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.

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.
Complete the Northwestern Integrated Competency Exam 2 (NICE 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.
Interpret a minimum of twenty (20) diagnostic imaging studies.
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.
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.