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 R2=0.96 for student competencies and R2=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
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