Hospitals and medical centers, such as the Walter Reed National Military Medical Center and Fort Belvoir Community Hospital
- Rehabilitation facilities and community clinics
- Sporting events
- Private offices, some of which focus on specialty areas or treat certain patient populations
"The clinical service component ties the whole chiropractic curriculum together by letting students apply what they've learned in different healthcare environments as well as tie in the business side of the chiropractic profession, such as scheduling, billing, and insurance," Maneri says.
The benefits of hands-on learning in chiropractic
To succeed in the growing chiropractic profession, you need the right combination of education and experience—which is why experiential learning in its myriad forms is central to Northeast's D.C. program. Taken together, each of these hands-on learning experiences—dissecting a cadaver; practicing evaluations, adjustments and techniques; and completing real-world clinical work—helps Northeast students successfully get licensed and transition to practice.