LACC Changes Entrance Requirements, Adds Advantage Program

The Council of Chiropractic Education (CCE) has established that a student enrolling in one of its accredited chiropractic colleges must have completed a minimum of 60 semester units.

The Los Angeles College of Chiropractic (LACC) has opted to raise the number of academic units required for entrance into the college, starting with the admission of the class of September 1991. The number of units required will change from 60 to 75 semester units (113 quarter units). LACC plans to eventually raise the requirement to 90 semester units (135 quarter units).

The change is part of an overall restructuring plan at LACC, with the school changing its focus from a "subject driven" curriculum to a "competency driven" one with the introduction of its new Advantage program.

The Advantage program emphasizes hands-on learning, in tandem with small group "problem solving" tutorials. Every Wednesday, first term students at LACC meet in groups of eight to ten with a faculty tutor to discuss a simulated case. Through active group participation, and discussion with the faculty member, the students work toward an explanation of the hypothetical patient's problem.

At the end of this two-hour tutorial session the students begin a self-directed study period, dividing group learning goals among themselves, using the rest of the week to investigate hypotheses. They are required to do extensive research, consult various resources, and take copious notes. Afterward, the group assembles to critique initial theories, elaborate on earlier discussions, and synthesize newly acquired knowledge.

The exploration of patient problems, and the subsequent research helps students to integrate their knowledge of the basic and clinical sciences essential to the practice of chiropractic.

The development of the Advantage program has led to the following curriculum changes:

1. Pathology lab: clinical cases are presented to tie the clinical experience to the disease processes.

    

2. Anatomy lab: radiographs are integrated with cadaver dissection and enhanced by a video monitoring system.

    

3. Histology lab: a video microscope projection system produces a tissue slide presentation which involves all students in group viewing and discussions.

LACC has hired new faculty, upgraded current faculty salaries, and purchased new instructional equipment. In addition, the school has hired educational consultant Shelley Bartenstein, Ph.D., to assist the faculty and administration. Dr. Bartenstein has extensive experience in professional health education, instructional design, and curriculum development. LACC has consulted other professionals from the University of Southern California, University of Newcastle (Australia), and Harvard University regarding the curriculum and faculty development process.

A tutorial demonstration of the Advantage program was presented to the LACC Board of Regents at their annual meeting held at Le Meridien Hotel in Newport Beach, California on November 17-18. An introduction to the new program, and the concept of problem based tutorials were presented by Drs. John Beckman, vice-president for Academic Affairs; Alan Adams, vice-president for Chiropractic Education; and Gary Miller, dean of Academic Affairs.

Seven first-term LACC student volunteers demonstrated the actual processes of the problem-based learning tutorial session with faculty member Dr. Keith Wells, associate professor and chairman of the Faculty Senate. The one-hour session was a modified representation of the four hours an actual Advantage program session takes.

Following the demonstration, Dr. Daryl Smith, associate professor of Education & Psychology at the Claremont Graduate School, spoke on the assessment of educational outcomes, reporting that, "This effort (the Advantage program) makes LACC a model for professional schools."

Chiropractic Competencies

Every program of professional studies should be for the purpose of providing the quality of education that enables its graduates to be skilled and caring practitioners. LACC's answer to this challenge is met by the Advantage program's competency-based approach to professional education.

LACC faculty began work on the "competency based" approach in 1983, with a document that identified qualities of an LACC graduate. The faculty members developed 2,000 objectives for the new approach, as well as diagnostic and care management protocols. The protocols assist students in approaching diagnosis and management of clinical cases in clinical and preclinical settings.

LACC conducted research to identify 50 priority clinical conditions, which will serve as reference for the development of clinical cases. Studying these clinical conditions will ensure that the graduate is proficient in a wide range of standard health conditions.

LACC faculty member Emile Goubran, M.D., Ph.D., said of the Advantage program in her article, "The Advantage Program -- Coping with Curriculum Change, a Faculty Perspective": "The program's main focus is providing an environment that encourages the students to become competent doctors, by teaching them to become self-directed, lifelong learners."

The Advantage program is designed to fully integrate chiropractic competencies into each of the 10 trimesters of instruction. The curriculum is based upon these competencies (e.g. history taking, physical examination) -- not upon the subject matter (e.g. anatomy, physiology, biochemistry) which traditionally does not include applications to clinical cases. As a result, by focusing on competencies instead of subject matter, clinical learning activities occur from the beginning.

Dean of Academic Affairs Dr. Gary Miller is confident that the new competency based-program of chiropractic education will be highly successful in meeting the challenge of health care delivery in the '90s and beyond.