Inherent requirements – Master of Chiropractic Practice

Inherent requirement

This relates to the understanding and ability to comply with Australian and Victorian law and professional accreditation regulations. Examples include:

• Child protection and safety legislation (including the ability to pass a Working with Children Check)
• Criminal History / Police Checks
• Occupational health and safety
• Anti-discrimination legislation

Rationale

Knowledge, understanding, and compliance with legislative and regulatory requirements are necessary in order to reduce the risk of harm to self and others in clinical and related settings; compliance with these professional regulations and the Australian Law ensures students are both responsible and accountable for their practice.

Examples

• Respond to the requirements for student registration with the Australian Health Practitioner Regulation Agency (AHPRA)
• Comply with relevant legislation including child protection and safety, work health and safety, and anti-discrimination legislation. For examples of applicable Australian Federal legislations visit https://www.comlaw.gov.au/

Inherent requirement

This relates to the student's ability to understand and adhere to standards, codes, guidelines and policies that facilitates safe, competent interactions and relationships for students and the people they engage with.

Examples include:

• Complying with academic and non-academic conduct codes and policies, including academic integrity policies
• Understanding and complying with professional standards, codes of practice, and guidelines

Rationale

Compliance with standards, codes, guidelines and policies that facilitates safe, competent interactions and relationships for students and the people they engage with in the many environments of practice is required for the physical, psychological, emotional and spiritual well-being of all.

Examples

• Comply with academic and non-academic conduct codes and policies and professional standards
• Identify and enact relevant applications of these codes and standards, including those relating to academic integrity, informed consent, privacy, confidentiality, and equitable and respectful behaviour in academic and clinical settings.

Where relevant, this relates to considerations of current scope of practice, workplace health and safety, and any other matter related to safety. Examples include ability to:

• Ability to understand and comply with all relevant workplace health and safety policies and practices
• Ability to identify and respond to alarm systems
• Ability to understand and demonstrate compliance with current scope of practice
• Ability to manage one's own health in a manner that promotes the ability to fulfill the requirements of study, placements, and the role/s for which the study typically equips the graduate

Rationale

Compliance with current scope of practice, workplace health and safety, infection control considerations and effective and timely response to alarm systems are required to provide safe environments for students, staff and others.

Examples

• Limit task performance to current scope of practice as a chiropractic student within the course
• Comply with relevant workplace health & safety policies for equipment use and storage
• Remain up to date with first-aid and CPR knowledge and practice
• Work safely and sensitively with patients from vulnerable populations
• Be able to respond to alarm systems to maintain safety and/or effective health management for self and patients.

This relates to the student's capacity for knowledge acquisition, utilisation and retention. It also includes metacognitive capacity such as awareness of one's own thinking, and the ability to reflect, evaluate, adapt and implement new cognitive strategies. Examples include:

• Focus, memory, attention to detail, theoretical deliberation, and practical functioning sufficient to meet the course objectives
• Ability to reflect and take personal responsibility
• Ability to apply knowledge in practical and theoretical assessment settings

Knowledge & cognitive skills

Inherent requirement

Knowledge acquisition, utilisation and retention spanning and drawing together all coursework subjects. Cognitive skills for focus, memory, attention to detail, theoretical deliberation, and practical functioning.

Rationale

Understanding and retention of coursework information and the effective processing of this information is required for appropriate, safe and effective delivery of care/practice.

Examples

• Make safe and appropriate patient care decisions from retained knowledge
• Assess the application of policy and procedures in the context of clinical situations
• Source, research and use an evidence-based framework to make sound decisions between clinical management options
• Assess level and analyse causes of a patient's pain
• Notice and respond effectively to important changes in patient preferences or observable symptoms.

Metacognition

Inherent requirement

Awareness of own thinking, and skills to reflect, evaluate, adapt and implement new cognitive strategies for improved learning.

Rationale

Understanding and ongoing learning about oneself as an instrument in patient care is required for safe and effective delivery of practice.

Examples

• Demonstrate safe and appropriate decision-making in patient care using reflective processes to inform future practice;
• Review the outcome of treatment for a patient's particular symptom presentation and then adapt own knowledge for future clinical decisions;
• Review and reflect on personal responses and cultural paradigms around patient care challenges, and develop safe, effective and professional care approaches;
• Manage and proactively learn from academic and clinical set-backs by self- evaluation;
• Reflect on the options, ethical implications, and impact for all the stakeholders in patient care decisions; and

Be aware of, and take responsibility for, own personal role as a chiropractic student in the patient care process.

Inherent requirement

This includes both writing and reading, and is also linked to English language proficiency (literacy requirements are always established in terms of English). NB: For VE, literacy requirements are based on the Australian Core Skills Framework (ACSF). Examples include:

• Capacity to comprehend, summarise and reference a range of literature in accordance with appropriate academic conventions in written assignments
• Producing clear, accurate documentation relating to practical tasks

Rationale

Patient care information can be delivered by many different modes and competent literacy skills for these are essential to provide appropriate, safe and effective delivery of care/practice.

Examples

• Comprehend, summarise and reference a range of literature in accordance with appropriate academic conventions in written assignments
• Interpret written and spoken language to enact verbal directions or documented patient care plans
• Produce accurate, concise and clear practice documentation which meets legal requirements.

Inherent Requirement

This includes any form of numeracy required to complete the course successfully. For many courses, this will be basic functional numeracy. NB: For VE, numeracy requirements are based on the Australian Core Skills Framework (ACSF). Examples include:

• Competent reasoning and reliable accuracy with numerical concepts
• Ability to perform basic mathematical tasks

Rationale

Competent reasoning and reliable accuracy with numerical concepts are essential for safe and effective care/practice

Example

Calculate and interpret patient scores from patient reported outcome measures.

Verbal communication

Inherent requirement

Verbal communication in English to a standard that allows fluid, clear, and comprehensible two-way discussions, tailored to the local English-speaking audiences.

Rationale

Effective verbal communication, in English, with patients and University and clinical staff is required for effective learning and to provide safe and effective delivery of care/practice.

Examples

• Convey spoken messages accurately and effectively in a professional/clinical situation
• Understand and respond to verbal communication accurately and appropriately in a time-constrained environment when a patient provides important information
• Build rapport with a patient to encourage full disclosure of symptoms
• Present information to, and engage in developing discussions with, a wide audience, including academic, small groups, and professional/clinical presentations.

Non-verbal communication

Inherent requirement

Non-verbal communication skills that enable respectful communication with others.

Rationale

The ability to recognise, interpret and respond to non-verbal cues, to communicate with congruent and respectful non-verbal behaviour, and to be sensitive to individual and/or cultural variations in non-verbal communication is essential for safe and effective care.

Examples

• Recognise cues in a patient’s facial expression, appearance, behaviour, posture, or movement
• Deliver information to a distressed patient incorporating non-verbal behaviour that matches the nature of the information
• Recognise and adjust to differing touch preferences of patients.

Written communication

Inherent requirement

Ability to produce English text to a standard that provides clear and professional-level communication, with language usage and style tailored to the targeted recipients.

Rationale

Effective communication in English text is required to demonstrate applied skills in academic writing conventions and in sustained and organised academic argument and provide safe and effective delivery of care/practice.

Examples

• Communicate complex academic and clinical perspectives in writing
• Summarise and appropriately reference a range of literature in written assignments
• Use precise and appropriate language to contribute to both handwritten and electronic medical records in a time-constrained environment
• Construct reports for third-parties and patient care plans that meet professional standards

This includes visual, auditory and tactile capacity. NB: Care must be taken to not prescribe any sensory ability as an inherent requirement if the student might be able to achieve the desired result with the use of one or more adjustments. Examples include:

• Ability to interact with visual inputs sufficiently to manage learning environments
• Ability to interact with auditory inputs sufficiently to manage learning environments
• Ability to respond to tactile input and provide appropriate tactile interaction

Visual

Inherent requirement

Ability to interact with visual inputs sufficiently to manage learning environments.

Rationale

Elements in the working and learning environment are delivered by visual means, and the ability to learn from or respond to these inputs is required to provide safe and effective practice.

Examples

• Observe and detect subtle changes in a patient’s response to therapeutic procedures e.g. skin colour, muscle tone & strength, joint range of motion.
• Interpret diagnostic images.

Auditory

Inherent requirement

Ability to interact with auditory inputs sufficiently to manage learning environments.

Rationale

Elements in the learning and working environments are delivered by auditory means, and the ability to learn from or respond to these inputs is required to provide safe and effective practice.

Examples

• Detect and discriminate changes in blood pressure sounds, pain sounds and breathing sounds
• Accurately undertake blood pressure measurements by auscultation
• Detect and discriminate alarms, emergency calls over PA systems, and urgent verbal information for patient care
• Follow developing discussions with colleagues for patient care decisions.

Tactile

Inherent requirement

Ability to respond to tactile input and provide tactile interaction.

Rationale

Elements in the learning and working environment are detected and measured by tactile means, and the ability to learn from or respond to these inputs is required to provide safe and effective practice. The appropriate use of touch as a part of effective patient care is also required. 

Examples

• Detect changes in circulation e.g. temperature of extremities, palpable pulses
• Conduct a physical assessment and detect any anatomical or physiological abnormalities
• Detect changes in skin, muscle tone and joint range of motion
• Provide patient care through appropriate chiropractic manual techniques and reassuring touch

This includes both gross and fine motor ability. NB: Care must be taken to not prescribe any motor ability as an inherent requirement if the student might be able to achieve the desired result with the use of one or more adjustments. Examples include:

• Strength, range of motion, coordination and mobility sufficient to meet the requirements of the study, including placements included in the course
• Manual dexterity and fine motor skills sufficient to meet the requirements of the study, including placements included in the course

Gross motor ability

Inherent requirement

Strength, range of motion, coordination and mobility.

Rationale

A wide range of physical patient care actions in a time-constrained environment is required to provide safe and effective practice.

Examples

• Effectively ascertain patient information from percussion and palpation of a patient's body parts
• Efficiently undertake a physical examination of patient, including assessment of range of motion, motor strength and reflexes
• Instigate and contribute to emergency life support
• Move readily around patients, assist patients moving onto treatment table and changing positions
• Maintain balance and safely assist patient transfers and walking.

Fine motor ability

Inherent requirement

Manual dexterity and fine motor skills.

Rationale

A wide range of fine-motor manual tasks in a time-constrained environment are required to provide safe and effective practice. 

Examples

• Undertake physical and neurological examinations, noting subtle changes in motor tone, motor strength or reflexes
• Contribute to both handwritten and electronic medical records.

Inherent requirement

This includes a person's ability to sustain their performance in a given activity or series of activities over time. Care must be taken to not prescribe sustained performance in a way that allows no room for temporary changes to performance levels due to illness or other factors.

Examples include: Ability to sustain a working posture, associated manual tasks, cognitive engagement, performance level and emotional control for the full duration of any task required as part of the course or any placement

Rationale

A range of complex, multi-component or extended patient care tasks carried out over a period of time and in a time-constrained environments is required to provide safe and effective practice. 

Examples

• Sustain study practices and clinical performance to sufficiently engage with the learning workload for a study period, and for the degree, within a constrained time-frame
• Sustain a working posture, associated manual tasks, cognitive engagement, performance level and emotional control for the full duration of a patient care process e.g. undertaking manual chiropractic treatment on patients with acutely painful conditions
• Sustain performance for durations that are manageable within overall shift-planning for patient care.

Inherent requirement

This includes the personal flexibility and resilience required to adapt behaviour to different situations, even when they are stressful or difficult. NB: Care must be taken to allow room in the inherent requirements for the individual to demonstrate behavioural adaptability through withdrawing from activities for a time to undertake medical interventions and self-care measures. Examples include:

• Ability to adjust ways of working to work within teams of varied personal and professional backgrounds
• Being receptive and responding appropriately to constructive feedback
• Maintaining respectful communication practices in times of increased stressors or workloads
• Adjusting to changing circumstances in a way that allows self-care

Rationale

Behavioural adaptation is required to manage personal emotional responses as an individual and within teams in changing and unpredictable environments, including emergency situations and times of human distress. Students will also be required to adapt their behaviour appropriately during times of additional stressors in their own lives, whether this adaptation involves ways of continuing to engage with their role or withdrawing for self-care for a period. 

Examples

• Adjust ways of working within teams of varied personal and professional backgrounds and clinical opinions to facilitate effective patient decisions
• Work effectively and collegially with other students in group projects and presentations
• Work effectively and collegially with other professionals in the team based care of patients
• Cope with own emotions and behaviour effectively when dealing with changing responses of individuals and families in the clinical setting
• Be receptive and respond appropriately to constructive feedback
• Maintain respectful communication practices in times of increased stressors or workloads
• Adjust to changing circumstances in a way that allows self-care while maintaining a professional-level focus on the patient.