Hour 1

• Indicate the immune system’s complexity as it fits into the body’s function
• Give examples of various Interleukins involved in the immunity
• List neurotransmitters, and vasoactive dilators
• Contrast TH1 and TH2 immune cells and apply a working knowledge of their clinical phenotype.

Hour 2

• Discuss signs and symptoms of anaphylaxis and current therapy.
• List the major immune cells responsible for allergic reactions
• Name the major receptor responsible for IgE sensitization, and what cells it is primarily found on.
• Summarize the meaning of WAO.
• List signs and symptoms of a typical allergic response after re-exposure to a sensitized allergen
• List different methods of allergy testing and critique their strengths and weaknesses.
• Give an example of a complicating factor that might skew an IgE(total) test result
• Apply the terms sensitivity and specificity in lab tests
• Categorize who is at risk of allergic sensitization.

Hour 3

• List 1-2 examples of research supporting IgE sensitization prevention.
• List 1-2 examples of factors which may increase risk of IgE sensitization.
• Explain the effect of smoking on IgE
• Have working knowledge of the effect of SO2 on health, and its primary source.
• Describe how and why it Ragweed is fast becoming worse of a problem throughout the US and worldwide.
• Indicate a potential sequela of Rhinoconjunctivitis and why it is meaningful to treat
• Identify and name a treatment backed by clinical evidence for Ragweed allergy and its meaning for natural therapy to be used by non-prescribing practitioners
• Describe a potential problem with medical Sublingual allergy therapy, and then defend it.
• Outline the major allergens in Ragweed.
• Give an example of co-sensitivity
• Define Pan allergen and give an example

Hour 1

• List the cells where histamine is predominantly found.
• Describe the role of the Mast Cell.
• Explain histamine’s function and recall what causes its release.
• List the Histamine receptor types and where each are each found.
• Summarize or give examples of symptoms in over activation of histamine receptors.
• Many of our patients are on OTC Antihistamine medications.  List their effects, positive and negative.

Hour 2

• Quote what OAS stands for.
• Define OAS and describe what happens to those with this problem.
• Recognize at what age(s) OAS occurs.
• Memorize, recognize and describe 1-5 OAS examples.
• Educate your patient on how to deal with OAS.
• Describe NFkB as a system
• Describe NFkB’s role in canonical and non-canonical pathways
• Explain what IκBα is and its potential role in downregulating inflammation

Hour 3

• Discuss how specific herbs, nutrients, and Vitamin E work to manage histamine at both a macro and microscopic level.
• Be able to describe allergic inflammation
• Discover how NSAIDs are being noted to reduce CNS diseases with inflammation and may help manage allergic disorder(s). 
• Identify what particular NSAID is naturally occurring and available to us and your patients to help them manage their allergic inflammation.  Calculate its clinical dose and avoid its lethal dose.
• List various SPMs (Specialized Proresolving Mediators)
• Describe how SPMs can control IgE production and play a potential role in the treatment of Alzheimer’s Disease.
• Relate histamine’s role in IBS (Irritable Bowel), name and synthesize the type of 2 known GI receptors involved.

Musculoskeletal

• Explain the causes behind Musculoskeletal Injuries
• Compare the minimum/maximum times during the Acute, Repair, and Remodeling Phase of Recovery
• Summarize protocols for acute inflammation
• Demonstrate a Kinetic Chain Assessment
• Explain why indirect cause of injury can be as disabling due to tissue overuse and overload
• Contrast and compare male vs female most common extremity injuries
• Contrast the differences between high school, collegiate, and professional athletic injuries
• Summarize how gold-standard management drives lower injury rates and duration
  

Nutrition

• Develop components of a typical healthy meal plan for athletes
• Differentiate between healthy and unhealthy food choices in each category of FAT, CHO, PRO
• Identify problem foods specific to the individual athlete
• Explain CHO loading and examples of high glycemic index foods
• Describe meal plan for post-exercise "window of recovery"
• Describe benefits and sources of branched chain amino acids for athletic recovery
• Explain purpose of omega 3 fatty acids during recovery phase of athletic activity
• Define components of female athlete triad
• List vitamins and minerals required to rebuild bone health in female athlete triad
• Name ergogenic nutrients acceptable to the World Anti-Doping Agency

Dehydration

• Explain difference between dehydration and hyponatremia
• Recognize early or acute signs and symptoms of dehydration and hyponatremia
• Discuss benefits of each method of determining hydration status
• Demonstrate treatment intervention for heat cramps
• Compare energy drink to sports drink

Concussion

• Define and recognize brain concussion, second impact syndrome, and chronic traumatic encephalopathy.
• Describe frequency of sports concussion and common duration of signs and symptoms.
• Describe all possible results of head trauma, including second impact syndrome, intracranial hematoma, skull fracture, brain contusion, cervical injury (both mild and dangerous)
• Differentiate and rule out dangerous results from head trauma.
• Demonstrate proper exam procedures following head trauma on field.
• Demonstrate proper exam procedures to clear the cervical spine on field.
• Perform the SCAT 3 exam and describe how it is to be used both on field and in the office.
• Describe how and why one performs serial exams after head trauma on field.
• Describe return to play protocols for concussed athletes.
• Describe prevention procedures for sports concussion.

• Explain the phases of human walking gait
• Discuss the biomechanical events associated with stance phase of gait
• Discuss the biomechanical events associated with swing phase of gait
• Explain biomechanically what is happening during each phase of gait in the foot, ankle, knee and hip
• Discuss the 3 rockers of the foot and how they apply to the gait cycle
• Understand the calcaneocuboid locking mechanism and defend it's importance in the stance phase of gait
• Summarize the ranges of motion of the foot, ankle, knee and hip and their importance in normal gait
• Explain how stance phase abnormalities would impact the gait cycle
• Demonstrate competency in obtaining a reproducible Pedograph print
• Interpret rearfoot, midfoot and forefoot mechanics as seen on a pedograph print
• Identify and interpret problem areas in a pedograph print
• Identify stance phase abnormalities on a Pedograph print
• Extrapolate pathomechanics which would occur rostrally in the kinetic chain during pathomechanics occurring in the gait cycle
• Evaluate the impact of gait abnormalities on human locomotion

• This contains all courses with the educational objectives listed from Biomechanics 201 through Biomechanics 216

• Describe how the motor and sensory homunculus relate to the foot and are integral to training and rehabilitation
• Discuss the 3 rockers of the foot
• Give examples of problems that result from a loss of the 3 rockers of the foot
• Explain the concept of pelvis neutrality and its effect on training
• Describe and examine the tripod of the foot
• Breakdown most movement into 2 basic rules or tenets
• Give examples of the problems which can arise if the 2 basic rules or tenets of movement are not followed
• Discuss the clinical consequences of loss of the medial and lateral tripods of the foot

• Discuss the normal walking gait cycle
• Apply the biomechanics of the pelvis and lower kinetic chain during walking to clinical practice
• Predict and discuss problems and clinical strategies that can arise from altered lower extremity biomechanics
• Apply visual analysis skills
• Evaluate case studies in gait analysis
• Clinically apply solutions for gait abnormalities

• Describe and identify how the parts of a running shoe affect running biomechanics
• Compare and contrast different shoe constructions to the biomechanical needs of an individual
• Determine the appropriate last shape for different foot types
• Discuss the biomechanical consequences of improper vs. proper selection of last types
• Predict which features in a shoe are necessary to correct faulty gait patterns

• Explore barefoot running from a position of biomechanical efficiency
• Contrast the differences in shod vs unshod running
• Predict problems that can arise from shod and barefoot running
• Apply visual analysis skills to barefoot running technique
• Describe how to introduce barefoot running to your patient population

• Discuss the salient points of conducting a visual gait analysis
• Review the gait cycle and associated kinetics and kinematics
• Discuss step length, stride length and how they are affected in a case of a person with posterior compartment weakness
• Review the biomechanics associated with heel rise
• Propose rehabilitation strategies for specific cases that were reviewed

• Discuss the pitfall of video assessment of gait cases
• Review the gait cycle with respect to stance phase abnormalities in a gait case
• Differentiate between step length and stride length
• Review heel rise and the windlass mechanism
• Discuss the function of the long flexors of the toes in gait
• Evaluate pelvic posturing as it relate to a gait case
• Discuss the gait pathomechanics that result from a herniated disc

• Review the pertinent anatomy of the knee
• Review the kinematics and kinetics of knee function during the gait cycle
• View and discuss case studies involving knee function
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Review the pertinent anatomy of the hip
• Review the kinematics and kinetics of hip function during the gait cycle
• View and discuss case studies involving hip function and common clinical scenarios
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Review the walking gait cycle
• Review the running gait cycle
• Identify the key differences between walking and running gait
• Review the kinematics and kinetic differences between walking and running gait
• View case studies involving different walking and running gait styles
• Predict pathomechanics that may arise from gait abnormalities presented

• Review anatomical vs functional short leg
• Review the kinematics and kinetics of the short leg during the gait cycle
• View and discuss case studies looking at functional and anatomical short legs
• Predict pathomechanics that will arise from a short leg
• Propose remedies for the gait abnormalities seen

• This contains all courses with the educational objectives listed from Biomechanics 211 through Biomechanics 222

• Review fore foot to rearfoot relationships
• Review the different rear foot types
• Review the kinematics and kinetics of rear foot function during the gait cycle
• View and discuss case studies involving different rear foot types
• Predict pathomechanics that will arise from gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Breakdown the gait cycle into its component parts
• Recognize some less common gait abnormalities seen in gait analysis
• Assess actions of the lower kinetic chain during gait
• Predict pathomechanics that will arise from gait abnormalities presented

• Review how to determine foot type
• Describe and identify the five common foot types
• Explain how foot type effects gait biomechanics
• Compare and contrast different clinical examples of each foot type
• Discuss some treatments that can be utilized when a client presents with a particular foot type

• Briefly describe the history of the pedograph
• Compare pedographs with other technologies available for foot imprinting
• Explain how to obtain a reproducible pedograph
• Discuss pedograph interpretation and what it means clinically

• Review the pertinent anatomy of the foot
• Review the kinematics and kinetics of foot function during the gait cycle
• View and discuss case studies involving foot function and common pathomechanics
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Define the crossover gait
• Visually identify the crossover gait
• Explain the biomechanical elements of the crossover gait
• Analyze the cross over gait
• Give examples of the cross over gait
• Integrate your knowledge of the cross over gait to formulate an appropriate treatment plan
• Outline some common exercises for cross over gait remediation

• Examine how arm swing correlates and integrates with the gait cycle
• Visually identify arm swing
• Explain the biomechanical elements of arm swing
• Analyze arm swing
• Give examples of normal and abnormal arm swing
• Integrate your knowledge of arm swing to formulate an appropriate treatment plan

• Define minimal vs. neutral vs. guidance vs. motion control shoes
• Contrast minimal vs. neutral vs. guidance vs. motion control shoes
• Discuss current shoe trends
• Discuss ramp delta and its implications in shoes and shoe fit

• Review the injuries associated with an improperly fitting bike frame and how to properly size a frame to a person
• Discuss how cleat position can lead to biomechanical problems and injuries related to power loss.
• Demonstrate how to properly place cleats on shoes to avoid injury and increase power transfer
• Discuss injuries that stem from inappropriate seat height, saddle for and aft position and handlebar reach and explain how to determine appropriate seat height, fore and aft saddle position and handlebar reach.

• Review static postural foot assessment as it relates to a case study
• Describe muscular compensations that may occur as the result leg length differences
• Compare muscular action vectors and their changes with aberrant foot mechanics
• Discuss the concept of flexor dominance and how it relates to the long flexors of the toes

• Discuss the gait cycle and gait cycle biomechanics
• Discuss Tetrasomy 18 and Chronic Inflammatory Demyelinating Polyneuropathy etiologies
• Discuss Tetrasomy 18 and Chronic Inflammatory Demyelinating Polyneuropathy gait abnormalities
• Propose rehabilitation strategies for abnormalities commonly seen in many neurological disorders

• Review the anatomical and functional causes of  leg length discrepancies
• Review the kinematics and kinetics of leg length discrepancies during the gait cycle.
• View and discuss several new case studies looking at anatomical leg length discrepancies and the impact of compensations to accommodate the fixed changes. 
• Discuss examination procedures to facilitate understanding of the pathomechanics resulting from a leg length discrepancy. 
• Propose intrinsic and extrinsic remedies for the gait abnormalities seen.

• Provide an overview of orthotic therapy
• Review orthotic casting processes and contrast differences and potential pitfalls in them
• Discuss common problems arising from orthotic prescription (blisters, pain during use, pressure spots, etc)
• Propose mechanisms for why problems occur biomechanically
• Present remedies for common problems that arise

• Discuss retraining CNS sensory and motor patterns
• Present several key concepts in visual gait analysis
• Introduce lesser known anatomical points of interest in the sacroiliac joint
• Discuss some rehabilitation strategies for the sacroiliac joint

• Discuss retraining CNS sensory and motor patterns
• Present several key concepts in visual gait analysis
• Introduce lesser known anatomical points of interest in the sacroiliac joint
• Discuss some rehabilitation strategies for the sacroiliac joint
• Discuss the ideal kinetics and kinematics of the walking gait cycle
• Present the normal lower extremity parameters/ontogeny surrounding the requisites for gait
• Explore the impact of lower extremity torsions on foot progression angle
• Highlight the differences between tibial and femoral leg length discrepancies
• View video examples of different aspects of gait
• Review the mechanics of the bridge exercise
• Discuss the current indexed literature surrounding the bridge exercise
• Describe potential pitfalls in performing and prescribing the bridge exercise
• Point out the differences of maintaining a "neutral spine" versus an increased or decreased lumbar lordosis
• Identify potential ways to correct faulty mechanics and optimize performance of the bridge exercise
• describe a new, novel test to diagnose gluteus medius tears
• explain the various functions of the gluteus maximus and medius
• explore the effects of a resistance band around the knees on the gluteus maximus, quadricep and valgus angles on the knees during a back barbell squat
• contrast gluteus medius resistance and rehabilitation exercises with respect to maximal recruitment
• discuss electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the Monopodal Squat, Forward Lunge and Lateral Step-Up exercises

• Discuss the ideal kinetics and kinematics of the walking gait cycle
• Present the normal lower extremity parameters/ontogeny surrounding the requisites for gait
• Explore the impact of lower extremity torsions on foot progression angle
• Highlight the differences between tibial and femoral leg length discrepancies
• View video examples of different aspects of gait

• Review the mechanics of the bridge exercise
• Discuss the current indexed literature surrounding the bridge exercise
• Describe potential pitfalls in performing and prescribing the bridge exercise
• Point out the differences of maintaining a "neutral spine" versus an increased or decreased lumbar lordosis
• Identify potential ways to correct faulty mechanics and optimize performance of the bridge exercise

The bridge exercise has been a staple amongst conditions seeking to rehabilitate everything from lower back pain to gait abnormalities. Traditionally, this is predominantly a gluteus maximus exercise however we often find that it is dominated by the hamstrings. This presentation goes through the recent research surrounding this exercise as well as ways to optimize its efficacy and clinical utility.

• describe a new, novel test to diagnose gluteus medius tears
• explain the various functions of the gluteus maximus and medius
• explore the effects of a resistance band around the knees on the gluteus maximus, quadricep and valgus angles on the knees during a back barbell squat
• contrast gluteus medius resistance and rehabilitation exercises with respect to maximal recruitment
• discuss electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the Monopodal Squat, Forward Lunge and Lateral Step-Up exercises.

• Review ideal walking gait biomechanics
• Discuss the current indexed literature surrounding sandals and open back footwear relative to musculoskeletal symptoms
• Describe pathomechanics associated with wearing flip flops and open back footwear
• Contrast the ideal gait cycle with the gait cycle while wearing flip flops, sandals and open back footwear
• Identify potential ways to correct faulty mechanics associated with wearing open back footwear

Ever wonder if “flip flops” are bad for you? How about open back shoes? With the prevalence of sandal and open back footwear use, we thought it appropriate to talk about the biomechanics and potential pitfalls of this type of footwear. In this preservation we examine the biomechanics, pathomechanics literature and potential sequelae of sandals and open back shoes.

• Review ideal walking gait biomechanics
• Discuss the indexed literature surrounding movement patterns, gait remodeling and therapeutic uses of a split treadmill
• Rehab gait movement patterns
• Develop a deeper understanding of arm swing, leg swing, and interlimb timing and coordination.

• Identify ideal walking gait biomechanics
• Discuss the indexed literature surrounding movement patterns, gait impairments and compensations.
• Analyze arm swing, leg swing, and interlimb timing and coordination.
• Interpret local foot biomechanics and compensations.

• Review the gait cycle and gait cycle biomechanics
• View and discuss case studies of gait pathologies
• Assess actions of the lower kinetic chain during gait
• Predict pathomechanics that will arise from gait abnormalities presented
• Propose remedies and rehabilitation strategies for the gait abnormalities seen

Hour 1

• Identify some common gait abnormalities seen in gait analysis and develop mental strategies in evaluating the 3 cardinal planes of motion and potential failures in the loading of these planes.
• Categorize the Fast and Slow phases of an imbalance asymmetrical gait and define rehabilitation strategies to remedy the gait pathology.
• Develop a conceptual overview of how step length and stride length change in a limping gait.
• Breakdown portions of the gait cycle into its component parts, including compensation patterns
• Conceptualize the gait changes oriented around a hallux (great toe) amputation and learn to predict gait compensations off of a fixed anatomic anomaly.
• Describe arm swing and how it plays out in gait, particularly asymmetrical, and develop some treatment concepts in addressing this asymmetry.

Hour 2

• Discuss the critical function of the deep neck flexors and transverse abdominus, and how they related to gait, especially the running athlete.
• Identify the 3 compartments of the thoracolumbar fascia and translate them into gait concepts and treatment concepts.
• Develop treatment concepts in addressing this asymmetry and define in-phase and out-of-phase arm and leg swing assimilation
• Discuss on a surface level the concepts of speed in gait, and how to adjust the speed of one's gait to break down gait components that might lead to better treatment directions.
• Describe central pattern generators and relate to arm swing on a neurologic level.
• Recognize some common gait abnormalities seen in gait analysis such as arm swing, step length, the cross over gait, and develop mental strategies in evaluating the 3 cardinal planes of motion and potential failures in the loading of these planes when it comes to these gait parameters.

• Discuss the concept of Gender as it relates to society, language and culture
• Identify Gender roles in Western Society
• Recognize innate gender traits in males and females
• Summarize socially imposed gender traits

• This includes all courses with the educational objectives listed from Boundary Training 101 through Boundary Training 112

• Identify aspects of male and female psychological development
• Relate basic concepts of Gender and Power
• List female and male leadership factors
• Discuss gender and the Doctor/Patient relationship
• Identify the ways which gender affects the Doctor/Patient relationship

• Describe what accounts for the differences, in practice style and patient care, between males and females healthcare providers
• Define differing sexualities in western culture
• Review sexuality as it relates to the Doctor/Patient relationship
• Identify misconceptions in personal definitions of male, female, power and sexuality
• Recognize when Power is misused and becomes a threat

• Define Touch as it relates to perception, gender and culture
• Discuss the giving up of power as it relates to patients and touch
• Recognize the perception, intention, and uses of touch
• Perform an analysis of individual conceptions of gender and sexuality

• Perform an exercise to identify personal concepts of touch
• Create practical applications for healthcare practitioners with regard to gender, touch, and sexuality
• Define sexual misconduct
• Recognize the difference between sexual misconduct and sexual harassment
• Critique different models of misconduct

• Describe how misconduct occurs
• Distinguish between different types of offenders
• Give examples of case studies in sexual misconduct
• Identify common fears and misconceptions of sexual misconduct
• Specify important concepts of treated a patient who has a history of abuse

• Define professional boundaries and relate the issue of consent
• Describe the three types of power, the three patterns of power, and how power is used
• Discuss the differences between adherence vs. compliance and transference vs. countertransference
• Identify anatomical risk levels for touch

• Develop safe touch guidelines
• Create a set of office based interventions and patient based interventions in the development of safe practice strategies
• Define educational interventions for safe practice strategies
• Define the basics of the supervision for a safe practice strategy

• Develop and outline for safe practice analysis
• Perform a risk factor analysis
• Execute a healthcare provider questionnaire
• Create a staff evaluation to implement at the office

• Develop and implement a buddy/supervisor evaluation of the healthcare provider and staff
• Develop and implement a patient evaluation of the healthcare provider and staff
• Create a system of analysis for the buddy/supervisor, healthcare provider, staff and patient evaluations

• Develop a plan for change based on the risk factor analysis (RFA) and practice evaluation questionnaires
• Identify areas of improvement for touch, consent, communication and respect
• Address concerns raised by staff and patients
• Discuss ways to defuse attraction

• Develop guidelines of dealing with a patient who is attracted to you
• Develop guidelines of dealing with feeling an attraction
• Discuss the six factors for a safe practice
• Describe the new partnership between healthcare providers and patients

• Define and discuss professional boundaries
• Define and discuss sexual misconduct
• Sensitize The D.C. To Issues Relating to Sexual Interaction With The Patient
• Discuss the problem of sexual misconduct, either real or perceived
• Define and discuss specific examination procedures
• Provide methods for recording examinations and incidents
• Discuss case of alleged sexual misconduct
• Discuss strategies to avoid misunderstandings that may lead to charges of sexual misconduct

• Describe how trust and trustworthiness give shape to the idea of respect between patient and health professional
• Assess the roles of competence and reassurance in strengthening the necessary connections between you and the patient
• Explain the phenomena of transference and countertransference in the health professional and patient relationship
• Contrast courteous behaviors with casualness and how each is perceived by the patient to bridge the gap of estrangement between you when you fi rst meet and as the relationship develops
• Give some examples of what it means to focus on caring behaviors
• Distinguish contractual characteristics of the health professional and patient relationship from covenantal characteristics and evaluate the role of each

• Describe why the idea of professional boundaries is relevant to respect
• Distinguish a respectful, professional approach from one based on objectivity and efficiency alone
• Identify and discuss appropriate physical boundaries in relation to unconsented touching, sexual touching, and sexual contact
• Describe three types of situations in which maintaining emotional boundaries are crucial to avoiding enmeshment
• Identify clues that may alert you that your sympathy is becoming pity
• Define overidentifcation and its negative effects
• Describe what it means to care too much
• List some ways that honoring professional boundaries serves the positive goals of the health professional and patient relationship

• Recognize disability in your practice.  Today one in five Americans has a disability and this percent will continue to increase because of medical advances and the aging of our population.
• Become familiar with the range of disabilities including those involving mobility, hearing, speech, vision as well as the wide range of non-apparent disabilities.
• Integrate the course's Seven Themes for Setting Appropriate Boundaries with the Disability Community into your everyday practice.
• Avoid limiting beliefs about what people with disability can or cannot do.  Today people with disability have access to technological and other adaptive techniques that make full inclusion possible.
• Gain disability competence through skillful navigation of physical boundaries as well as psychological, emotional and social boundaries.

• Appreciate how your patients with disability have learned to adapt so you can work with their adaptive techniques and compensatory skills.
• Integrate do’s and don’ts about how to respond to specific disabilities.
• Surface – and learn to overcome – your hidden prejudices and stereotypes.
• Recognize how non-apparent disabilities can impact effective communication, compliance and other important health care outcomes.
• Familiarize yourself with legislative and technological breakthroughs that can support your patients during healing and recovery.

• Recognize the barriers that people with disability face in securing employment and aim to dismantle those barriers whenever you can.
• Become familiar with specific workplace accommodations for employees with disability.  These can be easy to execute and inexpensive.
• Commit to making your own workplace more inclusive by adopting simple changes to aid employees as well as patients.
• Accept your own uncomfortable feelings about disability in order to move beyond their grip.

• Identify the purpose of professional boundaries
• Differentiate between boundary violations and boundary crossings
• Identify the various factors related to dual relationships
• Identify issues related to bartering, gifts and boundaries

• Recognize the challenges of social networking and boundaries
• Evaluate issues specific to boundaries
• Clarify guidelines for maintaining professional boundaries
• Reflect on the maintenance of professional boundaries

• Describe the biomechanics of rotation of a thoracic ring at the levels T1-T7.
• Describe the biomechanics of the Cervical spine, Thoracic spine, ribs, clavicle and manubrium with elevation of the right or left shoulder.
• Describe the biomechanics of flexion and extension at the Costotransverse joint at T9.
• Describe the differences in motion of the mobile segments between T3 -T7 with side flexion occurring first in the Thoracic spine.

• This contains all courses with the educational objectives listed from Breathing Essentials 201 through 204

• Describe the physiology of breathing and how altered pH can affect the body.
• Describe two functions of the diaphragm.
• Identify limited chest expansion and Bradcliff angles and ski jumps
• Identify limited lateral costal breathing and how to facilitate normal lateral costal breathing

• Describe how altered breathing patterns can alter pH and how this can affect the body.
• Describe the autonomic nervous system and function.
• Name three physiological consequences of respiratory alkalosis.
• Describe suboptimal breathing patterns and their effect on the cervical spine and chronic pain.

• Name and describe the different types of sleep apnea.
• Describe the three levels of Apnea-hypopnea index AHI.
• List five symptoms of sleep apnea.
• List two treatments for sleep apnea.

• Describe the physiological response of aerobic exercise on the respiratory system.
• Describe the effect of running on the viscera and the diaphragm.
• Describe the response to inspiratory muscle fatigue on the body.
• List one device than may increase endurance of the respiratory muscles.

• Describe the anatomical structure of the diaphragm including innervation and blood supply.
• List four causes that may damage the innervation to the diaphragm and effect normal function.
• Describe the factors involved in Intensive Care Unit Acquired Weakness.
• Be able to describe the pros and cons of early mobilization in the ICU.

• Outline the most commonly encountered neurological complaints of pregnancy that a D.C. might encounter in practice
• Differentiate between similar complaints to establish best course of care
• Modify normal practices, techniques and methods to accommodate for the biomechanical changes of the pregnancy patient
• Integrate other palliative therapies to relieve these complaints
• Analyze and adjust according to the complaint and concomitant exam findings

• This contains all courses with the educational objectives listed from Chiropractic and Pregnancy 201 through Chiropractic and Pregnancy 207

• Outline eight commonly encountered complaints of pregnancy that a DC might encounter in practice
• Differentiate between similar complaints to establish best course of care
• Understand the various causes of each complaint and how to address these causes
• Integrate other palliative therapies to relieve these complaints
• Analyze and adjust according to the complaint and concomitant exam findings

• Outline the most common herbal and homeopathic remedies that may be useful to a DC who cares for pregnant patients
• Differentiate between helpful remedies and those contraindicated for use during pregnancy
• How and when to successfully integrate these palliative therapies to relieve common complaints of pregnancy
• Recognize the basics of homeopathy, why and how it works, how to administer remedies and proper use and storage of remedies
• Generalize the use and need for these remedies to accommodate the special needs and concerns of the pregnancy patient

• Outline necessary dietary requirements for the mother to be
• Differentiate between safe and unsafe exercises that can be recommended to the expectant mother
• Give examples of safe exercise practices to the pregnant patient
• Identify the normal and customary weight gain during a healthy pregnancy
• Offer dietary recommendations and healthy food choices to the pregnant patient

• Identify the most common birth trauma(s) to a newborn
• Assess the biomechanics of the pregnant pelvis
• Recognize how certain maternal pelvic misalignments can lead to increased incidence of various birth traumas
• Modify adjustive techniques and methods to better care for the pregnant patient
• Reduce the prevalence of certain birth traumas due to distortions and misalignments in the maternal pelvis

• Identify the most common medical tests and procedures performed on pregnant and laboring women
• Recognize the risks of these tests and procedures
• Assess the benefits of these tests and procedures
• Effectively explain these risks and benefits to the pregnant patient
• Assist in the preparation of a well thought out and defined birth plan for the pregnant patient

• Outline commonly encountered misalignment and/or subluxation patterns that present with a breech presentation
• Outline commonly encountered misalignment and/or subluxation patterns that present with various common complaints of pregnancy
• Identify the various causes of a breech presentation and how to address these causes
• Integrate or eliminate other palliative therapies to aid in the reversal of a breech presentation and common complaints of pregnancy
• Analyze and adjust according to the patient history and concomitant exam findings

• Outline commonly encountered misalignment and/or subluxation patterns that present with a breech presentation
• Outline commonly encountered misalignment and/or subluxation patterns that present with various common complaints of pregnancy
• Outline commonly encountered misalignment and/or subluxation patterns that present with a twin breech presentation
• Integrate or eliminate other palliative therapies to aid in the reversal of a breech presentation and common complaints of pregnancy
• Analyze and adjust according to the patient history and concomitant exam findings

• This contains all courses with the educational objectives listed from Chiropractic and Pregnancy 208 through Chiropractic and Pregnancy 212

• Outline commonly encountered misalignment and/or subluxation patterns that present with a breech presentation
• Identify the correlation between a misaligned pubic bone and an occiput posterior presentation
• Draw a parallel between a superior pubic bone misalignment and round ligament pain
• Develop a pregnancy care plan based on exam findings and presenting complaints

• Outline commonly encountered postpartum complaints that a chiropractor might encounter in practice
• Understand the various chiropractic causes of each complaint and how to address these causes.
• Integrate other palliative therapies to relieve these complaints if applicable
• Analyze and adjust according to the complaint and concomitant exam findings
• Modify adjustive techniques and methods to better care for the postpartum patient

Hour 1

• Examine all reported cases of serious adverse events in infants and children receiving manual therapies from chiropractors as well as practitioners from other disciplines
• Outline the connection between pregnancy-related pelvic girdle pain and biomechanical changes during pregnancy
• Review differential diagnostic consideration for the important causes of back pain in children and adolescents
• Analyze the design and results of a pragmatic study on chiropractic care for infant colic
• Justify the chiropractic management of pregnant patients with low back or pelvic pain

Hour 2

• Outline the state of the literature on the treatment of childhood respiratory conditions with manual therapy
• Evaluate the effect of supplementing various combinations and types of micronutrients on the course and outcomes of pregnancy
• Examine whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to relieve pain and reduce impairment and disability in the antepartum period
• Assess the peer-reviewed literature on the effectiveness of physical therapy interventions in treating lumbopelvic pain during pregnancy
• Summarize the results of a systematic review evaluating the evidence for the use of spinal manipulative therapy for pediatric conditions

• Appraise the literature pertaining to the safety of acupuncture for pregnant women
• Summarize consensus-based recommendations regarding best practices for the chiropractic care of children
• Explore the association between exercise levels and types pre-pregnancy and pelvic girdle pain during pregnancy in nulliparous women
• Assess alterations in pelvic floor function in pregnant women secondary to spinal manipulation
• Compare the effectiveness of Kinesio taping combined with exercise on abdominal recovery in women post-caesarean section compared with exercise alone

• Identify safety measures involved with essential oils
• Understand the various possible reactions if safety measures are not followed properly 
• Outline common methods of applications of various essential oils
• Identify the essential oils commonly used during pregnancy and labor and the uses of each
• Further identify essential oils that are contraindicated during pregnancy and labor

• Discuss the role of chiropractic manipulation and the evidence surrounding reduced back pain in pregnant women.
• Discuss the role of chiropractic manipulation and the evidence surrounding musculoskeletal conditions related to pregnancy
• Describe the somatovisceral reflex
• Review options for conservative pain management for musculoskeletal conditions related to pregnancy
• Interpret evidence-based data for safety of spinal manipulation of pregnant women.
• Describe presentation of musculoskeletal conditions seen in postpartum patients
• Perform evaluation of musculoskeletal conditions seen in postpartum patients
• Discuss treatment options for musculoskeletal conditions seen in postpartum patients
• Formulate a nutritional plan for women

Hour 1

• Discuss the Inflammatory Cascade
• Identify the mechanics of concussion that results in inflammation
• Describe the neuro-chemical cascade of concussion

Hour 2

• Perform physical exam protocols in inflammation as it relates to concussion
• Perform Neurological exam protocols in inflammation as it relates to concussion
• Perform Chiropractic exam protocols including incorporating AK exam
• Apply Chiropractic exam protocols in inflammation
• Utilize advanced examination protocols in inflammation

Hour 3

• Perform structural treatment protocols to treat inflammation related to concussion
• Utilize phytonutrient protocols to treat inflammation related to concussion
• Use specific therapeutic protocols to resolve inflammation with literature citations

• This contains all courses with the educational objectives listed from Concussion 201 through 202

Hour 1

• Discuss the Selye Stress Response
• Discuss the mechanics of concussion that results in the inflammatory response
• Describe the cortisol cascade response associated with concussion

Hour 2

• Perform physical exam protocols in the stress response
• Perform Neurological exam protocols in the cortisol cascade
• Apply Chiropractic exam protocols in the cortisol cascade
• Utilize advanced examination protocols in evaluating the stress response

Hour 3

• Perform chiropractic treatment protocols to treat the stress response
• Utilize nutritional protocols to treat inflammation related to the stress response and concussion
• Use evidenced based therapeutic protocols to address the cortisol cascade associated with concussion with literature citations

Hour 1 and 2

• Describe the components of the core and the function of the core.
• Describe the function of the diaphragm as it relates to posture, muscular relationships and stability of the spine.
• Describe the function and structure of the superficial muscle system of the body.
• Describe two concepts of spinal stability. 

Hour 3

• Demonstrate how to determine the length of quadratus lumborum and erector spinae. 
• Demonstrate how to evaluate Transversus abdominus function
• Demonstrate how to facilitate the core and initiate a core training program

Hour 4

• List three pathologies related to less than optimal core function.
• Describe three postural strategies that the patient may develop when the core is in dysfunction.
• Describe how weakness of the abdominals can alter diaphragm contractions.
• Explain how respiratory fatigue can alter core control.

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions
• Identify the professional's own cultural identity/judgments /biases and their impact on their behavior and how they are perceived by clients and patients
• Recognize cultural variables that appear in verbal and non-verbal communication
• Examine the influence of culture in our patient population
• Differentiate the provider's culture

• Examine the historical background of the various Latino/Hispanic groups in the U.S.
• Develop the skills needed to care for people from Spanish speaking parts of the world
• Increase our understanding of the cultural traits of Latino/Hispanic groups in the U.S.
• Summarize specific traits of various Latino/Hispanic groups
• Recognize how we can narrow the gap between us

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship.
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions.
• Identify our own provider culture/judgments /biases and their impact.
• Examine characteristics of Asians, Blacks and Middle Easterners.
• Summarize how to care for patients of these three ethnic/racial groups and how to narrow the gap between us
• Develop an understanding/plan of how to reach out to these populations.

• Describe cultural diversity
• Recognize the need for cultural competence in health care
• Explain the concept of health disparity
• Define culture and cultural competence
• Differentiate between the concepts of culture, race, ethnicity, diversity, and minority
• Describe the Cultural Competence Continuum
• Discuss the interdependency between the levels of cultural competence

• Discuss the evolution of multicultural policy
• Describe the phases of multiculturalism
• Discuss three major perspectives on culture and diversity that have influenced healthcare literature and practice
• Identify the common myths and misconceptions associated with culture
• Recognize the paradoxical dilemmas associated with cultural competence

• Identify the need for cultural competence in health care and in medical literature.
• Examine and Research the historical perspectives
• Examine your world view or cultural beliefs about diversity and explain how you can develop an attitude of cultural competence.
• Analyze the five aspects of ethnicity used to describe cultural differences in the health care environment. 

• Review and explain the racial and ethnic disparities in health care.
• Explain the role of health care providers and organizations as mechanisms to reduce racial and ethnic disparities in health care. 
• Explain how language and communication of the health care provider can be a barrier to establishing relationships.
• Identify tools that can foster empathy for differing cultures.

• Explain the need for improving cultural awareness in the workplace to build cultural competency.
• Identify five practices that can be implemented to increase cultural awareness in the workplace.
• List the benefits of building an organization's cultural competence
• Explain how to deliver culturally competent care.

• Demonstrate The ability to communicate clearly and concisely with current and future patients 
• Describe ways to establish and maintain relationships and facilitate constructive interactions with individuals and diverse groups.
• List strategies to align personal and organizational conduct with ethical and professional standards that include a responsibility to the patient and health care community. 
• Demonstrate an understanding of the healthcare system and the environment in which healthcare managers and providers function.

This module focuses on culturally sensitive practices and conflicts within the health care organizations and examines some of the culturally responsive strategies that an organization needs to address to protect the diverse cultural needs within the internal and external communities of the health care environment.

• Comprehend basic diagnostic ultrasound terminologies and definitions. 
• Outline general diagnostic ultrasound equipment and image formation. 
• Identify the normal sonographic appearance of muscle, tendon, ligament, bone, nerve and cartilage. 
• Identify sonographic artifacts. 
• Utilize diagnostic ultrasound in the assessments and diagnosis of common musculoskeletal conditions. 

• Comprehend basic diagnostic ultrasound terminologies and definitions. 
• Outline general diagnostic ultrasound equipment and image formation. 
• Identify the normal sonographic appearance of muscle, tendon, ligament, bone, nerve and cartilage. 
• Identify sonographic artifacts. 
• Utilize diagnostic ultrasound in the assessments and diagnosis of common musculoskeletal conditions. 
• Review normal anatomy of the shoulder 
• Discuss the ultrasound examination scanning techniques of the shoulder 
• Recognize normal sonographic anatomy of the shoulder 
• List the complete standard sonographic protocol of the shoulder 
• Distinguish abnormal sonographic findings and pathologies of the shoulder 
• Review normal anatomy of the ankle
• Discuss the ultrasound examination scanning techniques of the ankle
• Recognize normal sonographic anatomy of the ankle
• List the complete standard sonographic protocol of the ankle
• Distinguish abnormal sonographic findings and pathologies of the ankle
• Review normal anatomy of the knee
• Discuss the ultrasound examination scanning techniques of the knee
• Recognize normal sonographic anatomy of the knee
• List the complete standard sonographic protocol of the knee
• Distinguish abnormal sonographic findings and pathologies of the knee

• Review normal anatomy of the shoulder 
• Discuss the ultrasound examination scanning techniques of the shoulder 
• Recognize normal sonographic anatomy of the shoulder 
• List the complete standard sonographic protocol of the shoulder 
• Distinguish abnormal sonographic findings and pathologies of the shoulder 

• Review normal anatomy of the ankle
• Discuss the ultrasound examination scanning techniques of the ankle
• Recognize normal sonographic anatomy of the ankle
• List the complete standard sonographic protocol of the ankle
• Distinguish abnormal sonographic findings and pathologies of the ankle

• Review normal anatomy of the knee
• Discuss the ultrasound examination scanning techniques of the knee
• Recognize normal sonographic anatomy of the knee
• List the complete standard sonographic protocol of the knee
• Distinguish abnormal sonographic findings and pathologies of the knee

• Develop the skills for medical documentation record keeping for proper patient care and adherence to insurance protocols
• Summarize informed consent, Evidenced-based care, Medicare guidelines and NCQA guidelines
• Identify common treatment procedures and modalities used in a chiropractic practice And recognize contraindications to them
• designate specific items to consider when interpreting and/or taking plain film X-rays
• Summarize the value of laboratory and diagnostic testing.
• Recognize the importance of patient communication skills in order to assist in the diagnosis and treatment of patients
• Modify procedures and forms to prevent the possibility of a legal malpractice action against the doctor

Hour 1

• Utilize improved patient communication skills with Medicare Patients 
• Apply appropriate risk management procedures to enhance patient communication
• Identify the four elements of legal malpractice and recognize the key components to avoid a malpractice action  
• Utilize key components of good documentation and record keeping
• Integrate the legal requirements of informed consent in your informed consent process 

Hour 2

• Summarize why doctors are held to higher standards
• Discuss the Do’s and Don’ts of record keeping
• Use the 21 NCQA guidelines for appropriate medical record keeping and integrate the 3 key components of Evidence Based Practice (EBP)

Hour 3

• Assess Medicare’s mandatory Electronic Health Records (EHR) requirement        
• Discuss key items related to the Office of Inspector General (OIG) reports regarding Medicare and chiropractic services
• Summarize Executive Order issued by the White House titled reducing improper payments and eliminating waste in the Federal Programs

Hour 4

• Determine what triggers an audit and key items to consider if audited
• Utilize a step by step approach to meet all Federal Medicare Documentation guidelines 
• Summarize Medicare’s guidelines for necessity of chiropractic care and its covered services
• Prepare treatment plans per Medicare’s regulation requirements
• Recognize Medicare’s policy requirements pertaining to x-ray/diagnostic reimbursement
• Determine if ordering vs. referred services meet Medicare’s policy when performed by a chiropractic physician

Hour 1

• Demonstrate the key elements pertaining to Medicare’s documentation requirements for initial and subsequent patient encounters  
• Describe the three categories of chiropractic care covered through Medicare and the one category exempt from Medicare coverage
• Apply Medicare’s x-ray requirements for documenting a subluxation
• Utilize Medicare Advance Beneficiary Notification (ABN) form and its guidelines 
• Use Medicare’s PARTS system to document a subluxation
• Summarize the transformation of Medicare’s PARTS system utilizing the AIR S & M method               
• Include proper Medicare documentation for daily progress notes (SOAP), in order to meet insurance guidelines and meet medical necessity 

Hour 2

• Integrate a 4 step approach to meet E/M (Evaluation/Management) coding requirements to meet Medicare’s guidelines

Hour 3

• Review Medicare Access and CHIP Reauthorization Act of 2015 (MARCA) aka Medicare Quality Payment Program (QPP) and the Merit Based Incentive Payment Program (MIPS)                                                                    

Hour 4

• Apply the critical components of Chiropractic Manipulative Treatment (CMT) coding and Medicare’s requirements for documentation
• Use diagnostic codes ICD-10 (primary subluxation M-codes biomechanical lesions and secondary medical codes) to meet Medicare’s diagnosis requirements
• Recognize Current Procedure Terminology (CPT) codes and how it relates to the Medicare system
• Utilize Medicare modifiers   
• Identify some of the key items with regards to completing the Center for Medicare and Medicaid Services (CMS) 1500 claim form   
• Summarize Medicare’s mandatory claims submission policy                                   
• Explain the five levels of Medicare appeals process
• Distinguish between Medicare participating vs. non-participating provider requirements

• Develop the skills for medical documentation record-keeping for proper patient care and adherence to insurance value based parameters
• Recognize the importance, and benefits of thorough chart documentation from the standpoint of the patient, the provider, the profession and third-party payors
• Show how outcome assessment documentation benefits the patient, the provider, the profession, and third-party payors
• Demonstrate physical examination procedures that are the basis for diagnosis formulation and value based data
• Examine skills necessary to incorporate an outcomes-based, evidenced-influenced approach to patient-centered health care in bodily injuries

• Develop the skills for medical documentation record-keeping for proper patient care
• Recognize the importance and benefits of documentation methodology from the standpoint of risk management
• Identify selected documentation problems and errors
• Summarize recommendations for improving patient care documentation

• Define the Problem Oriented Medical Record (POMR).
• Demonstrate taking a complete patient history.
• Define the Evaluation and Management examination for the musculoskeletal system.
• Define Outcome Assessment.
• Illustrate the P.A.R.T. format of documentation.
• Define proper assessment for SOAP notes.
• Discuss proper documentation of treatment performed on each visit.
• Discuss proper documentation of treatment plans.

• Comprehend the reasons for transitioning from ICD9 to ICD10
• Determine the critical differences with the new ICD10 codes
• Utilize the proper alpha and numeric aspects of commonly used ICD10 codes for  Chiropractic
• Observe the practicality of combining clinical documentation and the proper use of ICD10 codes.

• Discuss the history of ICD-10-CM codes
• Discuss the Official ICD-10-CM Guidelines for Coding and Reporting
• Identify and discuss the tools needed to navigate the ICD-10 codes
• Discuss the General Equivalence Mappings (GEM’s) and their significance and how they relate to ICD-10-CM Tabular List of Diseases and Injuries
• Identify and discuss how to select the appropriate ICD-10 code to its highest specificity
• Examples to be discussed

• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately
• Utilize E/M (Evaluation/Management) coding appropriately to meet insurance guidelines and medical necessity
• Identify the 3 categories and 2 subcategories of E/M codes
• Identify the 5 levels of E/M services for new and established patients
• Identify the 7 components (descriptors) used to determine the level of E/M service
• Select the appropriate level of E/M services utilizing 7 simple steps

• Differentiate between active and maintenance care in clinical documentation
• Execute the use of advance notice in third party patients correctly and accurately
• Identify and implement strategies to clarify the difference between active and maintenance care in documentation
• Recognize and adopt best practices in proper notification about maintenance care vs. active treatment

• Properly document findings and recommendations around muscle therapies
• Master the documentation necessary in daily visits to verify medical necessity
• Identify and implement strategies the most important findings and rationale necessary to add muscle therapies to the treatment plan
• Recognize how to differentiate between various manual therapies to meet the requirements of third-party payers' medical review policy

• Differentiate between supervised modalities, constant attendance modalities, and therapeutic procedures
• Properly document the time and service for any physical medicine modality and procedure
• Clearly define the rationale for these services within the patient's medical record

• Recognize the varying specific requirements for documenting unique adjusting techniques in regards to compliant records and risk management
• Properly document patient encounters for medical necessity
• Discuss the Medical Review Policy insurers use in reviewing medical documentation
• Review case studies and examples to identify documentation errors during self-auditing

• Apply best practices for using abbreviations, addressing legibility, authentication of signatures, and managing the day-to-day flow of your patient records 
• Clearly delineate the beginning and end of episodes of patient care, proper recording of these episodes, and boundary discussions with patients 
• Locate and utilize the definitions of medically necessary care, and apply it as a differentiator from clinically appropriate care
• Assess documentation across the life cycle of the patient’s chart from history to discharge and on through maintenance and wellness care based on live examples demonstrated
• Identify the deficiencies that may be present in your documentation through the eyes of an auditor

• Utilize documentation requirements for the most commonly used CPT codes in the profession
• Apply coding techniques and algorithms to ensure the proper code is selected to meet E/M documentation guidelines
• Recognize the codes that carry the highest degree of risk and confirm that documentation meets the code requirements
• Identify the mandatory elements of medical review policy for selected chiropractic codes

• Compose Complete and Accurate Treatment Plans
• Formulate multiple Standard Treatment Protocols for better compliance and efficiency
• Differentiate patient care plans per Patient condition severity
• Propose recommendations based on exam findings, not third party coverage

• Discuss Medicare’s guidelines for documenting quality measures 
• Discuss Medicare’s Merit-Based Incentive Program (MIPS)
• Identify and determine the eligibility requirements for MIPS
• Identify and discuss the 4 categories under MIPS (Quality, Cost, Promoting Interoperability (PI) and Clinical Practice Improvement Activities (CPIA)
• Recognize how Medicare calculates MIPS to determine payment adjustments

• Know how to document exactly what’s required for initial visit treatment plans including physical medicine procedures
• Apply sample language to include in each daily visit note that will meet documentation guidelines for these modalities and procedures, including properly recording time for timed services
• Command the mechanics of how to authenticate documentation for services provided by auxiliary team members
• Tie the patient’s diagnosis to the treatment plan for tissue-specific, physical medicine solutions
• Tell a complete and coherent account of the patient’s daily visit journey, outlining the crucial language necessary to justify medical necessity for all services rendered

• Recognize and document the difference between active and maintenance care
• Use a decision-making matrix to determine the reportability of active treatment, and to be able to help the patient understand the distinction
• Apply the Medicare standard of recordkeeping to intake requirements to establish a baseline for episodes of care
• Determine whether routine visits qualify as active treatment when presented with new and updated complaints

• Describe the need for prognosis
• Summarize what a prognosis is
• Demonstrate the use of prognostic tools
• Appraise your individual patient’s outlook for recovery.
• Measure the progress
• Make evidence based clinical decisions
• Substantiate your opinion for expert testimony.
• Illustrate the evidence for care.
• Prescribe evidence based care plans.
• Properly document and code complicated cases
• Improve the patient report of findings and discharge procedures

Hour 1 - 5

• Describe the need for prognosis
• Summarize what a prognosis is
• Demonstrate the use of prognostic tools
• Appraise your individual patient’s outlook for recovery.
• Measure the progress
• Make evidence based clinical decisions
• Substantiate your opinion for expert testimony.
• Illustrate the evidence for care.
• Prescribe evidence based care plans.
• Increase your reimbursement for complicated cases.
• Improve the patient report of findings and discharge

Hour 6

• Interpret in documentation, the difference between active, medically necessary care vs. clinically appropriate but possibly maintenance adjustments
• Able to distinguish compensatory vs. primary subluxations and document them properly
• Specify proper documentation techniques as a full spine adjuster
• Demonstrate the ability to classify documentation for each chiropractic technique employed

• Interpret in documentation, the difference between active, medically necessary care vs. clinically appropriate but possibly maintenance adjustments
• Able to distinguish compensatory vs. primary subluxations and document them properly
• Specify proper documentation techniques as a full spine adjuster
• Demonstrate the ability to classify documentation for each chiropractic technique employed

• Perform functional testing to identify patients who will benefit from active care rehab
• Correlate functional testing findings with a protocol-driven care plan customized to the patient’s diagnosis
• Recognize and document preferred outcomes that result from properly executed active care techniques
• Follow clinical algorithms to best understand the beginning, middle and end points of active care rehab
• Properly document the clinical rationale for active care rehab by linking it to the diagnosis and treatment plan of initial visit documentation

• Discover all the elements necessary for appropriate documentation of an episode of care, from the initial visit through the discharge from active treatment
• Have clearer delineation of the beginning and end of episodes of patient care
• Decide when an active episode of care should turn into maintenance care, and document the decision making appropriately
• Identify the required components of documentation as they are outlined in state board documentation requirements, Medicare documentation requirements and other entities’ regulations

• Define and recognize common procedures that may be deemed unproven, investigational or experimental
• Determine how individual state boards and payers view these various treatments
• Recognize guidance or rulings from state boards that dictate the need for informed consent
• Properly document the procedures in the medical record
• Apply correct coding to describe the procedure provided
• Personalize a sample Consent to Treat for the procedure provided

• Awareness of the value of orderly documentation to you and others
• Ability to duplicate key documentation components that auditors and reviewers expect
• Steps necessary to address how poor documentation can turn a simple record review into a full audit
• Ability to identify commonly missed links connecting documentation to treatment

• Recognize and apply E/M documentation requirements for history and consultation
• Properly execute the four sub-components of history to be documented for new and established patient documentation
• Properly execute the appropriate documentation for chiropractic examination components necessary to meet E/M documentation requirements
• Reproduce quality documentation components within history and examination for new and established patients
• Distinguish necessary elements of E/M documentation guidelines necessary for various levels of coding

• This contains all courses with the educational objectives listed from Documentation 180 through Documentation 181

• Recognize and apply E/M documentation requirements for medical decision making, to include levels of risk, problem points, and data points.
• Calculate the appropriate levels of medical decision making based on complexity tables
• Properly execute the appropriate documentation medical decision-making components necessary to meet E/M documentation requirements
• Reproduce quality documentation elements necessary in new and established patient documentation
• Compute, using appropriate algorithms, the levels of E/M coding based on documentation

• Differentiate and document for the difference between medical necessity and clinical appropriateness
• Execute a complete and compliant treatment plan that includes all required elements
• Properly record the elements necessary to justify the full-spine adjustment
• Command the mechanics of properly documenting clinical rationale for ordered diagnostics and treatment
• Ensure the inclusion of diagnostic assessment and doctor’s rationale in routine daily visit notes

• Evaluate the necessary elements to properly document established patient re-evaluations of all types
• Deliver appropriate evaluation and management services to justify continued care, assess progress, and discharge from this active care when the time is right
• Report the necessary components of documenting the transitional diagnosis and treatment plan after a periodic re-evaluation
• Complete the fundamentals of documenting the assessment of change since the last evaluation as it applies to federal regulations in Medicare

• Recognize the mandatory enrollment guidelines for chiropractors and apply the rules to daily practice
• Distinguish between active and maintenance care and employ proper procedure to administrate both types of care
• Complete and document required elements of documentation of active treatment
• Prepare patients to best differentiate care that Medicare considers medically necessary from care that the patient is expected to pay for
• Apply the Medicare standard of financial transactions with patients in order to stay within the Federal collection guidelines

• Discover how proper documentation impacts the revenue cycle and profitability of your office
• Distinguish between Medically Necessary and Clinically Appropriate Care
• Demonstrate how your office compliance program either leaves you vulnerable or reduces your risk
• Develop understanding of compliant fee systems
• Evaluate federal guidelines regarding discounting and/or hardship

• Discern Part B from Part C and know the rules for each
• Discuss mandatory enrollment necessary for Chiropractic specialty
• Master the definition of medical necessity vs. clinical appropriateness and who pays in either case
• Recognize the differences between acute, chronic, and maintenance car
• Locate and understand the Medicare Local Coverage Determination (LCD) for your state including all the rules and guidelines
• Identify CMT coding and how it is differentiated from maintenance in Medicare

• Understand the difference between clinically appropriate and medically necessary care
• Identify the clinical indications of when to initiate therapeutic withdrawal
• Execute the components of a final discharge evaluation with proper documentation and recommendations
• Learn how to transition a client from an active phase of care to maintenance as a part of your treatment plan

• Cite the difference between Therapeutic Exercise and Therapeutic Activities
• Properly document all aspects required when utilizing timed therapy services
• Assimilate payer policy details to ensure proper code utilization
• Discuss common errors when documenting and billing exercise therapy services

• Demonstrate why each and every digit of the DX tells the payer something important Distinguish the nuances of specialized DX coding rules for carriers such as Medicare.
• Discover the importance of DX pointing, and which CPT codes are an absolute MUST to point to DX
• Illustrate how to diagnose with a higher level of specificity and through proper hierarchy Identify the role of the diagnosis in the documentation process'

• Understand the necessary components of initial and routine visit documentation
• Recognize and evaluate the relationship between documentation and billed codes
• Demonstrate how to conduct a complete baseline audit of medical record documentation
• Establish the parameters for subsequent audit requirements

• Demonstrate the components of recognizing Medical Necessary Care vs. Clinically Appropriate
• Identify CMT coding trends and indicators as they relate to medical necessity
• Properly manage treatment effectiveness for exacerbations and reoccurrences
• Determine Proper Diagnosis and Assessment for Federal Patients
• Acknowledge and audit CMT coding ratios to evaluate the potential risk

• Recognize the key documentation requirements and components required to be eligible to treat Veterans Administration referrals
• Compose documentation that meets these required VA elements, while avoiding missteps most commonly found in denials and audits
• Appraise and self-audit the VA process from referral through discharge,
• Determine key factors known to be often missing, and understand what to do to correct the deficiency
• Demonstrate the proactive steps to take in treating VA patients from clinical and financial submisisons

• Apply the new algorithm to choose your E/M code appropriately using either time or decision making
• Disucss existing E/M codes were deleted and details on the new Prolonged Service codes
• Uses the the new process for typical chiropractic evaluations
• Identify elements that count as Time-Activities and how to calculate appropriately
• Discuss what it means to do a clinically appropriate history and exam

• Apply the changes in the 2022 ICD-10 code set to the clinical diagnosis process
• Compare examination findings, couple with history, to select the most appropriate written diagnosis
• Document within the clinical record your thought process of selecting diagnostic codes
• Classify diagnoses in order of severity and hierarchy to match projected treatment plan

• Properly document “doctor thinking” daily in routine patient visit documentation
• Recognize the role of the PART documentation process in Routine Office Visit notes
• Identify and execute the key components of written assessment in daily documentation
• Recognize aspects of documentation and coding of Route Office Visits (ROV) whether active treatment, preventative maintenance, or wellness care.
• Distinguish the unique components of Subjective, Objective, Assessment and Plan

• Know how to prepare for a medical emergency
• Review four emergency medical conditions: Stroke, Heart Attack, Difficulty Breathing, Diabetic Emergencies
• Recognize the causes, symptoms and signs for these emergencies
• Understand how to provide the appropriate emergency treatments

• Gain the knowledge to develop an Emergency Preparedness Manual for your office
• Define crisis management procedures in advance for fires, child abduction, workplace violence, bomb threats and other situations
• Explain the importance of an emergency continuity plan
• Recognize why CPR was changed and compare the new rules
• Perform more effective CPR even before you refresh your certification

• Recognize Altered Mental Status and apply the appropriate emergency response
• Distinguish types of Burns, their mechanisms of injury and pathophysiology
• Plan for the treatment of burns and the appropriate emergency response
• Apply and use the Rule of Nines
• Recognize Allergic Reactions, discuss their pathophysiology and the proper emergency response

• Identify the most common emergencies that occur on airline flights
• Describe what may be expected of you in caring for a patient at high altitude
• Describe what resources and equipment may be available to you as an in flight medical provider
• Observe important clinical differences seen on examination of patients on airplanes
• Demonstrate to patients skills to prevent medical emergencies during air travel

• Define morality and ethics and distinguish between the two
• Describe three moralities that health professionals must integrate into their own moral life
• Identify some major sources of moral beliefs in Western societies
• Distinguish between an ethical issue and ethical problem
• List three ways that ethics is useful in everyday professional practice
• Describe what material cooperation entails
• Identify some mechanisms available to protect the personal moral convictions of health professionals

• This contains all courses with the educational objectives listed from Ethics for Professionals 101 to Ethics for Professionals 105.

• Identify the goal of professional ethics activity.
• Describe the basic idea of a caring response and some ways this response in a professional relationship is distinguished from expressions of care in other types of relationships.
• Identify three component parts of any ethical problem.
• Describe what an agent is and, more importantly, what it is to be a moral agent.
• Name the three prototypical ethical problems.
• Describe the role of emotions in ethical distress.
• Distinguish between two varieties of ethical distress.
• Compare the fundamental difference between ethical distress and an ethical dilemma.
• Define ethical paternalism or parentalism.
• Describe a type of ethical dilemma that challenges a professionals desire (and duty) to treat everyone fairly and equitably.
• Identify the fundamental difference between distress or dilemma problems and locus of authority problems.
• Identify four criteria that will assist you in deciding who should assume authority for a specific ethical decision to achieve a caring response.
• Become familiar with AOTA and APTA Code of Ethics
• Become familiar with the Guide to Professional Conduct for PT
• Indiana PTs - become familiar with the IN PT Rules and Practice Act
• Texas PTs - become familiar with the TX PT Rules and Practice Act
• Utah PTs - become familiar with the UT PT Rules and Practice Act

• Identify six steps in the analysis of ethical problems encountered in everyday professional life and how each plays a part in arriving at a caring response.
• Describe the central role of narrative and virtue theories in gathering relevant information for a caring response.
• List four areas of inquiry that will be useful when gathering relevant information to make sure you have the story straight.
• Describe the role of conduct-related ethical theories and approaches in arriving at a caring response.
• Describe why imagination is an essential aspect of seeking out the practical alternatives in an ethically challenging situation.
• Discuss how courage assists you in a caring response.
• Identify two benefits of taking time to reflect on and evaluate the action afterward.
• Become familiar with AOTA and APTA Code of Ethics
• Become familiar with the Guide to Professional Conduct for PT's

• Define the terms confidential information and confidentiality.
• Identify the relationship of a patient's legal right to privacy with his reasonable expectations regarding confidential information.
• Describe how the telling and keeping of secrets is relevant to understanding the importance of confidentiality.
• Discuss the ethical norms involved in keeping and breaking professional confidences.
• Name five general legal exceptions to the professional standard of practice that confidences should not be broken.
• Consider practical options that a professional can take when faced with the possibility of breaking a confidence.
• Discuss some important aspects of documentation that affect confidentiality.
• Compare ethical issues of confidentiality traditionally conceived with those that have arisen because of computerized medical records and patient care information systems.
• Describe the key ethical strengths and challenges of the recent U.S. federal regulations related to privacy considerations (Health Insurance Portability and Accountability Act of 1996).
• Become familiar with AOTA and APTA Code of Ethics
• Review and become familiar with the TX PT Rules
• Read case scenarios illustrating ethical decision making

• Describe three basic legal concepts that led to the doctrine of informed consent.
• Describe three approaches to determining the disclosure standard for judging that a patient or client has been informed.
• Discuss three major aspects of the process of obtaining informed consent.
• Distinguish "general consent" from "special consent" documents.
• Differentiate between the never-competent and once-competent patient or client and the challenges posed by each in regard to informed consent.
• Compare informed consent as it is used in health care practice and in human studies research.
• Describe some considerations one must always take into account to be sure one is being culturally competent and honoring cultural difference when informed consent is the standard.

• Appreciate the current epidemiologic trends in autoimmune incidence, morbidity and mortality in the Western industrialized countries versus the under-developed world.
• Acknowledge the importance placed in human biology on mucosal immunity and the massive amount of immune tissue and functional resources dedicated to GI mucosal immune surveillance.
• Comprehend the linkage and association between autoimmune disease prevalence and factors including the GI microbiota composition, stealth infections, and molecular mimicry.
• Apply clinical laboratory testing related to autoimmune disease risk assessment and diagnosis, including qPCR molecular-based evaluation of the GI microbiota.

• Appreciate the current epidemiologic trends in autoimmune incidence, morbidity and mortality in the Western industrialized countries versus the under-developed world.
• Acknowledge the importance placed in human biology on mucosal immunity and the massive amount of immune tissue and functional resources dedicated to GI mucosal immune surveillance.
• Comprehend the linkage and association between autoimmune disease prevalence and factors including the GI microbiota composition, stealth infections, and molecular mimicry.
• Apply clinical laboratory testing related to autoimmune disease risk assessment and diagnosis, including qPCR molecular-based evaluation of the GI microbiota.

• This includes all content from Functional Medicine 201 thorugh 205. Please see educational objectives for those courses

• Identify the differences in methodology and application between quantitative molecular testing (qPCR) versus next-generation sequencing of the GI microbiota in the support of clinical decision making.
• Synthesize the available evidence-based integrative and complementary therapeutic GI antimicrobial interventions for treating GI dysbiosis, including in subjects with autoimmune disorders.
• Explore the linkage and association between autoimmune disease prevalence and food immune reactions and sensitivities.
• Apply the available evidence-based integrative and complementary therapeutic interventions using pro and pre-biotics for improving the GI ecology in subjects with autoimmune disorders.

• Identify the linkage and association between autoimmune disease prevalence and factors including lack of early diverse antigen exposure (i.e., the hygiene hypothesis).
• Interpret the available predictive autoantibody test options for autoimmune disorders.
• Learn to determine when to order the available clinical laboratory testing related to autoimmune disease risk assessment, diagnosis, and clinical management, including qPCR molecular-based evaluation of the GI microbiota, various food sensitivity assays, and predictive autoantibody tests.
• Apply evidence-based integrative and complementary therapeutic interventions for improvement of the GI mucosal health and barrier function (i.e., leaky-gut syndrome) in autoimmune disorders. 

• Utilize clinical decision making related to the linkage and association between autoimmune disease prevalence and individual factors, including the GI microbiota composition, food immune reactions, stealth infections, molecular mimicry, and lack of early diverse antigen exposure, in practical clinical cases.
• Interpret the available clinical laboratory testing related to autoimmune disease risk assessment, diagnosis, and clinical management, including qPCR molecular-based evaluation of the GI microbiota and predictive autoantibody tests in specific practical clinical case scenarios.
• Apply the available evidence-based integrative and complementary therapeutic interventions for autoimmune disorders in specific practical clinical case scenarios.
• Refer to other medical specialists and collaborative care opportunities in complex autoimmune disease clinical case scenarios.

• Identify the risks and complications of long-term PPI (Proton Pump Inhibition) exposure, complicating factors increasing our risks and their correction, and “best practices” for prescribing this therapy.
• Demonstrate a hiatal hernia correction technique with a Chiropractic Adjustment
• Integrate and apply phytotherapy treatment of different causes of dysmotility (SIBO, SIFO, IBD, IBS, neuropathy) based upon identifying key colonocyte target receptors in both TH1 (autoimmune) VS TH2 (allergic) situations.
• Identify and summarize Metabolic Inflammation, explain its’ triggers, resultant diseases and prescribe treatment for it.
• Discuss inflammation in the Intestine-Lung axis, apply dietary and lifestyle preventative and corrective treatment.
• Develop the use of therapeutic “biotics” for asthma, airway inflammation, and atopic disorders,
• Associate GI and respiratory biodome imbalances with asthma and allergic disorders, and their relationship to allergic sensitization
• Critique the interaction of the hygiene hypothesis and our “window of opportunity” to prevent asthma and allergic diseases
• Apply home and office based environmental therapy to help limit daily allergic exposure, allergy and asthma reactions.

Hour 1:

• Discuss PNI and its relationship to musculoskeletal conditions
• Review the interaction of the Hippocampus-Pituitary-Adrenal axis with PNI and its effect on musculoskeletal conditions Discuss clinical approach to managing these syndromes

Hour 2:       

• Explain what factors affect the baby boomer population
• Establish Patient education and doctor patient relationship
• Establish protocols to improve treatment outcomes

Hour 3:

• Mind over matter- how the brain and neuropathways affect musculoskeletal conditions
• Describe cellular structure connections
• Evaluate patients with musculoskeletal conditions and consider the effect of the mind, body, cellular and neurological alterations manifesting of these conditions.

• Identify the Importance of the Microbiome in Leaky Gut Syndrome
• Examples of symptoms of Leaky Gut Syndrome
• Discuss the health conditions caused by Leaky Gut Syndrome
• Breakdown the causes of Leaky Gut Syndrome
• Explain Nutritional Therapies used to heal Leaky Gut Syndrome

• Explain the importance of Glutathione as a Nutritional Therapy.
• Demonstrate the Symptoms of Alzheimer’s, Liver dysfunction, Lung conditions and Eyes, Ears, Nose and Throat conditions and the benefits of Glutathione therapy in each case.
• Discuss abstracts that illustrate the benefits of Glutathione therapy in Alzheimer’s, Liver and lung dysfunction and conditions of the Eyes, Ears, Nose and Throat.
• Illustrate the primary benefit of Glutathione therapy for Alzheimer’s and conditions of the liver, lung and ears, eyes, nose, and throat.
• List the primary precursors for Glutathione in the body.

• Explain how beneficial commensal microbes support gastrointestinal health
• Describe the major components of the intestinal barrier
• Summarize the microbial composition of a typical stool sample
• Explain the role of comprehensive stool testing in assessing gastrointestinal health

• Recognize the three most common types of microbial dysbiosis
• Describe common factors that can reduce beneficial microbes and disrupt the intestinal barrier
• Assess pathogens and opportunistic microbes identified with comprehensive stool testing
• Discuss how the selection of microbial testing methodology may affect the identification of pathogens and opportunists
• Outline therapeutic approaches that address common dysbiosis types identified via comprehensive stool testing

• This course contains all courses with the educational objectives listed from Functional Medicine and Nutrition Virtual Classroom 201 through 210

• Describe the current epidemiologic trends in autoimmune incidence, morbidity and mortality.
• Associate the linkage between autoimmune disease prevalence and factors including the GI microbiota composition, food immune reactions, stealth infections, molecular mimicry, lack of early diverse antigen exposure, and other elements.
• Examine the available clinical laboratory testing related to autoimmune disease risk assessment, diagnosis, and clinical management, including qPCR molecular-based evaluation of the GI microbiota.
• Explain the difference between quantitative molecular testing (qPCR) versus next-generation sequencing of the GI microbiota in the support of clinical decision making.
• Appraise the available evidence-based integrative and complementary therapeutic interventions for autoimmune disorders.

• Describe the current common routes and mechanisms of toxic exposure for individuals living in the industrialized world.
• Associate the linkage between chronic diseases, including mitochondrial dysfunction, obesity, diabetes, Alzheimer’s disease, Parkinson’s disease, cancer and others with increased levels of exposure to various environmental and food toxins.
• Examine the available clinical laboratory testing related to toxic load and related disease risk assessment, diagnosis, and clinical management using various lifestyle and nutritional approaches.
• Explain the difference between the various methods to assess toxic burden and detoxification at the level of the individual in the support of clinical decision making.
• Appraise the available evidence-based integrative and complementary therapeutic interventions for lowering toxic load and improving detoxification function.

Hour 1

• Describe the general diagnostic criteria of Metabolic Syndrome and CVD.
• Demonstrate an understanding of the enhanced diagnostic criteria and the importance of investigating these potential earlier markers.
• Demystify the “Cholesterol and HDL hypothesis” and explain the compensation mechanisms of the body for this.
• Recognize the biometric and physical signs of the progressive nature of CVD, CHD and MetS.
• Investigate Lifestyle Modification Programs as the major intervention strategy for the reversal and stagnation of these comorbidities. 

• Describe the general dietary interventions of Metabolic Syndrome and CVD.
• Demonstrate an understanding of sodium/salt as it relates to CVD/HTN.
• Demystify the confusion of major supplements and foods as it relates to CVD/HTN. 
• Recognize the associations between insomnia and CVD, CHD and MetS.
• Investigate various peer reviewed studies and the outcomes of nutritional interventions.  

• Provide an understanding of the clinical applications of biochemical/metabolic evaluations to determine a patient’s hormonal status
• Explain the differences between various assessments of hormonal status
• Evaluate hormonal imbalances and disorders
• Evaluate nutrient needs in metabolic disorders Plan and monitor nutrient interventions to correct abnormalities found by the tests

• Describe the origin of mitochondria from an evolutionary perspective.
• Understand the critical role that the thyroid plays in metabolism and how this relates to healthy mitochondrial function.
• Explain how to test for mitochondrial function/dysfunction.
• Show how living in a thermos neutral modern society contributes to obesity.
• Recognize how antibiotics can damage mitochondria and how that can play a role in obesity.
• Give examples of toxins/drugs that can adversely affect mitochondria.

• Describe how common mitochondrial genetic problems are in the general population.
• Explain how mitochondria are needed to produce glutathione and why glutathione is needed for healthy mitochondria.
• Discover how oxidative stress can be both good and bad for the body.
• Discuss how mitochondrial dysfunction plays a key role in a variety of diseases ranging from Parkinson’s, Cancer, NASH, Alzheimer’s, Autism and Diabetes.
• Discover key ways to optimize mitochondrial function in patients.

• Describe the associations of micronutrient deficiencies as it relates mental health disorders.
• Demonstrate an understanding of major prescriptive medications and their negative influence on mental health disorders. 
• Explain the overlap of certain pathophysiological conditions and mental health disorders.
• Recognize the current lack of proper diagnosis of mental health disorder.

• Describe the associations of micronutrient and nutritional deficiencies as it relates mental health disorders.
• Demonstrate an understanding of the major biochemical pathways, their enzymes and nutritional elements as it relates to psychological issues.
• Explain the importance of fatty acids in mental health disorders.
• Recognize the current lack of proper nutritional interventions as it pertains to TBI, mTBI and PCS.

• Provide an understanding of the clinical applications of biochemical/metabolic evaluations to determine a patient’s status of nutrients, toxicants and cell regulators, and functional gastrointestinal status.
• Explain the differences between various assessments of element status
• Evaluate specific nutrient deficiency states
• Determine weaknesses in digestive, assimilative and intestinal microbiological status
• Plan and monitor nutrient interventions to correct abnormalities found by the tests

• Define and explain the difference between "calories in, calories out" versus the “carbohydrate-insulin model of obesity”. Discuss the causes of increased intestinal permeability in competitive athletes and identify strategies to combat the condition. Identify the energy intake athletes require by calculating their total energy expenditure.
• Recall the quality and function of macronutrients and their role in physical performance.
• Describe common micronutrient deficiencies seen in competitive athletes and identify strategies to prevent such occurrences.

• Summarize the physiological energy and macronutrient requirements of the sprint/power athlete and game-playing athlete. Identify supplement strategies to support the sprint/power athlete and game-playing athlete.
• Summarize the physiological energy and macronutrient requirements of the endurance athlete.
• Identify supplement strategies to support the endurance athlete.
• Outline an effective whole food diet to support competitive athletes.