College of Chiropractic Intern’s Clinic Handbook 2021-2022

15.0 Clinical Requirements for Graduation

Winter 2022 Cohort

Fall 2022 Cohort

Winter 2023 Cohort

15.1 Documentation of Requirements

The following forms must be used to document your clinical quantitative requirements – Monthly Adjustment Record, Diagnostic Imaging Report form, Case Management form and/or Time Log. Faculty clinicians must approve all documents submitted in the eMedley, NWHSU documentation software program and Zoho Analytics. Credit will be given once the documents have been approved by the faculty clinician and reviewed by the Clinical Education Dept.. The following procedure for the transmittal of interns’ monthly paperwork is in affect to meet federal regulations regarding patient privacy. This procedure helps us comply with the Health Information Portability and Accountability Act (HIPAA) regulations to safeguard patient information as we verify student requirements.

 

The electronic procedure for transmitting interns’ monthly paperwork to Clinical Education is through the following platforms:

eMedley

Login to: https://he.emedley.com/univ/he/common/login/login.php

 

Zoho Analytics

Login to: https://analytics.zoho.com/

 

Monthly paperwork must be submitted at the end of each clinic shift. The following are requirements for completing monthly paperwork:

  1. Adjustment Record
    1. Only one intern will receive credit per adjustment. Credit will be given for a limit of 1 spinal and 1 extremity per patient. 
    2. There are no assists allowed in adjustments. In order to receive adjustment credit, the intern must participate in the patient's care enough to establish a true doctor/patient relationship - no credit shall be given solely for observing.
    3. 75 adjustments need to be directly observed by the faculty clinician and the assessment completed in eMedley. Assessed adjustments are only applicable to Fall 2022 grads and prior.
  2. Case Management Form
    1. Clinical examinations are to be recorded on the Case Management form.
    2. The intern needs to submit a Case Management form in eMedley. A Case Management form is completed on a new patient exam or a patient with a new condition. Credit is not allowed for reexaminations. Interns fill in the appropriate exam information using case protocols provided on the form. The date recorded on the form is the date the initial exam was performed. The intern and faculty clinician meet to review the patient file, discuss the case, and the faculty clinician must approve the form in eMedley to receive credit.
    3. Case Managements may be earned through CoC approved activities. Grand Rounds, HPC or Case Management assignments available on Moodle.
  3. Diagnostic Imaging (DxI) Reports
    1. Complete the Diagnostic Imaging Reports using the required form in eMedley or Moodle. Beginning Winter 2022, Dxl reports will be completed through Zoho Forms. DxI Report credit will be earned after review of reports by the NWHSU Radiology Department faculty.

  4. Time Log
    1. Complete a Time Log for all clinic hours earned in eMedley to receive credit.
    2. The Time Log should be completed by the intern on a daily basis. Record TAC time on the Time Log to receive clinic hours when absent from clinic. TAC time taken during the term does not count toward the required 78 (T7) or 300 (T8/9/10) clinic hours. If TAC is used, the intern is responsible for ensuring they will meet the required clinic hours by the end of the term.  TAC time not used during the term will be added as clinic hours at the end of the term.
    3. Interns will not receive clinic hours for University, CBI or T10 Only clinic observed holidays that fall during their contracted time. An exception is made for reaching the minimum weekly required clinic hours on weeks that holidays affect their contractSee section 7.4.3 Clinic Holidays.
    4. Interns receive 1:1 clinic hours for a Rotation Program visit provided this does not interfere with their normal clinic shift. If it does, the intern will receive clinic hours for time spent at the rotation facility, but will not receive time for their missed contracted hours. Rotation hours will be recorded as “Add Other Time” in eMedley and will be approved once the Rotation Assignment is completed in Moodle (Survey Monkey).
    5. Community and University events (see section 7.5 Earning Additional Clinic Hours) pre-approved by Clinical Education should be reported in eMedley as Time Log during the week they occur. This allows Clinical Education to track how many clinic hours interns have earned each week.
    6. Interns are expected to meet the number of weekly clinic hours even though their faculty clinician may be absent. In this instance, please see section 7.5.1 Clinic Hours during Faculty Clinician Absence.
  5. Communication
    1. Clinical Education has one main avenue of communication with interns – NWHSU email. It is the responsibility of every intern to check their email.  When interns are on campus Monday- Thursday, The Clinical Education Department welcomes you to visit Room 12 if you have any questions.
  6. Checkout procedures
    1. Each intern must Checkout at the end of T5, T6, T7, T8, T9 and T10 with Clinical Education.
    2. T5- T8: Interns will be notified near the end of the term (via email) regarding the Checkout process.
    3. T9: If all paperwork is not present or completed accurately, Checkout is not complete. Interns who have not completed clinical requirements by the end of the 9th term will not be allowed to participate in the Preceptorship program outside of the University/CBI program.
    4. Interns will progress to the next term only when Checkout procedures and paperwork have been approved. If all paperwork has not been turned in by the end of the term, students will receive an Incomplete (I) grade. Incomplete grades must be resolved within the first 4 weeks of the next term or the Incomplete will turn into an “F”.
    5. T10: Interns will be required to turn in all assignments, monthly time logs, and evaluations in order to be cleared for graduation.
  7. General

    Any Monthly Adjustment Record, Case Management, and Diagnostic Imaging Report forms not completed in its entirety, or completed incorrectly, will be returned as “Denied” in eMedley/DxI program. No credit will be issued until the form has been completed correctly, re-submitted and approved by the faculty clinician/NWHSU Radiology Faculty.  All forms must be reviewed by Clinical Education/NWHSU Faculty for official credit to be given.

It is the intern’s responsibility to resolve problems related to their requirements by contacting Clinical Education or Dr. Chris Major, The Diagnostic Imaging Dept. Chair for Dxl specific inquiries. Students should check Moodle – Grades to review their quantitative requirement standing or eMedley – eClas – Reports – NWHSU Accumulation Report.

It must be emphasized that patient care and clinical experience should be the primary objective of the intern.  Meeting quantitative requirements is one set of evaluative guidelines.  Clinical competence, confidence, and professionalism are other essential factors in the training of a future Doctor of Chiropractic at Northwestern Health Sciences University.

Winter 2022 Graduation Requirements

During clinic service the intern must meet a number of specific performance requirements prior to graduation. These requirements have been established by NWHSU College of Chiropractic and satisfy the graduation requirement guidelines established by the Council on Chiropractic Education (CCE) and most state statutes where there is state legislation concerning clinic experience requirements. Interns are encouraged to check the requirements for any states they plan to acquire a licensure to ensure they complete any requirements beyond those required by NWHSU.

 

For students entering Clinical Internship 1 prior to the Fall 2021 term:

The outpatient clinic experience requirements identified below are minimum quantitative requirements.

  1. Complete the Northwestern Integrated Competency Exam 2 (NICE 2)
  2. Perform a minimum of two hundred fifty (250) chiropractic adjustments/manipulations, of which at least two hundred (200) must be spinal, occurring during at least two hundred fifty (250) separate patient care visits. Students may begin accumulating chiropractic adjustments/manipulations for this requirement during the Clinical Internship 1 course.
  3. Perform a minimum of seventy-five (75) adjustments that are directly supervised and assessed by their supervising clinician.
  4. Interpret a minimum of twenty (20) diagnostic imaging studies.
  5. Perform at least forty (40) clinical case management activities. These may come from participating in clinical care during the internship, case studies discussed during approved course work or grand rounds sessions, or through simulated cases provided by Clinical Education. examinations with case history for the purpose of developing a diagnostic or clinical impression of the status of the patient relative to chiropractic care. To qualify, the case must include an appropriate history and examination aimed at providing the necessary information need to arrive at a clinical impression/working diagnosis; development of a clinically-appropriate, evidence-informed management plan; inclusion of appropriate referral for additional tests or adjunctive care; and discussion of any needed revisions to the care plan over time and the need to continue/discontinue care at the conclusion of the care plan.
  6. Accumulate the minimum number of clinic hours for Clinical Internship 2 (T7), 3 (T8), 4 (T9), and 5 (T10). The number of weeks in a term may vary.
 

T7: 6 clinic hours/week, for a minimum total of 78 hours 

T8: 18 clinic hours/week plus rotation hours, for a minimum total of 300 hours

T9: 21 clinic hours/week plus rotation hours, for a minimum total of 300 hours

T10: 25 clinic hours/week, for a minimum total of 300 hours

 

During T7-10, interns receive credit for services administered to clinic patients except for their own family members. Credit will be issued accordingly.

Adherence to all of these requirements plus completion of all didactic courses, all Clinical Internship Assignments, Student Internship Agreements, Clinical Rotation Assignments and Clinic Intern Handbook/Orientation Quizzes will qualify each intern for graduation.

 

Quantitative Requirements

(must be completed before you can participate in the Preceptorship Program)

Adjustments 250 No more than 1 spinal and 1 extremity per patient (must be documented in the patient treatment plan). Minimum of 200 must be spinal.
Assessed adjustments 75
Case Managements 40
Diagnostic Imaging Reports (DxI) 20
Clinic Hours T7 78 6-8 minimum each wk (no carry-over)
Clinic Hours T8 (primary site & rotations) 300 18-21 minimum each wk (no carry-over)
Clinic Hours T9 (primary site & rotations) 300 21-25 minimum each wk (no carry-over)
Clinic Hours T10 300 25-40 minimum each wk

Certifications on Record

BLS Current copy of certificate on file each term
HIPAA Training Online training certification
Background Check Completed prior to beginning clinical experience

Submitting documentation:

All forms must be submitted in eMedley or Zoho. The Faculty Clinician must approve each form and the Department of Clinical Education will do a final review before credit will be given.

Any questions contact: Ally Gellatly at 952-467-8852 or email agellatly@nwhealth.edu.

Time Log Approved by Faculty Clinician
Monthly Adjustment Record (MAR) Assessments completed and Adjustments Approved by Faculty Clinician
Case Management Forms Approved by Faculty Clinician
Diagnostic Imaging Report Form Available in Zoho for T8 -T10, Submit to Radiology Dept. Chair

Additional paperwork that needs to be completed and returned during the term.

Clinical Orientation Assignment This form is completed within the first two weeks of the term. You and your faculty clinician will meet to complete the form.
X-ray Tech Orientation Form This form is completed if you are at a CBI clinic only. The intern and faculty clinician/x-ray certified CA review each item and complete the form.
Midterm Evaluation This is completed during your midterm meeting between you and the faculty clinician. This must be submitted by the due date listed on the form.
Self-Assessment This form is to be completed in ExamSoft. There will be a set open and close date for the evaluation. Interns must meet the deadline.
Clinical Internship Experience Evaluation This form is to be completed in a Survey Monkey web link in Moodle at the end of the term.

Points to remember

T7 - T9: Clinic placement assignments are made through a placement process.
T10: You are responsible for locating your own preceptorship, using the Dept. of Clinical Education and eMedley as a resource.

 


Fall 2022 Graduation Requirements

During clinic service the intern must meet a number of specific performance requirements prior to graduation. These requirements have been established by NWHSU College of Chiropractic and satisfy the graduation requirement guidelines established by the Council on Chiropractic Education (CCE) and most state statutes where there is state legislation concerning clinic experience requirements. Interns are encouraged to check the requirements for any states they plan to acquire a licensure to ensure they complete any requirements beyond those required by NWHSU.

 

For students entering Clinical Internship 1 prior to the Fall 2021 term:

The outpatient clinic experience requirements identified below are minimum quantitative requirements.

  1. Complete the Northwestern Integrated Competency Exam 2 (NICE 2)
  2. Perform a minimum of two hundred fifty (250) chiropractic adjustments/manipulations, of which at least two hundred (200) must be spinal, occurring during at least two hundred fifty (250) separate patient care visits. Students may begin accumulating chiropractic adjustments/manipulations for this requirement during the Clinical Internship 1 course.
  3. Perform a minimum of seventy-five (75) adjustments that are directly supervised and assessed by their supervising clinician.
  4. Interpret a minimum of twenty (20) diagnostic imaging studies.
  5. Perform at least forty (40) clinical case management activities. These may come from participating in clinical care during the internship, case studies discussed during approved course work or grand rounds sessions, or through simulated cases provided by Clinical Education. examinations with case history for the purpose of developing a diagnostic or clinical impression of the status of the patient relative to chiropractic care. To qualify, the case must include an appropriate history and examination aimed at providing the necessary information need to arrive at a clinical impression/working diagnosis; development of a clinically-appropriate, evidence-informed management plan; inclusion of appropriate referral for additional tests or adjunctive care; and discussion of any needed revisions to the care plan over time and the need to continue/discontinue care at the conclusion of the care plan.
  6. Accumulate the minimum number of clinic hours for Clinical Internship 2 (T7), 3 (T8), 4 (T9), and 5 (T10). The number of weeks in a term may vary.
 

T7: 6 clinic hours/week, for a minimum total of 78 hours 

T8: 18 clinic hours/week plus rotation hours, for a minimum total of 300 hours

T9: 21 clinic hours/week plus rotation hours, for a minimum total of 300 hours

T10: 25 clinic hours/week, for a minimum total of 300 hours

 

During T7-10, interns receive credit for services administered to clinic patients except for their own family members. Credit will be issued accordingly.

Adherence to all of these requirements plus completion of all didactic courses, all Clinical Internship Assignments, Student Internship Agreements, Clinical Rotation Assignments and Clinic Intern Handbook/Orientation Quizzes will qualify each intern for graduation.

 

Quantitative Requirements

(must be completed before you can participate in the Preceptorship Program)

Adjustments 250 No more than 1 spinal and 1 extremity per patient (must be documented in the patient treatment plan). Minimum of 200 must be spinal.
Assessed adjustments 75
Case Managements 40
Diagnostic Imaging Reports (DxI) 20
Clinic Hours T7 78 6-8 minimum each wk (no carry-over)
Clinic Hours T8 (primary site & rotations) 300 18-21 minimum each wk (no carry-over)
Clinic Hours T9 (primary site & rotations) 300 21-25 minimum each wk (no carry-over)
Clinic Hours T10 300 25-40 minimum each wk

Certifications on Record

BLS Current copy of certificate on file each term
HIPAA Training Online training certification
Background Check Completed prior to beginning clinical experience

Submitting documentation:

All forms must be submitted in eMedley or Zoho. The Faculty Clinician must approve each form and the Department of Clinical Education will do a final review before credit will be given.

Any questions contact: Ally Gellatly at 952-467-8852 or email agellatly@nwhealth.edu.

Time Log Approved by Faculty Clinician
Monthly Adjustment Record (MAR) Assessments completed and Adjustments Approved by Faculty Clinician
Case Management Forms Approved by Faculty Clinician
Diagnostic Imaging Report Form Available in Zoho for T8 -T10, Submit to Radiology Dept. Chair

Additional paperwork that needs to be completed and returned during the term.

Clinical Orientation Assignment This form is completed within the first two weeks of the term. You and your faculty clinician will meet to complete the form.
X-ray Tech Orientation Form This form is completed if you are at a CBI clinic only. The intern and faculty clinician/x-ray certified CA review each item and complete the form.
Midterm Evaluation This is completed during your midterm meeting between you and the faculty clinician. This must be submitted by the due date listed on the form.
Self-Assessment This form is to be completed in ExamSoft. There will be a set open and close date for the evaluation. Interns must meet the deadline.
Clinical Internship Experience Evaluation This form is to be completed in a Survey Monkey web link in Moodle at the end of the term.

Points to remember

T7 - T9: Clinic placement assignments are made through a placement process.
T10: You are responsible for locating your own preceptorship, using the Dept. of Clinical Education and eMedley as a resource.

Winter 2023 Graduation Requirements

During clinic service the intern must meet a number of specific performance requirements prior to graduation. These requirements have been established by NWHSU College of Chiropractic and satisfy the graduation requirement guidelines established by the Council on Chiropractic Education (CCE) and most state statutes where there is state legislation concerning clinic experience requirements. Interns are encouraged to check the requirements for any states they plan to acquire a licensure to ensure they complete any requirements beyond those required by NWHSU.

 

For students entering Clinical Internship 1 Fall 2021 term and after:

 

The outpatient clinic experience requirements identified below are minimum quantitative and qualitative requirements.

  1. You are required to demonstrate competency in each CCE competency area prior to graduating. Clinical skills competency is measured through a combination of Skill-CEX, Mini-CEX, and Summary-CEX assessment tools; didactic coursework; and co-curricular activities. Competency is defined as having an average rating over the most recent three assessments of 4.0+ on the 5-point rating scale. Intern Competency Dashboards are available to interns and supervisors directly through Zoho and are updated regularly with the latest assessment data collected.

    T6 – At least 7 Skills-CEX– Interns will be assessed by their clinical supervisor during their clinical lab as part of Clinical Internship 1. The schedule of competency assessments is laid out in the course schedule and lab manual. Intern Competency Dashboards are directly available to both supervisors and interns. Interns are responsible for tracking their completion of the required assessments.

    T7 – At least 10 Skills-CEX – Interns will be assessed by their clinical supervisor during their clinic shift using one of the Skill-CEX assessments that focuses on a particular area of clinical skills. Interns should aim to be assessed once per week, but must get at least 10 during the course of the term. There are several different Skill-CEX assessments, and interns should be assessed using each of them, ideally more than once. Intern Competency Dashboards are directly available to both supervisors and interns. Interns are responsible for tracking their completion of the required assessments.

    T8-T10 – At least 10 Mini-CEX (or Skills-CEX) plus mid-term and end-of-term Summary-CEX– Interns will be assessed by their clinical supervisor during their clinic shift using the Mini-CEX (or Skills-CEX) in addition to a Summary-CEX assessment at both the middle and end of the term. Interns should aim to be assessed once per week, but must get at least 10 during the course of each term. [Students on T10 preceptorship have already met graduation requirements and do not need to meet the minimum of 10 Mini-CEX, but will need a mid-term and end-of-term Summary-CEX.] Intern Competency Dashboards are directly available to both supervisors and interns. Interns are responsible for tracking their completion of the required assessments.

  2. Complete the Northwestern Integrated Competency Exam 2 (NICE 2)
  3. Perform a minimum of two hundred fifty (250) chiropractic adjustments/manipulations, of which at least two hundred (200) must be spinal, occurring during at least two hundred fifty (250) separate patient care visits. Students may begin accumulating chiropractic adjustments/manipulations for this requirement during the Clinical Internship 1 course.
  4. Interpret a minimum of twenty (20) diagnostic imaging studies.
  5. Perform at least forty (40) clinical case management activities. These may come from participating in clinical care during the internship, case studies discussed during approved course work or grand rounds sessions, or through simulated cases provided by Clinical Education. examinations with case history for the purpose of developing a diagnostic or clinical impression of the status of the patient relative to chiropractic care. To qualify, the case must include an appropriate history and examination aimed at providing the necessary information need to arrive at a clinical impression/working diagnosis; development of a clinically-appropriate, evidence-informed management plan; inclusion of appropriate referral for additional tests or adjunctive care; and discussion of any needed revisions to the care plan over time and the need to continue/discontinue care at the conclusion of the care plan.
  6. Accumulate the minimum number of clinic hours for Clinical Internship 2 (T7), 3 (T8), 4 (T9), and 5 (T10). The number of weeks in a term may vary.

T7: 6 clinic hours/week, for a minimum total of 78 hours

T8: 18 clinic hours/week plus rotation hours, for a minimum total of 300 hours

T9: 21 clinic hours/week plus rotation hours, for a minimum total of 300 hours

T10: 25 clinic hours/week, for a minimum total of 300 hours

During T7-10, interns receive credit for services administered to clinic patients except for their own family members. Credit will be issued accordingly.

Adherence to all of these requirements plus completion of all didactic courses, all Clinical Internship Assignments, Student Internship Agreements, Clinical Rotation Assignments and Clinic Intern Handbook/Orientation Quizzes will qualify each intern for graduation.

 

Quantitative Requirements

(must be completed before you can participate in the Preceptorship Program)

Adjustments 250 No more than 1 spinal and 1 extremity per patient (must be documented in the patient treatment plan). Minimum of 200 must be spinal.
Case Managements 40
Diagnostic Imaging Reports (DxI) 20
Clinic Hours T7 78 6-8 minimum each wk (no carry-over)
Clinic Hours T8 (primary site & rotations) 300 18-21 minimum each wk (no carry-over)
Clinic Hours T9 (primary site & rotations) 300 21-25 minimum each wk (no carry-over)
Clinic Hours T10 300 25-40 minimum each wk

Certifications on Record

BLS Current copy of certificate on file each term
HIPAA Training Online training certification
Background Check Completed prior to beginning clinical experience

Submitting documentation:

All forms must be submitted in eMedley or Zoho. The Faculty Clinician must approve each form and the Department of Clinical Education will do a final review before credit will be given.

Any questions contact: Ally Gellatly at 952-467-8852 or email agellatly@nwhealth.edu.

Time Log Approved by Faculty Clinician
Monthly Adjustment Record (MAR) Assessments completed and Adjustments Approved by Faculty Clinician
Case Management Forms Approved by Faculty Clinician
Diagnostic Imaging Report Form Available in Zoho for T8 -T10, Submit to Radiology Dept. Chair

Additional paperwork that needs to be completed and returned during the term.

Clinical Orientation Assignment This form is completed within the first two weeks of the term. You and your faculty clinician will meet to complete the form.
X-ray Tech Orientation Form This form is completed if you are at a CBI clinic only. The intern and faculty clinician/x-ray certified CA review each item and complete the form.
Midterm Evaluation This is completed during your midterm meeting between you and the faculty clinician. This must be submitted by the due date listed on the form.
Self-Assessment This form is to be completed in ExamSoft. There will be a set open and close date for the evaluation. Interns must meet the deadline.
Clinical Internship Experience Evaluation This form is to be completed in a Survey Monkey web link in Moodle at the end of the term.

Points to remember

T7 - T9: Clinic placement assignments are made through a placement process.
T10: You are responsible for locating your own preceptorship, using the Dept. of Clinical Education and eMedley as a resource.