Development of performance indicators for manual therapy skills of chiropractic students entering senior internship: A modified Delphi study at a single institution
- 1Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
Abstract
Objective: In recent years, health sciences education has increasingly adopted competency-based frameworks to ensure graduates demonstrate the practical skills and professional behaviors required for safe and effective practice. This study aimed to identify performance indicators using a modified Delphi method to establish a program-specific expert consensus on the competencies that junior chiropractic interns are expected to demonstrate prior to their senior internship.
Methods: A modified Delphi method was conducted between June and November 2023 to achieve expert consensus among four stakeholder groups (junior interns, senior interns, recent graduates, and clinical supervisors) within a single chiropractic institution. An initial list of 124 indicators was developed by a multidisciplinary research team. Three iterative rounds of anonymous online surveys were used to rate, comment on, and refine performance indicators.
Results: Between 26 and 30 experts participated in each round. Upon completion of the three rounds, a final list of 124 indicators was retained. Of these, 103 were perceived as generally achieved by the end of the junior internship, whereas 21 did not reach consensus. Among the latter, seven were identified as critically important for guiding future pedagogical strategies. The indicators encompassed psychomotor and transversal competencies, including control of force, speed, and amplitude in manual therapy, as well as patient communication and professionalism.
Conclusions: This consensus-based framework proposes a structured set of performance indicators that may support the assessment of junior interns’ readiness for increased clinical autonomy while maintaining patient safety. It also identifies priority areas for curriculum development.
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BibTeX
@article{cyr2026development,
title = {{Development of performance indicators for manual therapy skills of chiropractic students entering senior internship: A modified Delphi study at a single institution}},
author = {Hubert Cyr and Danica Brousseau and Sébastien Robidoux and Chantale Doucet and Jade Gagnon and François Perron and Isabelle Pagé},
journal = {The Journal of Chiropractic Education},
year = {2026},
month = oct,
doi = {10.7899/jce-26-4},
url = {https://doi.org/10.7899/jce-26-4},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Development of performance indicators for manual therapy skills of chiropractic students entering senior internship: A modified Delphi study at a single institution
AU - Hubert Cyr
AU - Danica Brousseau
AU - Sébastien Robidoux
AU - Chantale Doucet
AU - Jade Gagnon
AU - François Perron
AU - Isabelle Pagé
PY - 2026
DA - 2026/10/27
JO - The Journal of Chiropractic Education
DO - 10.7899/jce-26-4
UR - https://doi.org/10.7899/jce-26-4
AB - Objective: In recent years, health sciences education has increasingly adopted competency-based frameworks to ensure graduates demonstrate the practical skills and professional behaviors required for safe and effective practice. This study aimed to identify performance indicators using a modified Delphi method to establish a program-specific expert consensus on the competencies that junior chiropractic interns are expected to demonstrate prior to their senior internship. Methods: A modified Delphi method was conducted between June and November 2023 to achieve expert consensus among four stakeholder groups (junior interns, senior interns, recent graduates, and clinical supervisors) within a single chiropractic institution. An initial list of 124 indicators was developed by a multidisciplinary research team. Three iterative rounds of anonymous online surveys were used to rate, comment on, and refine performance indicators. Results: Between 26 and 30 experts participated in each round. Upon completion of the three rounds, a final list of 124 indicators was retained. Of these, 103 were perceived as generally achieved by the end of the junior internship, whereas 21 did not reach consensus. Among the latter, seven were identified as critically important for guiding future pedagogical strategies. The indicators encompassed psychomotor and transversal competencies, including control of force, speed, and amplitude in manual therapy, as well as patient communication and professionalism. Conclusions: This consensus-based framework proposes a structured set of performance indicators that may support the assessment of junior interns’ readiness for increased clinical autonomy while maintaining patient safety. It also identifies priority areas for curriculum development.
SN - 1042-5055
SN - 2374-250X
ER -