Pennsylvania Chiropractic Continuing Education

• Cite statistics on the scope of child abuse in Pennsylvania
• Define the term child
• Define the term perpetrator
• Differentiate the commission of abuse from failure to act
• Explain the religious exemption to neglect
• Describe the effects of domestic violence on children in the home
• Define human trafficking
• List the risk factors to children / adolescents becoming victims of human trafficking
• Compare and contrast Child Protective Services and General Protective Services
• List the responsibilities of the Child Protective Services agencies
• Explain the goals of General Protective Services
• Outline the investigative process that occurs once a report is filed
• Indicate the additional procedures involved when the alleged perpetrator is a school or child services employee
• Define mandatory reporter and permissive reporter
• Explain the reporting requirements of mandatory reporters
• Outline the process of making a report of suspected abuse – Childline
• Summarize the suspension of privileged communication and the exemptions
• Define Presumption of Good Faith
• Explain the granting of immunity to mandatory and permissive reporters
• List the penalties for failure to report suspected child abuse by mandatory reporters
• List signs of abuse and neglect
• Explain the appropriate history and examination components in cases of suspected abuse and neglect
• Cite resources for patient education

• Cite statistics on the scope of child abuse in Pennsylvania
• Define the term child
• Define the term perpetrator
• Differentiate the commission of abuse from failure to act
• Explain the religious exemption to neglect
• Describe the effects of domestic violence on children in the home
• Define human trafficking
• List the risk factors to children / adolescents becoming victims of human trafficking
• Compare and contrast Child Protective Services and General Protective Services
• List the responsibilities of the Child Protective Services agencies
• Explain the goals of General Protective Services
• Outline the investigative process that occurs once a report is filed
• Indicate the additional procedures involved when the alleged perpetrator is a school or child services employee
• Define mandatory reporter and permissive reporter
• Explain the reporting requirements of mandatory reporters
• Outline the process of making a report of suspected abuse – Childline
• Summarize the suspension of privileged communication and the exemptions
• Define Presumption of Good Faith
• Explain the granting of immunity to mandatory and permissive reporters
• List the penalties for failure to report suspected child abuse by mandatory reporters
• List signs of abuse and neglect
• Explain the appropriate history and examination components in cases of suspected abuse and neglect
• Explain the reasons victims do not report abuse
• Outline the psychological sequelae to abuse during childhood
• Recognize the DSM-5 criteria for psychiatric conditions associated with victims of abuse
• Cite resources for patient education

• Identify the various styles of acupuncture
• List the branches of Chinese Medicine
• List the various way of stimulating acupuncture points
• Recognize the strengths and weakness of various acupuncture related treatments
• Describe the application of each of the Branches of Chinese Medicine

• This contains all courses with the educational objectives listed from Acupuncture 400 through Acupuncture 420

• This contains all courses with the educational objectives listed from Acupuncture 400 through Acupuncture 462

• Describe the paradigm and progression of Traditional Chinese Medicine.
• Define the five branches of Chinese medicine.
• Explain the basic relationships and theoretical constructs of Yin and Yang
• Identify the most clinically useful associations of Yin and Yang
• Summarize the most clinically useful functions of Yin and Yang

• Compare and contrast Yin and Yang disorders.
• Describe the Yin and Yang relationships within the human body.
• Give Examples of how the Eight Principles relate to one another and to Yin and Yang
• Summarize how the Eight Principles function in relation to human physiology
• Explain how the Eight Principles relate to pathology

• Differentiate Uses of 5 Element Theory in Chinese Medicine
• Reconstruct the Five Elements according to the Creative and Control Cycles
• Explain the functioning of the Creative Cycle
• Explain the functioning of the Control Cycle
• List the Organs Associated with each Element

• Compare and contrast the qualities and characteristics associated with the Five Elements
• Summarize the qualities and characteristics associated with the Five Elements
• Point out the major differences between the Five Elements
• Reconstruct the major Correspondences of the Five Elements
• Differentiate Individuals based on the Five Elements

• Outline the times of day associated with the Organs in Chinese Medicine
• Interpret the significance specific times with regard to Organs
• Relate the Essential substances in Chinese Medicine
• Explain theoretical process of Substance Production
• Reconstruct the role of the three warmers in Qi, Blood, and Fluid Production

• Relate the Theoretical Process of Jing Formation
• Give examples of The Functions of Jing
• Describe Functions of Shen
• Diagram Fluid Production
• Assess Common Fluid Pathologies

• Relate the Theoretical Process of Jing Formation
• Give examples of The Functions of Jing
• Describe Functions of Shen
• Diagram Fluid Production
• Assess Common Fluid Pathologies

• Differentiate the External Pathogenic Factors
• Explain Internal Pathogenic Factors
• Describe How External Pathogenic Factors Influence the body
• Recognize Miscellaneous Pathogenic Factors
• Discuss the TCM viewpoint on the Causes of Disease

• List the Yin & Yang Organs
• Compare and Contrast Yin & Yang Organs
• Reconstruct the Yin/Yang Organ Relationships
• Summarize the similarities and differences of Yin & Yang Meridians
• Reconstruct the SIx Division Meridian Pairs

• Relate the common symptoms associated with the Lungs & Large Intestines
• Define properties of the Lungs & Large Intestines
• Describe the functions of the Lungs & Large Intestines
• Discuss the most common disharmonies of the Lungs & Large Intestines
• Explain the clinically relevant “nicknames” of the Lungs & Large Intestines

• Relate the common symptoms associated with the Spleen & Stomach
• Define properties of the Spleen & Stomach
• Describe the functions of the Spleen & Stomach
• Discuss the most common disharmonies of the Spleen & Stomach
• Explain the clinically relevant “nicknames” of the Spleen & Stomach

• Relate the common symptoms associated with the Organs of the Fire Element
• Define properties of the Organs of the Fire Element
• Describe the functions of the Organs of the Fire Element
• Discuss the most common disharmonies of the Organs of the Fire Element
• Explain the clinically relevant “nicknames” of the Organs of the Fire Element

• Relate the common symptoms associated with the Liver & Gall Bladder
• Define properties of the Liver & Gall Bladder
• Describe the functions of the Liver & Gall Bladder
• Discuss the most common disharmonies of the Liver & Gall Bladder
• Explain the clinically relevant “nicknames” of the Liver & Gall Bladder

• Relate the common symptoms associated with the Kidney & Urinary Bladder
• Define properties of the Kidney & Urinary Bladder
• Describe the functions of the Kidney & Urinary Bladder
• Discuss the most common disharmonies of the Kidney & Urinary Bladder
• Explain the clinically relevant “nicknames” of the Kidney & Urinary Bladder

• Compare the major point categories
• Derive Tonification and Sedation points
• Describe The 12 Main Meridians
• Contrast the functions of Yin and Yang Meridians
• Explain the 6 major Meridian Categories

• List the 14 Acupuncture Meridians that possess acupoints
• Summarize the clinical applications of Yin and Yang Meridians
• Point out the beginning and end points of each of main Meridians
• Outline the main functions of each of the main meridians
• Illustrate the trajectories of the main meridians

• Name the Extraordinary Organs
• Distinguish Extraordinary Organs from Yin & Yang Organs
• Name the Extraordinary Meridians
• Discuss the functions of the Extraordinary Meridians
• Reconstruct the classical treatment sequence for Extraordinary Meridians.

• List the areas of the tongue, as they apply to different aspects of the body
• Relate the common features of the tongue, which indicate disharmonies
• Utilize tongue colors, shapes, coats, and movements for diagnosis
• Determine common Organ disharmonies based on tongue observation
• Distinguish between excess and deficient conditions, based on tongue observation

• Describe normal and common pathological pulses
• Diagnose pathological signs associated with pulse speed
• Explain common pulse qualities
• Summarize usual pulse combinations
• Recognize tongue and pulse combinations associated with common disorders

• Explain Universal Precautions
• Prepare a Clean Field for administering acupuncture
• Secure, handle and dispose of Biohazard material, normally encountered in an acupuncture practice
• Recognize, avoid, and handle acupuncture side effects
• Explain the cautions and contraindications of acupuncture treatment

• List the types of acupuncture meridians
• Distinguish between various types acupuncture meridians
• Describe the functions of various types acupuncture meridians
• Determine and apply individual patient measurements, in order to locate acupuncture points
• List the Transport Points

• This contains all courses with the educational objectives listed from Acupuncture 421 through Acupuncture 436

• Distinguish between acupuncture points categories
• Create supplementing & reducing treatments based on the Five Element points
• Describe the functions of various categories acupuncture points
• Compare and contrast Acupuncture point actions and indications

• Describe and point out the general pathway of the Du Meridian
• Locate each of the individual points on the Du Meridian
• Recognize Du Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Du Meridian

• Describe and point out the general pathway of the Ren Meridian
• Locate each of the individual points on the Ren Meridian
• Recognize Ren Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Ren Meridian

• Describe and point out the general pathway of the Lung Meridian
• Locate each of the individual points on the Lung Meridian
• Recognize Lung Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Lung Meridian

• Describe and point out the general pathway of the Large Intestine Meridian
• Locate each of the individual points on the Large Intestine Meridian
• Recognize Large Intestine Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Large Intestine Meridian

• Describe and point out the general pathway of the Stomach Meridian
• Locate each of the individual points on the Stomach Meridian
• Recognize Stomach Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Stomach Meridian

• Describe and point out the general pathway of the Spleen Meridian
• Locate each of the individual points on the Spleen Meridian
• Recognize Spleen Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Spleen Meridian

• Describe and point out the general pathways of both the Heart & Pericardium Meridians
• Locate each of the individual points on both the Heart & Pericardium Meridians
• Recognize Heart & Pericardium Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on both the Heart & Pericardium Meridians.

• Describe and point out the general pathway of the Small Intestine Meridian
• Locate each of the individual points on the Small Intestine Meridian
• Recognize Small Intestine Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Small Intestine Meridian

• Describe and point out the general pathway of the Bladder Meridian
• Locate each of the individual points on the Bladder Meridian
• Recognize Bladder Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Bladder Meridian

• Describe and point out the general pathway of the Kidney Meridian
• Locate each of the individual points on the Kidney Meridian
• Recognize Kidney Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Kidney Meridian

• Describe and point out the general pathway of the San Jiao Meridian
• Locate each of the individual points on the San Jiao Meridian
• Recognize San Jiao Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the San Jiao Meridian

• Describe and point out the general pathway of the Gall Bladder Meridian
• Locate each of the individual points on the Gall Bladder Meridian
• Recognize Gall Bladder Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Gall Bladder Meridian

• Describe and point out the general pathway of the Liver Meridian
• Locate each of the individual points on the Liver Meridian
• Recognize Liver Meridian points that are associated with contraindications
• Compare and contrast the actions and indications of the main points on the Liver Meridian

• Describe and point out the Location of 31 Extraordinary Points
• Recognize Extraordinary Points that are associated with contraindications
• Recognize both the English and Chinese names of 31 Extraordinary Points
• Compare and contrast the actions and indications of 31 Extraordinary Points
• Describe specific needling associated with those acupuncture points which require unconventional needling techniques or directions

• List the similarities in treatment associated with all acupuncture microsystems
• Describe and point out the location of 17 discrete hand acupuncture points
• Describe and recreate a useful somatotope associated with hand acupuncture
• Compare and contrast 3 different styles of hand acupuncture
• Describe specific needling techniques associated with those hand acupuncture points which require specific needling techniques and/or directions

• This contains all courses with the educational objectives listed from Acupuncture 437 through Acupuncture 440

• List the similarities associated with ear acupuncture and other acupuncture microsystems
• Describe and recreate a clinically-useful somatotope/homunculus associated with ear acupuncture
• Locate the physical structures of the ear, such as the helix, antihelix, triangular fossa, antitragus, etc.
• Describe and point out the location of the major landmarks for auriculotherapy point location
• Describe and point out the location of 36 or more discrete ear acupuncture points

• List the similarities associated with Chinese Scalp Acupuncture and other acupuncture microsystems
• Describe and find treatment areas associated with the somatotope of the cortex of the brain
• Describe and point out the location of the major landmarks, lines, and points, used to find Chinese Scalp Acupuncture treatment areas and lines.
• Describe and point out the location of the 10 most commonly used Chinese Scalp Lines/Areas
• Describe and find the correct layer for needling Chinese Scalp lines, and begin practicing the techniques needed to use this form of acupuncture in clinical practice.

• List the similarities associated with YNSA Scalp Acupuncture and other scalp acupuncture microsystems
• Describe and find treatment areas associated with the YNSA somatotope
• Describe and point out the location of the major landmarks used to find YNSA Scalp Acupuncture points.
• Describe and point out the location of the most commonly used YNSA Scalp Points
• Describe and find the correct procedure and needling technique for treating YNSA Scalp Points, and begin practicing the techniques needed to use this form of acupuncture in clinical practice.

• Identify the various types of acupuncture needles
• List the main formats for administering moxibustion
• Set up and maintain a clean field
• Recognize and take steps to avoid the main risks to acupuncture providers
• Recognize and take steps to avoid the main risks to acupuncture patients

• This contains all courses with the educational objectives listed from Acupuncture 441 through Acupuncture 446

• Identify the various sizes of acupuncture needles
• Describe needle techniques to tonify and sedate acupuncture points
• Demonstrate the common needle insertion angles
• Compare and contrast the size of acupuncture needles with other common needles
• Infer safe and appropriate needle depths for many common acupuncture points

• Identify the various grades of moxa
• Describe various methods for applying indirect moxa
• Demonstrate safe procedures for administering indirect moxa
• Compare and contrast direct and indirect moxibustion
• Determine appropriate methods for administering moxibustion in specific clinical

• Identify conditions which are amenable to treatment with electro-acupuncture
• Distinguish between invasive and non-invasive electro-acupuncture devices and administrative practices.
• Demonstrate safe procedures for administering electro-acupuncture
• Compare and contrast milliamp stimulation with microamp stimulation
• Determine appropriate frequency and intensity settings for administering electro-acupuncture, based on clinical findings

• Identify conditions which are amenable to treatment with cupping and gua sha
• Identify various types of cups and gua sha instruments
• Demonstrate safe procedures for administering gua sha
• Describe post-treatment recommendations and procedures for gua sha & cupping
• Demonstrate safe procedures for administering cupping with both fire silicone cups

• Identify conditions which are amenable to treatment with Laser and TDP Lamp.
• Identify various types and wavelengths of lasers employed in acupuncture
• Demonstrate safe procedures for administering laser acupuncture
• Describe the physical mechanisms associated with photobiology
• Demonstrate safe procedures for administering TDP Lamp

• Differentiate most painful conditions according to TCM theory
• Compare and contrast pain associated with Cold, Heat, Damp, Qi, & Blood Stagnation
• Assess local, distal and adjacent points for the treatment of pain
• Select appropriate modalities for various painful conditions
• Formulate meridian based treatment strategies for many painful conditions

• This contains all courses with the educational objectives listed from Acupuncture 447 through Acupuncture 451

• Identify many primary points for the treatment of pain
• Describe the relationships of the individual meridians within yangming, shaoyang, and taiyang classifications
• Formulate treatment strategies based on the 6 Divisions
• Compare and contrast yangming, shaoyang, and taiyang areas of influence
• Choose appropriate techniques for treating trigger points

• Describe the special pathways of the sinew meridians relevant to the treatment of pain
• Identify Jing points for the treatment of pain according to main and sinew meridian pathways
• List the points used to activate the anterior, posterior, lateral and medial  treatment zones
• Compare and contrast posterior, lateral and medial zones as they relate to acupuncture treatment
• Describe the procedure using zonal treatment for treating pain

• Identify the most common painful disorders of the head and neck that can be treated effectively with acupuncture
• Choose effective points for treating many painful disorders of the head and neck
• Identify the most common painful disorders of the upper extremity and trunk that can be treated effectively with acupuncture
• Choose effective points for treating many painful disorders of the upper extremity and trunk
• Determine appropriate treatment modalities for common painful conditions of the upper body

• Identify the most common painful disorders of the back and lower extremity that can be treated effectively with acupuncture
• Choose effective points for treating many painful disorders of the back and lower extremity
• Compare and contrast the Bladder and Gall Bladder Meridians an their influences on the lower back
• Compare and contrast the zones and meridians associated with the back and leg
• Choose appropriate treatment modalities for painful conditions of the back and leg

• Interpret phenomena in terms of Yin &Yang
• Apply the theory of Yin-Yang to Chinese medicine
• Describe the concepts of deficiency and excess of Yin & Yang
• Identify phenomena according to the Five Elements
• Apply the theory of Five Elements to Chinese medicine
• Summarize the interrelationships of the Generating, Controlling, and Over-acting Cycles of the Five Elements  
• Differentiate the origin, nature, & functions of Pre-Heaven Essences
• Explain the functions of Qi in the body
• Outline the relationship between Blood and Qi
• Explain the relationship between Blood and Essence
• Contrast and Compare Blood and Body Fluids
• Identify the different aspects of the Mind as it is understood within Chinese medical theory

• This contains all courses with the educational objectives listed from Acupuncture 452 through Acupuncture 461

• Describe the functional activities of Qi and their associated physiological processes in the body
• Explain the role of the Original Qi as the dynamic motive force for transformation
• Analyze the interrelationship of the Essence and the Fire of the Gate of Life
• Explain the process of the movement of Qi in the body
• Summarize the role of the bones as one of the deepest energetic layers
• Paraphrase how the entering and exiting of Qi from the space between the skin and  muscles regulates sweating
• Describe how Qi enters and exits from the joints, and how this process can become interrupted
• Explain the nature and functions of the Yin and Yang organs in general, and the essential differences between them
• Infer how the Kidneys, as the foundation of Yin and Yang and the origin of Fire and Water in the body, impact the other Organs
•  Give examples of how the role of the Stomach and Spleen as the “center,” impacts the body’s function
•  Summarize the relationships between Heart and Blood
• Outline how anger affects the Liver and how a Liver disharmony affects our moods

• Describe the importance of the Pericardium channel in acupuncture treatment
• Discuss the significance of the Triple Burner in the Qi mechanism
• Match the Heart with various emotions, substances, & organs
• Differentiate the relationships of Blood to the Heart, Liver, and Spleen
• Recognize the various aspects of the soul, and the organs to which those aspects are most closely related
• Give examples of how the Liver and Spleen interact in making and storing the Blood
• Explain the significance of the descending of Lung-Qi and the ascending of Liver-Qi
• Relate the free flow of Liver-Qi to the Spleen's function of transformation and transportation
• Explain how a deficiency of Spleen-Qi, leading to the formation of Phlegm, affects the Lungs
• Summarize the relationships between the Kidneys and the Spleen
• Discuss the complexities of the relationship of Blood to Spleen, Heart and Liver
• Distinguish the roles played by the Yin and Yang organs, in the management of fluids
• Diagram the more significant interrelationships of the five Yin organs
• Compare and Contrast the Extraordinary organs with the Yin & Yang organs

• Explain how climatic factors can become a cause of disease
• Assess the influence of the constitution on predisposition to health or disease
• Compare diagnostic signs of a strong or weak constitution
• Discuss how excessive physical work and exercise can cause disease
• Relate the significance of poor diet and eating habits as a cause of disease
• Summarize the importance of paying attention to a patient's constitutional type
• Interpret clinical meaning of changes in the tissues and other parts of the body
• Recognize the importance of the tongue as a pillar of diagnosis
• Integrate tongue and pulse diagnosis to confirm suspected patterns and indicate the presence of patterns not evident from other signs and symptoms
• Recognize the frequency of tiredness as a complaint in Western patients, and utilize  methods of questioning to ascertain appropriate patterns of disharmony
• Differentiate the clinical significance of feelings of cold, heat, and fever, and their different clinical significance in exterior and interior conditions
• Justify the importance of questioning and observing the patient's emotional state
• Recognize the significance of asking about menstruation, leucorrhoea, pregnancy, and childbirth
• Examine children's symptoms, in the areas of digestion, respiration, sleep and immunization

• Describe the role of the radial pulse in diagnosis
• Give examples of the problems inherent in pulse diagnosis
• Discuss the clinical significance of the three levels of the pulse
• List the factors to take into account when evaluating the pulse
• Recognize signs from palpating the temperature, moisture, and texture of the skin
• Explain how palpation of the abdomen provides valuable diagnostic information
• Recognize the various forms taken by 'Excess of Yang' and 'Deficiency of Yang'
• Recognize the various forms taken by 'Excess of Yin' and 'Deficiency of Yin'
• Summarize the diagnostic significance of the sounds of breathing, cough, vomiting, hiccup, borborygmi, sighing etc.
• Analyze the implications of ascending/descending and entering/exiting of Qi
• Point out the significance of the smell of bodily secretions
• Identify the Full/Empty nature of a condition, according to the presence or absence of a pathogenic factor and the strength of the body's Qi

• Identify the four pathological patterns of Qi disharmony
• Defend the importance of distention as a characteristic of Qi stagnation
• Identify the four Blood pathology patterns
• Distinguish between various types of Blood stasis in the Liver, Heart, Lungs, Stomach, Intestines and Uterus
• Recognize the causes of Blood stasis
• Identify the three types of pathological Body Fluid patterns
• Give examples of Phlegm in Chinese medicine
• Outline the role of the Spleen, Lungs and Kidneys in the production of Phlegm
• Differentiate between the various Heart pathologies
• Discuss how pathologies of the Pericardium differ from those of the Heart
• List the general characteristics of Liver pathology
• Differentiate between the various Liver pathologies

• Describe how exterior Wind (combined with Heat or Cold) can invade the Lung Exterior portion to cause exterior patterns
• Discuss and differentiate the effects of Dryness and Dampness on the Lungs
• Recognize Lung Deficiency patterns
• Identify Lung Excess patterns
• Differentiate Lung Phlegm patterns
• Describe and differentiate Spleen Deficiency Patterns
• Compare and contrast Spleen Cold-Dampness and Damp-Heat in the Spleen
• Analyze the significance of the duality of Kidney-Yin and Kidney-Yang in Kidney pathology
• Point out the differences and similarities associated with Yin, Yang, and Jing Deficiencies in the Kidneys
• Outline the importance of heredity in determining the strength of a child's Kidneys
• Apply the significance of Stomach-Qi in prognosis
• Illustrate how Stomach-Qi manifests on tongue and pulse

• List the main functions of the Small Intestine
• Describe the main functions of the Large Intestine
• Summarize the role of diet in Large Intestine pathology
• Discuss the importance of the Gall Bladder's function of storing bile
• Relate the pathology of Gall Bladder pathology to that of the Liver
• Outline the main Bladder function of transforming and excreting fluids
• Explain why the Kidneys do not have Full patterns
• Differentiate Damp-Heat in the Bladder from Damp-Cold in the Bladder
• Give examples of symptoms of the stages of external Wind invasion
• Identify the main clinical manifestations of the emergence of Latent Heat
• Recognize Damp-Heat in the Gall Bladder and Liver
• Distinguish between Bright Yang, Greater Yang, Lesser Yang, Greater Yin, Lesser Yin, and Terminal Yin patterns
• Distinguish between Wei, Qi, Ying and Blood Level patterns

• Identify patterns according to the Three Burners
• Relate patterns according to the Three Burners to those of the Four Levels
• Integrate the relationship between the channels and the organs in disease
• List the causes of channel problems
• Diagnose channel patterns 
• Identify the Generating and Overacting sequence patterns
• Relate the Qi of the channels to a flow of water
• Explain the importance of the Transporting Points in clinical practice
• Describe the connection between the channels and the environment
• Summarize the dynamism of points at the end and beginning of the channels
• Outline the significance of the regulating, balancing and integrating functions of the extraordinary vessels
• List the different ways that opening and coupled points can be used to open the Vessels
• Determine when to use the extraordinary vessels

• Cite the clinical applications of the Governing Vessel
• Recall the clinical applications of the Directing Vessel
• Distinguish the five branches of the Penetrating Vessel
• Relate the clinical applications of the Girdle Vessel
• Give examples of the clinical applications of the Yang Stepping Vessel
• Discuss how the Yin and Yang Stepping Vessels combine in Pathology
• Recognize the importance of adopting the correct treatment principle
• Point out how the Root and Manifestation relate to each other
• Describe how a Manifestation can become a Root of further Manifestations
• Explain the importance of tracing clinical manifestations back to their Roots
• Summarize the importance of knowing when to tonify Qi or expel pathogenic factors
• Recognize the importance of being aware of residual pathogenic factors
• Compare herbal treatment and acupuncture

• Needling Basics: Establish a solid foundation in proper hand positioning, needle insertion, and withdrawal techniques to ensure precision and safety.
• Anatomical Point Location: Develop skills in locating key acupuncture points using anatomical landmarks and palpation techniques with accuracy and consistency.
• Safe and Effective Practice: Demonstrate proficiency in applying appropriate needle depths, angles, and insertion techniques tailored to different body areas, types, and conditions while adhering to safety protocols.
• Advanced Manipulation Techniques: Learn and apply advanced needling methods, such as tonification (strengthening) and sedation (calming) to achieve specific therapeutic outcomes.
• Patient Interaction and Response Management: Recognize and respond to patient feedback—verbal and non-verbal—to enhance comfort and optimize effectiveness.
• De Qi and/or Trigger Point Release Proficiency: Identify and work with the De Qi sensation and/or Point Release Signals, understanding their importance in therapeutic efficacy and adjusting techniques based on tactile feedback.
• Troubleshooting Complications for patient safety and risk management: Learn to address common challenges like fainting, needle retention, or discomfort in real-time clinical settings.
• Clinical Application: Integrate needling techniques into case-specific treatment plans for common issues like musculoskeletal pain, stress, and internal disorders.
• Regulatory and Ethical Considerations: Apply ethical guidelines and legal requirements for acupuncture within the chiropractic scope of practice to ethically apply acupuncture and Manage Risk
• Building Confidence Through Live Interaction: Gain experience through live model demonstrations and interactive Q&A to build competence in needling techniques.

• Explain the concept of whole-being care and its relationship to chiropractic philosophy, emphasizing the integration of physical, mental, and spiritual health.
• Describe the role of spinal alignment in optimizing nervous system function and its downstream effects on overall health outcomes, including stress resilience, sleep quality, and immune function.
• Identify evidence-based strategies for patient education that move beyond symptom management to long-term health empowerment.
• Interpret key research findings linking chiropractic interventions with measurable health benefits, such as reduced surgery rates and improved neuroplasticity.
• Apply lifestyle and care recommendations—including sleep hygiene, movement, nourishment, stress management, and growth mindset—to enhance patient engagement and clinical outcomes.

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

• 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

• 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.

• 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.

• Present the etiology of blister and callus formation
• Review the gait cycle and the biomechanical events relevant to callus formation
• Review pronation and supination motions of the foot and how they relate to low and high gear push off
• Review the 3 rockers and how they can relate to callus formation
• Discuss the more common callus patterns in feet
• Describe the foot pathomechanics that lead to callus formation

• Discuss the anatomy of the tibialis posterior muscle
• Emphasize the importance of blood supply and the presence of watershed areas leading to tendon pathoanatomy
• Present the biomechanics associated with this muscles normal activity vs dysfunction
• Show clinical examples of posterior tibial tendon dysfunction
• Discuss orthotic intervention and exercises that are useful in remediation of posterior tibial tendon dysfunction

• Discuss the anatomy of the tibialis posterior muscle
• Emphasize the importance of blood supply and the presence of watershed areas leading to tendon pathoanatomy
• Present the biomechanics associated with this muscles normal activity vs dysfunction
• Show clinical examples of posterior tibial tendon dysfunction
• Discuss orthotic intervention and exercises that are useful in remediation of posterior tibial tendon dysfunction

• Review the pertinent anatomy of the achilles tendon and adjacent structures
• Discuss watershed zones of microvascualrity and how they can be compromised 
• Discuss the mechanisms of how many achilles tendinopathies and pathologies occur
• Present some methods of treatment and remediation for achilles tendinopathies

• Review the pertinent anatomy of the achilles tendon and adjacent structures
• Discuss watershed zones of microvascualrity and how they can be compromised 
• Discuss the mechanisms of how many achilles tendinopathies and pathologies occur
• Present some methods of treatment and remediation for achilles tendinopathies

• Discuss actual cases of problems remediated by orthotic therapy
• Discuss the pathomechanics of the problem and kinetics/ kinematics of the remediation
• Show orthotic modifications for specific issues
• Demonstrate additional therapies/exercises/modalities that assist in specific problem management

• Present the 5 basic foot types
• Discuss the biomechanics of each foot type
• Show and explain pedograph prints of each foot type
• Contrast and compare traditional vs a novel method of foot type determination
• Talk about common orthotic prescriptions for specific foot types

• Describe some of the more common orthotic postings
• Discuss the clinical reasoning behind using orthotic postings
• Highlight some clinical examples of orthotic postings and their use
• Outline some pitfalls and precautions of orthotic postings

• Discuss the basic biomechanics of gait
• Identify lower extremity coronal plane abnormalities
• Discuss pronation and supination mechanics
• Define bunions, hammertoes and hammer toes
• Review ranges of motion for lower extremity articulations
• Introduce lower extremity torsions and versions
• Highlight the differences between walking and running gait
• Discuss finer points of gait analysis and gait kinematics
• Utilize a pedograph
• Discuss pitfalls in obtaining a pedograph
• Demonstrate evaluation techniques for the clinical examination of the lower extremity in a case setting
• Go through expected ROM’s for different joints in the lower extremity and their clinical significance when limited
• Demonstrate evaluation techniques for the clinical examination of the lower extremity in a case setting
• Go through expected ROM’s for different joints in the lower extremity and their clinical significance when limited
• Discuss some common muscular dysfunctions in the lower extremity and their clinical sequelae
• Present concepts of “shoe anatomy” and “shoe biomechanics” and discuss their significance in shoe selection
• Name and describe the parts and functions of a typical shoe
• Discuss common manufacturers defects in shoes
• Introduce the topic of orthotic therapy
• Identify the when, where and why an orthotic may be prescribed
• Highlight the similarities and differences of over the counter vs custom orthotics
• Present a reproducible method for orthotic casting
• Describe and demonstrate some of the more common orthotic postings
• Discuss the clinical reasoning behind using orthotic postings
• Highlight some clinical examples of orthotic postings and their use
• Outline some pitfalls and precautions of orthotic postings
• Outline foot types and appropriate orthotic postings
• Introduce equipment needed to perform orphic postings and modifications
• Demonstrate examples of orthotic postings
• Provide instruction of how to perform common orthotic postings
• Provide instruction of how to perform common orthotic modifications
• Outline some pitfalls and precautions of orthotic postings
• Emphasize the importance of the orthotic/shoe interface
• Discuss some more common problems with orthotics and how to remedy them
• Investigate how physical signs (like blistering) can lead you to the cause of the problem with the orthotic or orthotic/shoe interface

• Describe the anatomy and biomechanical function of the first MTP sesamoid complex, including how these structures contribute to weight distribution, force generation, and joint stability throughout the gait cycle.
• Perform a comprehensive clinical examination and interpret radiographic findings to accurately diagnose sesamoid pathology and differentiate between bipartite sesamoids and fractures.
• Develop and implement conservative management strategies using orthotics, taping, strengthening exercises, and adjunctive modalities to address sesamoid-related pain and dysfunction.
• Explain the consequences of sesamoid pathology and degenerative changes (including hallux valgus complications) on first MTP joint stability, cartilage integrity, and functional alignment.
• Evaluate surgical options and their outcomes, including the indications, advantages, and serious complications (particularly bilateral sesamoidectomy consequences) when conservative management fails.
• Apply biomechanical principles to address associated forefoot pain syndromes through footwear modifications, orthotic design, and gait training strategies.

• 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

Hour 1

• Define standard of care.
• Examine the requirements of Chiropractic documentation.
• Evaluate Chiropractic care and the functional relationship.
• Review state specific examples of documentation requirements.
• Discuss what is mean by episode of care.

 Hour 2

• Establish the baseline of care.
• Identify the inadequacies of intake forms.
• Comply with the requirements of the initial encounter report.
• Review the consultation documentation in various case scenarios.
• Apply appropriate medical decision-making processes and documentation.

 Hour 3

• Examine the Documentation Requirements of a SOAP Note.
• Utilize PART in documentation.
• Utilize outcome assessment tests in documenting medical necessity of care.
• Identify Assessment and its relationship to medical necessity.
• Solidify elements of the treatment plan to support medical necessity.
• Apprise utilization management and review analysis of documentation.

• Recognize the common pitfalls that can put your clinic at risk
• Review the difference between a mandatory ABN and a voluntary ABN
• Identify the appropriate time to initiate a mandatory ABN
• Implement customized and compliant ABNs for your clinic by following the rules

• Demonstrate understanding of the key elements of revised E/M services
• Determine the elements that count as Time-Activities and how to calculate appropriately
• Establish protocol to determine Medical Decision Making element of E/M encounter
• Apply the new algorithm to appropriately code for E/M services under the 2021 model
• Discover how to still demonstrate Medical Necessity with the revised E/M codes
• Determine why history and examination are still needed

• 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 for those Doctors not using an EHR

• 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

• 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

• 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

• 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.
• Distinguish between active and maintenance care.
• Employ proper procedure to administrate both active and maintenance types of care.
• Complete and document required elements of documentation of active treatment.
• Apply the Medicare standard of financial transactions with patients in order to stay within the Federal collection guideline.

• 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

• 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

• 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'

• Identify the expected standards of a compliant and complete patient record
• Audit documentation to ensure the most important details are present
• Demonstrate how to conduct a complete baseline audit of record documentation

• 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

• 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

• Identify Dually Eligible Individuals (QMB) and Understand How Medicare Works with Medicaid
• Ascertain the practice’s obligations for QMB patients, regardless of Medicaid participation or coverage
• Provide accurate and legal advance notice to dually eligible individuals within the new guidelines
• Recognize the differences between acute, chronic, and maintenance care and how that affects billing and charges
• Duplicate Medicare financial rules and collections guidance into a process within the practice

• Identify the key players in the patient provider relationship
• Recognize the key documentation requirements and components required to be eligible to treat Veterans
• Compose documentation that meets  required VA elements
• Locate key resources for successful referral management
• 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 submission

• Identify missing components before they become critical issues for your practice
• Determine the basic requirements of documentation for all payer classes
• Learn to identify payer requirements as part of your documentation standards
• Understand the key documentation components that boards, auditors and reviewers expect

• 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

Hour One: Documentation and Compliance Overview, Rules and Regulations

• Recognize and avoid or correct behavior that is contrary to the rule of “no opt-out for chiropractors”
• Apply compliance rules set forth by governmental agencies that apply to providers of service to Federally insured patients
• Demonstrate day-to-day application of guidance on Federal Program and state requirements for coding, billing, and finances
• Differentiate between active and maintenance care, according to the official Medicare definitions and other third-party guidelines
• Interpret the four types of risk the Office of Inspector General (HHS) expects providers to focus on with Policy and Procedure, per the OIG Guidance for Small Practices
• Recognize the limitations of experimental, investigational, and unproven technologies

 Hour Two: Documentation of Initial Visits-New Patients, New Episodes, and New Conditions

• Identify and apply concepts that differentiate types of initial visits, from new patients to updated episodes
• Produce documentation of initial visits that comply with board requirements for chiropractors
• Summarize documentation requirements as they apply to the new initial Evaluation and Management guidelines set forth January 1, 2021
• Establish medical necessity for your care and know with surety that initial visit documentation is complete
• Rank complicating factors and contraindications according to priority and include with initial assessment
• Populate a required treatment plan for care, whether for short- or longer-term care

 Hour Three: Documentation and Case Management for Routine Visits, Preventive Maintenance, and Wellness Care

• Differentiate between requirements for medically necessary services vs. maintenance which is self-pay
• Apply primary subluxation vs secondary compensation logic to mitigate risk for the full-spine adjustment
• Reproduce the key elements of routine chiropractic visits in documentation as set forth by third-party, State and Federal guidelines
• Interpret functional data to determine stages and levels of care
• Demonstrate the ability to implement therapeutic withdrawal and to document its results
• Recognize maximum therapeutic benefit (MTB) and properly document discharge from active treatment

 Hour Four: The Risks Associated Billing and Financial Compliance Regulations

• Give examples of billing and financial compliance that cross the line of False Claims Act and Anti-Kickback Statute violations
• Apply billing and financial compliance regulations to the day-to-day operations of the practice, including payment and prepayment plans
• Execute random auditing of charges and collections to meet OIG compliance guidelines
• Recognize and apply the rules of offering financial hardship discounts
• Produce advertising that falls within the guidelines of board and federal rules

• Label the main driver is for “Medical Necessity”, how and why you must communicate this to 3^rd party payers
• List the foundation of coding and be able to apply pertinent ICD10 coding guidelines
• Discover how correct coding may dictate our strength to 3^rd parties and have national implications for our profession.
• Discuss critical questions of the benefits and risks of our Chiropractic diagnosis codes in the insurance industry.
• Identify red flags, complicating factors, and have awareness of Risk management when documenting and coding.
• Identify how insurance companies rank the importance of various diagnoses and its effect on claims’ coverage and processing

• Explore contemporary healthcare issues from the perspective of Robert Lustig, MA and John Abramson, MD.
• Integrate the relevance of these issues to the chiropractic profession.
• Evaluate at the concept of evidence-based “medicine,” especially the “randomized controlled trial,” and describe how it applies to the chiropractic profession.
• Discriminate recent examples of “randomized controlled trials,” especially as related to pain syndromes and opioid drugs.Discusss the importance of the 2021 Nobel Prize for the chiropractic profession and mechanical-based care.
• Detail the physiology of the Piezo1 mechanical receptor.
• Introduce the concepts of mechanical function and mechanical neurology.
• Integrate the importance of the cerebellum to mechanical integrity and mechanical based care.
• Explain a randomized clinical trial that supports mechanical-based chiropractic care for visceral physiology.
• Distinguish the basic physiology of the neurotransmitter norepinephrine.
• State the basic physiology of the neurotransmitter dopamine.
• Outline the basic physiology of the neurotransmitter serotonin.
• Integrate the balance of the neurotransmitters dopamine and serotonin.
• Recite the relationship between the neurotransmitters dopamine, epinephrine and norepinephrine.
• Explore the concept of Heart Rate Variability (HRV).
• Integrate upper cervical chiropractic care, spinal chiropractic care, and HRV.

• Describe the relationship of the sympathetic nervous system and immunology.
• Relate the sympathetic nervous system and headache.
• Emphasize the importance of the opiate receptors in the periaqueductal gray matter and pain suppression.
• Summarize activation of the periaqueductal gray matter with chiropractic adjusting for pain suppression.
• Define the tensegrous matrix as relevant to chiropractic assessment and care.
• Integrate electrical nerve interference as a component of the subluxation complex.
• Explore the “corking” of cerebral fluid flow as related to the occiput-atlas subluxation.
• Define the prevalence, patterns, and predictors of chiropractic use by the US population.
• Empathize the importance of the first-class lever system of upright posture to the chiropractic profession.
• Establish the functional and physiological relationship between the brain and the cervical spine.
• Discuss the integrated physiology between inflammation, fibrosis, the Gate Theory, and chiropractic adjusting.
• Create a model of pain based upon the fibrosis of repair, motion, and the Gate Theory.
• Complete an interactive model of neuroimmunology using mechanoreceptors, the sympathetic nervous system, norepinephrine and neurological magnification.
• Complete an interactive exercise of spinal mechanoreceptor driven vestibular nuclei controls of somatic function and visceral function.
• Integrate the importance of constant v. non-constant thalamic summation/integration.

• Identify the relationship between an upper cervical - trigeminal cervical nucleus and headaches.
• Integrate headache, upper cervical spine, and the temporomandibular joint.
• Distinguish between the clinical management of compressive neuropathology v. supersensitivity nerve interference.
• Identify “red flags” associated with compressive neuropathology.
• Discuss the relationship between mechanoreceptors, the sympathetic nervous system, and neuroimmunology.
• Highlight the uniqueness of upper cervical spine mechanoreceptors and the vagus nerve.
• Describe mechanobiology and diseases of mechanotransduction.
• Explain connective tissue as a body-wide signaling network.
• Summarize some randomized controlled/clinical trials pertaining to chiropractic and/or manipulation care.
• Recall studies looking at the influence of chiropractic care on opioid use.
• Interpolate the importance of sagittal posture on pain and function.
• Examine the importance of sagittal posture on cognition.
• Integrate evolutionary biology, infection, and the existence of chiropractic subluxation.           
• Summarize studies showing the influence of joint adjusting on a variety of visceral syndromes.
• Detail the relationship between an infectious agent and host health.
• Recognize the basic details of neuroimmunology.