College of Chiropractic Intern’s Clinic Handbook

14.0 Clinical Quantitative Requirements for Graduation

During clinic service the intern must meet a number of specific performance requirements prior to graduation. These requirements have been established by Northwestern College of Chiropractic and satisfy the graduation requirement guidelines established by the Council on Chiropractic Education (CCE) and most specific state statutes where there is state legislation concerning clinic experience requirements.

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

  1. Complete the Northwestern Integrated Competency Exam (NICE) – NICE 2 & NICE 3
  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. Authorized chiropractic adjustments will carry over from the UHS/DeRusha Clinic.
  3. Perform a minimum of seventy-five (75) adjustments that are directly supervised and assessed by the faculty clinician.
  4. Perform at least twenty (20) x-ray techs.
  5. Perform and interpret, order and interpret, or interpret at least twenty-two (22) area radiographic (diagnostic imaging) examinations with written reports of findings.
  6. Perform at least forty (40) clinical 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 examination must include an appropriate history and examination. Order, perform, and integrate the data for case management and follow-up from appropriate services.
  7. Accumulate the minimum number of clinic hours for Clinical Internship 2 (T7), 3 (T8), and 4 (T9). The number of weeks in a term may vary.

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

T8: 18 clinic hours/week, added with rotation and TAC hours, for a minimum total of 300 hours

T9: 21 clinic hours/week, added with rotation and TAC hours, for a minimum total of 300 hours

T10: 25 clinic hours/week, added with TAC hours, 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 Assignments, Student Internship Agreements, Clinical Rotation Assignments and Clinic Intern Handbook/Orientation Quizzes will qualify each intern for T10 Preceptorship.

14.1 Documentation of Requirements

The following forms must be used to document your clinical quantitative requirements – Monthly Adjustment Record, X-ray Studies form, Case Management form and/or Time Log. Faculty clinicians must approve all documents submitted in the eMedley, NWHSU documentation software program. Credit will be given once the documents have been approved by the faculty clinician and reviewed by the Senior Program Coordinator in the Dept of Clinical Education. 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:

eMedley – the NWHSU Documentation Software Program

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

Monthly paperwork must be submitted at the end of each clinic shift.

Following are requirements for completing monthly paperwork:

  1. Adjustment Record
    1. Only one intern will receive credit per adjustment. Credit will be given for one adjustment per patient per visit.
    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.
  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 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. X-Ray Studies
    1. Complete the X-ray Studies form in eMedley. X-ray tech and report credit are recorded on the X-ray Studies form. The intern and faculty clinician meet to discuss the form. The faculty clinician must approve the form in eMedley to receive credit.

      Only the views for which the intern is taking credit should be listed.

    2. The tech and report columns on the X-ray Studies form must be filled-in accurately by adding a check in the appropriate box(es).
    3. X-rays must be diagnostic to receive credit:
      • When x-rays are non-diagnostic, for any reason, an intern may take credit for only the original set or the repeat set, but not both.
      • The standard views must be contained in each series to receive credit.
    4. Interns may receive tech credit for taking x-rays in an approved CBI clinic other than their primary site. You must complete an X-ray Validation form provided by Clinical Education to show an orientation was received and to earn clinic hours at the office you obtain additional x-ray credit. The faculty clinician must sign the form and approve the X-ray Studies form and Time Logs in eMedley to receive tech credit and clinic hours.
  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 count toward the required 78 (T7) or 300 (T8/9/10) clinic hours. TAC time not used during the term will be added as clinic hours at the end of the term.
    3. Interns will receive 1:1 clinic hours for each of the four major holidays that fall during the contracted hours that particular term. This includes Memorial Day, Independence Day, Thanksgiving Day, and Christmas Day.
    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 6.5 Earning Additional Clinic Hours) pre-approved by Clinical Education should be reported in eMedley 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 6.5.1 Clinic Hours during Faculty Clinician Absence.
  5. Communication
    1. Clinical Education has one main avenue of communication with interns – NWHSU email. You are always invited to stop by Clinical Education in Room 12 if you have any questions.
    2. It is the responsibility of every intern to check their email each time they are on campus.
  6. Checkout procedures
    1. Each intern must Checkout at the end of T5, T6, T7, T8, T9 and T10 with the Senior Program Coordinator.
    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 X-ray Studies forms not completed in its entirety, or completed incorrectly, will be returned as “Denied” in eMedley. No credit will be issued until the form has been completed correctly, re-submitted and approved by the faculty clinician. These forms must include date, first name, last name initial and clinic patient number. All forms must be reviewed by Clinical Education for official credit to be given.

It is the intern’s responsibility to resolve problems related to their requirements by contacting Julie Erickson in Clinical Education. Students should check eNorthwestern (eNW) to review their quantitative requirement standing.

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.