continuing education has finally teamed up with the
Internet. While the CE credits from Internet-based
courses aren’t yet fully accepted by all state
boards, this trend has all the ingredients needed
to substantially change the world of continuing education
the end of a typical day, Dr. Randall Miller bids
goodbye to the last patient of the evening and, after
locking the door, heads back to his Chehalis, Wash.,
home. After dinner he settles in front of his computer,
dials up an Internet connection, and logs onto the
web site of ChiroCredit.com.
seconds the vivid picture of a knee appears on the
screen. With a click of his mouse he begins to peel
away muscles and nerves, displaying each layer in
turn. The images of human anatomy are as close as
you can get to the real thing—without the benefit
of scalpels, scrubs and formaldehyde. For many doctors
in need of continuing education for re-licensure it’s
also better than sitting in a darkened auditorium
watching overhead slides while an instructor drones
on about anatomy or pathology.
can get more out of this than I do at the seminars,”
says Miller, who has practiced in his community of
20,000 for the last 15 years. During that time he
has always closed down his practice and climbed in
his car for the 90-mile drive to Seattle and a class
mandated by the state board.
trips ended last year when he learned about ChiroCredit
and their online chiropractic education program. He
was delighted to learn that his state allows doctors
to earn all of their yearly credits in cyberspace.
growing number of DCs have joined Miller in Internet-based
continuing education. The trend is just beginning,
as several chiropractic colleges and a smattering
of private companies deliver courses in anatomy, radiology,
philosophy and a host of other topics.
mainstream academia—along with corporate trainers—jumped
on the e-education bandwagon years ago, chiropractic
has only recently adopted the technology. In many
cases, state licensing boards were reluctant to accept
credit for online learning, and those that now do—32
states so far—have created a hodgepodge of regulations.
the state of Washington, you can earn all 25 of your
required yearly credits online. In Virginia, on the
other hand, Internet courses are classified as Type
II credits—and can count for up to half of the
60 hours required every two years. In contrast to
the Type I credits, which must be from hands-on seminars,
Type II credits can include anything from online seminars
to watching a video to chatting with another doctor
about HIO. If you live in California, forget it. The
Golden State doesn’t accept any online CEUs.
boards question how online education can be of the
same quality as face-to-face sessions. To combat that
concern, online course providers have created technological
tools that not only encourage participation, but,
in many cases, require it.
they’re in their (online) class it’s almost
more interactive than a live seminar where doctors
are able to kick back and just listen,” says
Dr. Laurie Hogard, director of continuing education
with the Palmer Institute for Professional Advancement.
contends that, unlike live classes that only verify
attendance, online programs require active participation.
doctor has to work his way through the different elements
of each unit in order to complete the class,”
she explains. “So the doctor is being actively
engaged, working through the material and assignments
and answering questions that are posed to him. When
live chats are scheduled, doctors are having structured
discourse with other members in the class.”
material is divided into small timed units called
modules. The student has to spend a minimum amount
of time in each module before passing a multiple choice
test, qualifying him to move on to the next section.
of the concerns that we’ve encountered in dealing
with the various state licensing boards has been the
issue of how do we know that the doc is actually spending
an hour with the material,” observes Dr. Richard
Saririto, continuing education director at the University
of Bridgeport College of Chiropractic.
which sponsors ChiroCredit’s programs, allayed
those concerns by not only timing the material, but
also by making sure it was of sufficient length and
depth so that the students have to spend the required
amount of time working on it, says Saririto.
of online learning have also had to deal with another
criticism—where’s the give and take of
make up for the lack of human interaction that many
consider necessary for learning, online courses often
facilitate communication between students and instructors.
Nearly all allow the student to send email questions
to the instructor. Some use “threaded”
discussions in which participants can post comments
that can be seen by all students, creating an on-going
discussion that is often moderated by the teacher.
increasingly popular innovation is the chat room that
allows text communication between a group of people
in real time—a sort of virtual hallway conversation.
can go in and ‘speak’ to the instructor
at a set time,” says Dr. Patrece Frisbee, CEO
of TheCEU.com. The Miami-based start-up plans to provide
CE credit not just to DCs, but to other health professionals,
including medical doctors, nurses and massage therapists.
“The instructor will say that Wednesday night
I’ll be available from 8 to 9 p.m. We’ll
send emails to everybody who’s taking the course
and they can go on and ‘speak’ to the
instructor directly,” adds Frisbee.
CEU.com and other providers such as The Palmer Institute
and ChiroCredit do not limit their offerings to online
courses alone. They are following the example of more
traditional educational institutions that realize
that not everything can be taught effectively in cyberspace.
most cases (college and universities) are redesigning
their curriculums to have both in-class and face-to-face
learning in combination with web-based learning,”
says Karen Gage, vice president for marketing with
WebCT, a Lynnfield, Mass.-based provider of online
learning software. “They’re looking at
hybrid models that take advantage of the web to enhance
what they’re already doing.”
of “blended learning” include Palmer’s
Certified Chiropractic Sports Practitioner (CCSP)
program. Formerly an in-person course that required
10 weekends, it has been redesigned to take advantage
of web technology.
the online (programming) we’re able to cut the
course down to five intensive hands-on live weekends,
and put more of the academic material online,”
agree that courses which predominantly use lecture
material can be easily presented online. Those that
require feedback or hands-on practice are another
can’t see it being used for learning a technique,”
says Dr. Margaret Finn, a New York Chiropractic College
faculty member and educational director for BrightCourse,
a private firm that offers online courses in applied
pharmacology and radiology. “You need the feedback
of the patient and the feedback of the instructor,”
concept of distance education is nothing new. A century
ago the nation’s biggest colleges and universities
started offering correspondence courses by mail. Most
failed, but the concept didn’t disappear. In
fact, Thomas Edison State College in New Jersey was
founded as an exclusively distance learning institution,
first using video and mail, and now the Internet.
of its most popular programs is a degree program for
nurses that shows just how accepting of the new technology
the rest of healthcare has become. According to associate
dean and director Dr. Susan O’Brien, “I
can actually graduate a student that I’ve never
virtually every profession—from doctors and
lawyers to architects and engineers—offers online
learning to its members. The big question for the
critics is how good is it, really? Can professionals
actually learn the skills needed to keep them up-to-date
within their specialty?
Finn says they can. She divided a class into three
segments. One group took the traditional classroom
approach, while another did video teleconferencing.
The remaining students were enrolled in an online
version of the same program.
gave them the same exam,” she says. “Even
though they had different delivery systems, they all
had the same grades.”
limited experiment parallels those of other research
studies that found that students in online courses
did just as well, and sometimes better, than those
in more traditional classrooms.
Some of those involved in online learning contend
that results are determined by the quality of the
instructor as much as by the medium used.
more a case of learners getting comfortable and teachers
learning how to teach more effectively,” says
Dr. Ed Laydon, manager of the eTeaching Institute
at eCollege, the software provider for Palmer’s
cyber education efforts. “Where you get learners
who really want to learn, and you have really good
teachers who really want to teach, then the technology
is not the issue. The teacher is the one who really
makes the difference.”
fact, he maintains that courses using relatively simple
tools can be quite effective.
you have a nicely organized course with good web links,
good reading material, good threaded discussions groups
with good questions, and a teacher who actively mentors
people, you get rave reviews,” observes Laydon.
infant online learning ventures are finding success
because of the novelty of their offerings and the
ease of their use. Their long-term development will
depend on the quality of their programs as users become
To learn more about online chiropractic
continuing education, log on to these continuing
education sites and learn about the CEUs (continuing
education units) that they can provide for you.
Memorial Chiropractic College
Health Services University
Palmer Institute for Professional Advancement
Copyright 2003 Today's Chiropractic