It has been 47 years since I first became involved in offering postgraduate training for chiropractors. During that time there has been a lot of change but little improvement in the ways we. as a profession, ascertain whether our students actually have learned anything. In the early days, it was shocking to see that no one ever tested any attendees on the information they received at a seminar. Back then, doctors sat in the back of the room, read a newspaper, and did the crossword puzzle. Today, we sec a younger variation: seminar students sit at the back of the classroom, text their buddies, check e-mail, and pay no attention to what is being taught. (I suppose we can claim some improvement since main seminars now use a scannable. bar-coded registration card that will at least verify attendance.) As a witness to those early, poorly managed seminars. I made a vow that if and when I moved into postgraduate training as a business venture, testing would be a standard part of the package. Testing would help to determine whether our students were learning and how well they put their lessons into clinical practice. Tackling the Problem Inventing the Activator adjusting instrument solved a challenge that thousands of chiropractors faced (including me). It offered a new way to deliver a gentle yet marvclously effective low-force adjustment while siniultaneoush saving the doctor from daily bodily wear and tear of manual adjusting techniques. However, it also created a new challenge: to use this breakthrough instrument capably, doctors would have to be trained. That's how the Activator Method Seminars came into being. (I"ll continue to use Acth ator as an example because I created and teach the technique, and Acth ator standards arc those with which I am most familiar.) The good news was that the first doctors who came to us for Activator seminar training were not those who typically sat in the back of the room while killing time for credit. Instead, these clinicians were on a mission to upgrade their technique and deliver exceptional patient care. That said, there was an outcry when we first required them to take a test to become Proficiency Rated. Again, testing was unusual, and for many of our seminar students the questions asked were, "Why me? Why do I have to take an exam?" Their fears quickly abated when at least 90% passed the Basic Proficiency rating test on the first try. We were encouraged and wanted to know more, so we quickly added a practical test to sec if what they had learned on paper and in the classroom was transferring to clinical practice as more effective analysis and adjustment of their patients. Again, we found the results were outstanding. Through this testing experiment, we also achieved a secondary yet still important goal: to standardize Activator care worldwide. Today, when a Proficiency-Rated Activator doctor treats a patient—whether in Rio. London, Phoenix, or Tokyo—the adjustment will be the same. A New Generation and a New Challenge Tilings in the past five years have changed drastically as technology blossomed and as doctors" lives and careers began moving faster. In 2009. we developed the interactive, online version of the Basic Scan Protocol training to meet that increasing demand. Along with this new product came an old and familiar challenge: how to determine whether students—now separated by great distance—were learning the technique correctly and applying it effectively. The process was complicated and expensive, but worth it. Specialists in adult learning introduced us to "competency-based education." which essentially uses software to evaluate how well students have learned the material that lias been presented to them. In the online Basic Scan Protocol course, the interactive user must actually move elements on the screen to complete a virtual adjustment. The system then tests knowledge and performance to evaluate overall learning. In addition, the course is set up in modules. If a doctor lias not yet mastered the material, the system will point the user/doctor to the precise topics that need to be reviewed. However, the question remained: Is a chiropractor who is trained online as effective as one who receives the same training in-pcrson? We launched extensive efforts to find the answer. First, the electronic education specialist for the Federation of Chiropractic Licensing Boards did a review. We were thrilled when it came back with outstanding ratings in all areas. Next, we looked for a college that would use the product to train clinicians to oversee students. In a case of good fortune and great timing, the New Zealand College of Chiropractic agreed to have its clinicians take the Basic Scan Protocol course online: in return, a Proficiency-Rated Activator instructor would evaluate their skills with a practical exam. Once again, the results were outstanding. All the clinicians passed the written exam and the practical skills evaluation. Dr. Kelly Holt from the New Zealand College of Chiropractic then launched a project to determine how long it takes students to develop the reliable leg-testing skills that arc essential to the Activator Method. His answer: six. one-hour training sessions. Now. for the first time, we had a paper tliat defined the minimum training necessary for a clinician to achieve leg-testing proficiency. Finally. Activator embarked on its own field-testing. Students who had taken the Basic Scan Protocol course online were asked to join us in person at a seminar for testing. Our evaluation found them to be as competent as those students who had attended the full seminar in person. Surprised and gratified, we later developed a hybrid seminar that offered the online training augmented with extra, hands-on, in-pcrson training time, and once again achieved the same, consistent results. Conclusion: We Can Beat the 'Attention Deficit' and Provide Effective Postgraduate Training It's a busy world with plenty of distractions even for the most disciplined practitioners. I also suspect there will always be a few students who will try to hang onto a spot at the back of the classroom and learn through "osmosis." Now. though, we have the means— through technology and technique—to be sure that the training we provide is doing what we intend it to do: to produce an exceptional group of evidence-based and patient-centered practitioners. It's our job to make sure we use it. Dr.. Irian Fuhr travels extensively to chiropractic seminars, conferences and events around the world. He will be providing his insights and perspectives from these visits as a regular guest commentator for The American Chiropractor. You can reach him at 602-445-4230 or email awfuhr&activator.com.
