Kentucky Chiropractic Continuing Education

• Define obesity, including its symptoms, epidemiology and effects on health and wellness.
• Review conventional treatments for obesity
• Discuss popular diets for obesity and weight loss, and the macronutrients: carbohydrates, protein, and fats
• Review nutritional support strategies for weight loss.

• Adequately frame the problem and basic epidemiology of cardiovascular disorders (CVD)
• Present evidence of the relationship between obesity, insulin resistance, inflammation, stress and CVD
• Summarize the standard medical and laboratory evaluation techniques and why they may only screen for approximately 50% of people at significant risk for CVD
• Appraise the latest laboratory evaluations, including Lp (a), Apo A1, Apo B, hs-CRP, homocysteine, fibrinogen, AA/EPA, LDL-subclass and others to determine CVD risk
• Critique the current dietary, lifestyle, nutritional supplement, nutraceutical, and herbal strategies as therapeutic management options to reduce CVD risk and for the treatment of those who already have cardiovascular issues, including: high cholesterol and dyslipidemia, genetic susceptibilities, chronic inflammation, coagulation abnormalities, and insulin resistance-related risk factors

• Generate a list of disorders associated with gluten sensitivity
• Describe to patients where gluten is likely to be found and which foods are generally safe for a gluten sensitive patient
• Interpret journal articles or general publication articles in the light of the history of gluten sensitivity diagnosis
• Critique articles and authors who claim that celiac disease is the only proven form of gluten reaction
• Detect and differentiate chronic gluten reactions in patients from other causes of inflammation and disease

• Describe the historical context of celiac understanding
• Document reasons why celiac disease is nearly always misdiagnosed
• Present valid arguments from cited literature how celiac disease is an autoimmune condition
• Defend recent scientific advances for the leaky gut syndrome
• Discuss reasons why celiac disease is a global concern, not just an American issue.

• Defend the implementation of a gluten free diet in celiac and non-celiac gluten sensitive patients based on sound evidence from current literature
• Document reasons why a first-degree relative of a known celiac should be gluten-free
• Summarize the current rate of celiac diagnosis in the US
• Contrast the expected findings of a celiac patient and non-celiac gluten intolerant patient
• Recognize that neurological signs can result from gluten intolerance

• Identify which supplements are commonly used in exercise and sport
• Determine the benefits and risks of individual ergogenic aids
• Discuss the role that individual vitamins have in exercise and sport
• Examine the role that individual minerals have in exercise and sport
• Investigate the value of sport drinks
• Ascertain when fluids are most beneficial in sport
• Apply how exercise effects the immune system
• Review the positive and negative effects of exercise
• Identify the role of antioxidants in sport and exercise

• Summarize the bowel protective mechanisms and their role in health and disease
• Outline a treatment strategy for imbalanced gut flora/leaky gut
• Identify common food allergies and determine appropriate nutritional therapy
• Examine the role of fiber in gastrointestinal health
• Create a treatment plan for common GI complaints of constipation and diarrhea
• Determine appropriate nutritional treatments for ulcers
• Theorize how diet can affect Inflammatory bowel disease
• Understand how to successfully use nutrition to treat a variety of gastrointestinal disorders
• Comprehend a rationale treatment protocol for Irritable bowel syndrome
• Determine correct doses of supplements used for various gastrointestinal disorders
• Ascertain the safety and risks associated with commonly prescribed gastrointestinal supplements

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Identify various energy systems of the body and how they relate to exercise and sport
• Theorize which energy system is used for a specific sport event/activity
• Summarize the physiology of fat, protein and carbohydrate metabolism and utilization in exercise and sport
• Understand the relationship between the energy systems and various exercise parameters
• Create a diet protocol for the athlete prior to their sport or exercise activity
• Determine and understand the timing of meals in exercise and sport
• Outline a useful program for a person to maximize carbohydrate stores
• Theorize how glycemic index can affect exercise and sport activity
• Ascertain differences between food variables and how they affect exercise and sport performance

• Review nutritional supplements useful for weight loss.
• Discuss the research for conjugated linoleic acid for weight loss.
• Outline the associations between thyroid function and weight loss.
• Summarize dietary supplements that increase thermogenesis.

• Differentiate various nutrition assessment techniques.
• Determine which body fat/composition technique is most appropriate for the individual.
• Calculate essential measurements for weight loss patients.

• Appraise the reviewed research studies for salient elements of bias.
• Describe the sensitivity and specificity of common food sensitivity tests.
• Identify the effect of common natural interventions for IBS.
• Compare results of the low FODMAP diet to conventional dietary approach for IBS.
• Differentiate between clinical and statistical significance in natural medicine interventions for IBS
• Grade the magnitude of effect size for natural medicine interventions.
• Interpret the effect size of an intervention as it relates to the numbers needed to treat for benefit.
• Identify the risk of bias level for studies included in a systematic review on yoga for IBS.

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Review the clinical presentation of Diabetes
• Examine the role of nutrition and diet in Diabetes
• Design an appropriate supplement protocol for the diabetic patient
• Develop nutritional guidelines for hypoglycemia

• Identify sources and functions of carbohydrates, proteins, fats, alcohol, vitamins, minerals, and water in the human body.
• Demonstrate the importance of a balanced diet and use tools that can be utilized to evaluate the nutritional adequacy of a diet (RDA, Dietary Guidelines, MyPlate, etc.).
• Identify the relationship between diet and chronic diseases/illnesses (cardiovascular disease, diabetes, obesity, cancer, hypertension, osteoporosis, etc.) and what modifications can be made in the diet to reduce the risk for these diseases/illnesses.
• Recall current nutritional recommendations for healthy eating habits (American Heart Association, American Cancer Society, etc.).
• Utilize nutrition terminology and related terminology appropriately.
• Demonstrate lifelong healthful eating habits by differentiating between beneficial and non-beneficial dietary practices.
• Develop nutritional scripts for 10 of the most common adult pathologies that can be potentially palliative or reverses through dietary changes.

• Understand the relationship between BPH and nutrition/supplements
• Develop a nutrition treatment program for UTI's
• Design a nutrition therapy program for kidney stones and gallstones
• Explore the relationship between diet and hyperestrogenism and its related diseases such as PMS and FBD
• Outline a nutrition treatment program for menopause

• Analyze the relationship between tendonitis/bursitis and nutrition
• Identify the nutritional treatment of muscle cramps/leg cramps and soreness
• Discuss nutrition treatment for Muscular dystrophy
• Determine an appropriate nutrition treatment for Fibromyalgia

• Identify the etiology and pathology of arthritis.
• Outline a diet that is helpful in the treatment of arthritis.
• Apply specific supplements to an arthritic condition.

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• Quantify the prevalence rates of patients using opioids and herbal products
• Demonstrate the significance to the chiropractor of interactions between different herbs and common prescription drugs
• Discuss the at risk populations for interactions including the pregnant, and elderly populations
• Record and list the most common interactions of common food and herbal products
• Record and list the effects of the common interactions of common heart medication and herbal products
• Demonstrate evidence that supports the use of health care providers assessing patients for these interactions.
• Discuss the role of the chiropractor in the role of identifying these interactions.
• Illustrate several books, and smart phone based electronic applications to make the process of identification easier for a chiropractor and patient.
• Evaluate common case scenarios

Hour 1: Evolutionary Biology Influence on Clinical Physiology

• Discuss infection, evolution, immunity, inflammation, and fibrosis.
• Compare short-term survival v. long-term chronicity.

 Hour 2: Summarize Inflammation in both Pain and Disease

• Utilize Laboratory diagnosis of inflammation.
• Provide Nutritional management for inflammation.

Hour 3: Justification of Sleep Hygiene

• Explain the role for sleep and sleep’s influence on immunity, cognition, psychiatric conditions, hunger, fertility, blood sugar control, vascular health, and more.
• Summarize the influence of sleep on brain neurochemistry.

Hour 4: Define the Recently Discovered Glymphatic System

• Discuss the glymphatic system and how to optimize its influence on health.
• Emphasize the importance of the glymphatic system in relation to neurodegenerative diseases.

Hour 5: Point out the Role of Vitamins for Chronic Disease Prevention

• Emphasize the importance of B vitamins to lower homocysteine.
• Point out the relationship between elevated homocysteine and vascular injury risks.
• Justify why people need between 5-8 different supplements and explain why.

Hour 6: Analyze the Science of a Healthy Diet

• Justify high vegetable, low lectin, low glycemic dietary habits, and their influence on physiology.
• Summarize problems with refined carbohydrates, monosodium glutamate, aspartame, and chemical toxins.
• Explain the drivers and consequences of a leaky gut.
• Demonstrate glycation and its consequences.
• Explore the benefits of Intermittent Fasting

Hour 7: Appraise Chiropractic Clinical Practice and Pain Management

• Integrate the Gate Theory of Pain and the Chiropractic Adjustment
• Quantify the Opioids Epidemic and the Positive Influence of Chiropractic
• Diagram the importance of the omega-6 / omega-3 ratio
• Caution Against the Ingestion of Excitotoxins

Hour 8: Detail the Benefits of Exercise

• Emphasize the Benefits of High Intensity Interval Training.
• Introduce the Harmful Effects of Fructose on Energy Production

• Discuss the Nutritional Aspect of effect size of red meat reduction
• Discuss the importance of the GRADE evidence evaluation method.
• Explain the Nutritional importance of the choice of the red meat reduction target
• Summarize the multiple lines of evidence supporting the guideline recommendation.

• Define very low carb (ketogenic), low carb, and moderate carbohydrate diets
• Describe the proposed mechanism of how low carbohydrate diets may improve outcomes
• Summarize the evidence supporting low and very low carbohydrate diets in diabetes management
• Critique the arguments for the long-term use of ketogenic diets

• Understand the importance of normal bowl defense mechanisms
• Develop a nutritional treatment for candidiasis and gut flora imbalances
• Examine the importance of fiber on human health
• Design a nutritional treatment program for constipation and diarrhea

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.
• Examine the concept of health and aging
• Determine an appropriate lifestyle to increase the chances of living longer
• Analyze various diets and dietary patterns that play a role in aging
• Ascertain which foods are of greater benefit in regards to aging and longevity
• Develop an appropriate anti-aging diet
• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

Hour 1

• Define and explain the chronic illnesses so prevalent in today’s society.
• Recognize and calculate life expectancy statistics
• Describe the difference between traditional and modern (commercial diets)
• Distinguish the differences between raw and pasteurized milk
• Recognize the difference between healthy and commercial butter and eggs
• Discuss the difference between hydrogenated and non-hydrogenated fats/oils

 Hour 2 

• Contrast the differences between lacto fermented and non-fermented soy (tofu, edamame)
• Compare breast milk to soy formula
• Identify the difference between sea salt and industrialized salt
• Summarize the benefits of cholesterol
• Explain the dangers of cholesterol lowering drugs
• List the benefits of sunlight

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.

• Develop an appropriate nutrition program for an ulcer
• Identify the importance of diet in Celiac’s disease (non-tropical sprue)
• Outline a nutrition program for a patient with lactose intolerance
• Design a nutrition treatment program for GERD
• Examine the role of nutrition and supplements in irritable bowel syndrome

Hour 1

• Recognize normal cognitive and memory lapses and signs of declining cognition.
• Differentiate the assessment tools and the pros & cons of each
• Review evidence-based dietary patterns and specific foods that impact cognition
• Review additional evidence-based lifestyle factors that contribute to cognition
• Summarize dietary supplements which may impact cognition

Hour 2

• Recognize 5 categories of early aging
• Identify nutrient deficiencies associated with aging
• Examine epigenetics in aging, specifically COMT and MTHFR
• Review stress physiology and its contribution to aging
• Review contributions of microbiome to healthy physiology and aging

• Design an effective nutrition treatment program for carpal tunnel syndrome
• Develop a nutritional treatment program for Multiple Sclerosis
• Investigate the role of nutrition and supplements in regards to the treatment of headaches
• Understand how nutrition and nutrition supplements can influence dementia
• Identify appropriate diet and supplement agents in the treatment of dementia

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review the signs and symptoms of neuroinflammation and the processes that drive neurodegeneration.
• Identify the neurological signs and symptoms of long COVID and apply research-based protocols.
• Utilize dietary improvements and selected supplements to reduce neuroinflammation.
• Treatment protocols on testing to identify gut barrier and gut-brain axis imbalances.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Understand the effect of bacterial toxins originating in the gut on the gut-brain axis as a key to neurological disorders pathogenesis.
• Assess intestinal and blood-brain barrier dysfunction for better managing chronic neurological disorders.
• Understand new functional nutritional strategies for longevity.
• Incorporate leading-edge protocols for extending healthspan and longevity.
• Clarify the effects of intermittent fasting on immunity and longevity.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Integrate optimal lifestyle adaptations in diet, exercise, and supplement protocols to enhance neuroplasticity and improve quality of life.

• Outline the nature of and hallmarks of cancer
• Summarize the relationship between physical activity and cancer
• Summarize the relationship between nutrition and cancer
• Summarize the relationship between massage therapy and cancer
• Summarize the relationship between acupuncture and cancer
• Summarize the relationship between manual therapy and cancer

• Summarize the assessment and diagnosis of pain
• List and describe 5 common causes of back pain and how to prevent injury
• Outline the causes of fibromyalgia
• Illustrate the mechanisms of inflammation and pain
• Discuss the pain of peripheral neuropathy

• Evaluate the test-retest, intra- and inter-examiner reliability of the body pain diagram for determining pain distribution and location for musculoskeletal conditions
• Summarize the current state of knowledge on neuropathic pain, with focus on how it differs from nociception
• Review of the current literature regarding the epidemiology, diagnosis and management of Complex Regional Pain Syndrome
• Explore central nervous system neuroplastic adaptations that may contribute to the pathophysiology of chronic conditions
• Differentiate symptoms and signs of central sensitization, peripheral neuropathic pain and nociceptive pain in patients with low back pain (with or without leg pain)

• Gain insight into the different types of pain
• Differentiate different sources of spinal pain
• Summarize the societal and clinical challenges of the pain patient
• Describe the difference between acute and chronic pain
• Provide an initial appreciation of alternative treatment options
• Understand the importance of chiropractic principles with the pain patient

• Evaluate the relationships among thoracic spinal stiffness, pain and muscle activity in healthy subjects and those with chronic thoracic pain
• Summarize updated chronic pain classification updates from the ICD-11
• Compare and contrast the clinical presentation and pathophysiology of Fibromyalgia (FM) and Myofascial Pain Syndrome (MPS)
• Summarize a clinical framework to sub-categorize pain patients based on an individual’s dominant pain etiology 
• Examine the effect of neural tissue management on pain and disability in patients with chronic musculoskeletal pain

• Expand your application of the biopsychosocial model of chronic pain by exploring an enactive approach to pain
• Recognize the clinical complexities involved in identifying malingering in chronic pain patients
• Outline relevant factors pertaining to clinical presentation, pathophysiology and treatment of chronic neuropathic pain
• Investigate the hypoalgesic effect of thoracic spinal manipulation on pain induced by temporal summation
• Explore the potential brain mechanisms involved in pain relief achieved via Transcutaneous Electrical Nerve Stimulation (TENS) application

• Outline a recent clinical guideline on the chiropractic management of chronic musculoskeletal pain 
• Identify a common set of recommendations from high-quality clinical guidelines that can be applied to a wide range of musculoskeletal pain conditions 
• Explore which target concepts are important to patients who improved following a pain science education intervention for persistent pain 
• Investigate whether untrained trait mindfulness is associated with differential responses to pain stimuli and whether these intrinsic differences reflect differential patterns of resting-state functional connectivity in the brain 
• Characterize the pain-based mechanisms of thoracic spinal manipulation and advance the preliminary validation of brain-based models as potential clinical biomarkers of pain

Hour 1

• Define interventional pain management and how it can be applied to help solve acute and chronic pain.
• Outline and critique different pain theories.
• Outline the Biopsychosocial model of chronic pain and explain why this model is the most comprehensive for acute and chronic pain management.
• Summarize how to integrate interventional pain management with conservative care for acute and chronic pain.

Hour 2:

• Describe common interventional pain management procedures and how to integrate them into a comprehensive plan of care.
• List the most utilized injections and when they are considered.
• Identify when a spinal cord stimulator may be considered and how it can aid conservative management.
• Explain the use of endoscopic procedures and when they may be utilized to treat acute and chronic pain.

• Explore chiropractic patients’ perceptions of discomfort, pain, and stiffness to determine if and how they differentiate among the concepts 
• Describe the relationship between the presence of an audible pop during spinal manipulative therapy and pain outcomes
• Evaluate the effect of spinal manipulation on pressure pain thresholds in a real-world clinical setting 
• Assess whether a 10-second one legged stance test can independently predict survival in middle and older aged men and women 
• Illustrate the relationship between physical activity levels and pain

• Relate the different neurophysiologic mechanisms to the development of chronic pain states. 
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss basic science research that supports the main theories of chronic/central pain syndromes.  
• Apply basic neurorehabilitation techniques to modulate chronic pain circuits.
• Develop treatment plans for chronic pin patients consistent with current pain models.

• Relate the effects of interoceptive dysfunction to the development of chronic pain.
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss how the interoceptive nervous system may relate to Functional Neurologic Symptom Disorder.
• Apply knowledge of how interoceptive dysfunction may negatively affect higher cortical functions.
• Design and utilize strategies that normalize interoception to improve intractable patient symptoms.

• Relate the effects of cold sensory deficit to chronic central pain states.
• Map the pathways specific to Lamina I versus Lamina V sensory afferents.
• Discuss basic science research that links C-Fiber subpopulations with hyper-excitability of sensory neurons.
• Apply techniques to gate pain processing through the Dorsal Insula/Anterior Cingulate pain switch.
• Utilize relationship between cold pathways and pain pathways to gate chronic pain.

• Identify the relationship between the ANS and chronic pain.
• Explore the cause of sympathetic maintained pain.
• Discuss the emerging role of the brain and spinal cord in CRPS.
• Apply non-invasive neuromodulation techniques for pain control.
• Formulate an effective treatment plan based on current knowledge.

• Relate the effects of failure within the DNIC to the development of chronic pain.
• Draw the pathways specific to ascending sensory and descending pain modulatory circuits.
• Apply knowledge of the DNIC, as it relates to chronic lower back pain.
• Discuss basic science research that links the PAG with the phenomena of offset analgesia and conditioned pain modulation.
• Formulate and apply treatment plans based on stimulation of the DNIC utilizing spinal cord stimulation, motor cortex activation and heterotopic noxious conditioning stimulation.

• Relate the effects of cingulate cortex activation on chronic pain suppression.
• Draw and identify regions of the cingulate cortex pertinent to pain and suppression.
• Discuss basic science research that links area’s 32, 24 and 25 with pain and its relief.
• Apply specific techniques to modulate cortical areas 32, 24, and 25 for pain suppression.
• Formulate and implement a treatment plan based on the M1-ACC pain model.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

Hour 1 - PI Case Management Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many keys to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - PI Case Management Part 2

• Recognize common PI history red flags and contraindications 
• Identify symptoms and clinical history for two common PI traumatic injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - How to Humanize Your PI Cases

• Create a protocol to consistently implement outcome assessments into PI cases 
• Recognize other options and opportunities available to humanize PI cases   
• Identify common outcome assessments utilized in PI cases
• Improve awareness of clinical decisions that can be made from humanizing cases

Hour 1 - Your Personal Injury History: Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many “keys’ to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - Your Personal Injury History: Part 2

• Recognize common PI history “red flags” and contraindications
• Identify symptoms and clinical history for two common PI traumatic brain injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - Your Personal Injury Examination – Part 1

• Recognize the key elements of the Personal Injury post-traumatic examination
• Identify clinical contraindications and precautions prior to an examination
• Develop and map out a post-traumatic cervical spine examination protocol
• Identify and examine common motor vehicle crash shoulder conditions

Hour 4 - Your Personal Injury Examination – Part 2

• Discuss the critical components of a Personal Injury neurological examination
• Develop a traumatic brain injury examination screening protocol
• Recognize the documentation elements necessary in a PI physical examination
• Create a protocol for medical consultations, diagnostic imaging and testing

• Recognize the importance diagnostic imaging and testing in Personal Injury and trauma
• Summarize several of the common diagnostic imaging and testing available  
• Justify medical necessity and clinical rationale for imaging/testing in the treatment records
• Determine both a protocol and clinical necessity for plain film radiographs

• Review sensory-motor control and rehabilitation
• Discuss aerobic exercise for LBP patients
• Describe muscle training of the hip, abdominal and paraspinal muscles
• Identify how aerobic exercise improves motor performance in the elderly
• Distinguish the effects of different training styles on the cross-sectional area of paraspinal muscles

• Describe the contribution of hip vs. spinal motion
• Distinguish poor motor patterns of hip and low back movements and what to do about it
• Differentiate the role of exercise for neck disorders and determine what type of exercise works
• Delineate the neural adaptations to exercise and apply towards rehabilitation
• Describe current issues in low back rehabilitation (such as can low back tissues heal within a few weeks)

• Describe the long term course of LBP
• Describe neuromuscular impairments following LBP
• Differentiate the effects of pain on the neuromuscular system
• Discuss the models that explain the nature of motor problems with pain
• Differentiate and discuss the potential sources of LBP

• Identify and describe the major factors influencing muscular strength
• Assess the chiropractic influences on strength
• Identify and discuss the strength training principles
• Illustrate components of a training session
• Apply training principles into a practical strength program

• Define proprioception and describe how it is measured
• Discuss proprioception from a rehabilitative perspective
• Examine ankle, knee and shoulder proprioception and rehabilitation
• Examine spinal proprioception and sensorimotor training
• Summarize rehabilitation recommendations for proprioceptive deficits

• Illustrate basic principles of cardiovascular exercise
• Discuss the mechanisms of cardiovascular responses to exercise
• Discuss the acute effects of exercise on the cardiovascular system
• Discuss the training effects of exercise on the cardiovascular system

• Summarize the functional anatomy of core strength training
• Discuss the principles of core strength
• Develop an assessment of spinal stabilization
• Distinguish specific evaluation tests for spinal stability

• Summarize the effect of training on the fatigue of multifidi muscles
• Discuss which muscles are involved in stabilization exercises
• Assess the relation between low back pain and clinical instability
• Describe a study implementing manipulation and stabilization exercises for chronic LBP
• Introduce the concept of functional restoration vs. physical therapy for LBP

• Describe the early health care utilization for occupational low back pain
• Determine which factors are important in predicting outcome after a spinal stabilization exercise program
• Assess lumbar disc surgery rates before and after implementation of nonsurgical spine clinics
• Determine whether kinematic compromise can be used to predict spine loading in low back pain (LBP) patients under realistic lifting efforts in a workplace
• Determine the effects of subacute LBP and limitation of the straight leg raise on lumbar and hip kinematics during sit-to-stand and its reverse

• Summarize the effect of whiplash on neck muscle strength
• Discuss the effects of manipulation vs. mobilization on head and neck pain in whiplash patients
• Assess the effects of thoracic manipulation in whiplash patients
• Describe a study predicting the response of neck pain patients to neck strengthening exercise
• Introduce the smooth pursuit neck torsion test and its application in whiplash disorders

• Identify the anatomy of upper motor neuron tract systems and discuss the functionality of upper motor neuron tract systems
• Explain the effects of a spinal cord injury
• Discuss the anatomy and functionality of regions of the brain
• Describe complications post injury of brain and spinal cord injury
• Describe standard treatment procedures prior to rehabilitation of brain and spinal cord injured patients
• Explain the difference between neurological deficit rigidity versus disuse atrophy/spasm of spinal cord and head injured patients
• Describe treatment options for rehabilitation of spinal cord and head injured patients
• Explain treatment methods to transition C curve locomotion to S curve locomotion
• Explain treatment methods for atrophy and spasm
• Discuss most current curative research for spinal cord and head injured patients

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness

• Explain the anatomical constituents of the core musculature
• Consider implications of weak or inadequate core muscles
• Emphasize the importance of the gluteal muscle group in rehabilitation
• Illustrate common compensation patterns when individuals have weak core musculature with clinical examples
• Explain the concept of neural adaptation
• Review reciprocal inhibition and it's clinical application
• Discuss physiological overflow and its clinical application

• Discuss conventional situps and their pitfalls
• Provide a logical rationale for core training
• Explain and demonstrate a logical progression of exercises for core training, emphasizing skill, then endurance and strength

• Recognize some of the common mistakes with conventional sit ups and how to correct them
• View and narrate the ideal sit up
• Recognize the importance of the brain and cortex in core training
• Discuss how inhalation and exhalation affect muscular activity, and how to utilize this in training
• Point out the pitfalls of abdominal hollowing and core training
• Examine the importance of the thoracolumbar fascia
• Analyze what cues to look for when evaluating a bench press exercise

• Demonstrate the proper patient positioning for the lunge and squat exercises
• Explain and show common problems with the lunge and squat exercises
• Explain and show Dr cues for proper patient positioning of the lunge and squat exercises
• Explain, evaluate, compare and demonstrate variations of the squat exercise, including ball squats, theraband squats, potty squats, squat shuffles
• Explore and demonstrate how foot function and shoe type impacts squat and lunge activities
• Introduce, explain and demonstrate proper and improper performance of additional, advanced gluteal activation exercises including the Texas walk, ball squats, drops, roman chair and 1 legged dead lifts

• Apply core exercise to facilitate improved lower limb mechanics in women
• Recognize the connection between improved lumbar multifidus function and clinical improvement after spinal manipulation
• Discuss the potential of full kinetic chain manual therapy treatment for hip osteoarthritis
• Assess muscle activation and spinal loading profiles during common Kettlebell exercises
• Describe specific exercises that could improve hip strength and mechanics in women with patellofemoral pain

• Describe the Nordic Hamstring exercise and its potential applications for hamstring injuries
• Summarize the state of the literature on exercise interventions for adolescent scoliosis
• Integrate strength training with flexibility training to improve patient progress
• Appraise the potential role of yoga in managing spinal conditions
• Grade and recognize the state of the literature on physical and rehabilitation interventions for chronic non-specific low back pain

• Compare slower treadmill walking on a moderate incline to faster walking with no incline for moderately obese adults patients
• Summarize the current state of the literature on exercise interventions for Type 2 Diabetes Mellitus
• Explain the utility of interval training for patients with coronary artery disease
• Support the inclusion of resistance training in exercise programs for aging patients based on existing scientific research
• Appraise various types of exercise for patients with metabolic syndrome

• Outline the neuroendocrine-immune interactions and communication pertaining to exercise
• Contrast sprint training with endurance training regarding performance adaptations and cardiac output
• Identify the benefits and underlying mechanisms of agonist-antagonist paired set training for improving strength and power
• Summarize the validity of dehydration signs, compared with body weight change, in marathon runners
• Describe methods for developing maximal neuromuscular power

• Apply contemporary rehabilitation strategies for anterior cruciate ligament patients
• Illustrate the importance of proximal stability and rehabilitation in patients with patellofemoral pain syndrome
• Outline the relationship between quadriceps strength, proprioception and knee osteoarthritis
• Discuss the potential value of gait retraining for improving lower limb biomechanics in runners with patellofemoral pain
• Contrast lower extremity kinematics & muscle activation in patients with and without patellofemoral pain syndrome

• Discuss a proposed model for the logical sequence of active rehabilitation
• Review ‘the core’, its healthy functional role and how it is commonly changed in people with spinal and pelvic girdle pain syndromes
• Describe core muscle activity during physical fitness exercises
• Provide an introduction to dynamic neuromuscular (core) stabilization and athletic performance
• Introduce the basics of exercise prescription

• Illustrate the effects of external pelvic compression on the passive, active and neuromotor control systems of the lumbopelvic region and thigh
• Summarize the importance of core stability assessment and rehabilitation in lumbosacral radiculopathy cases
• Assess the differences in torso motion and muscle activity between elliptical trainer use and treadmill walking
• Discover how even small amounts of daily exercise can positively impact patients with neck and shoulder pain
• Critique and apply periodization concepts to rehabilitation for patients with non-specific low back pain

• Outline the relationship between exercise and brain health
• Describe the evidence for the links between physical activity/exercise and brain function across the lifespan
• Discuss the neurobiology of exercise
• Assess whether exercise is neuroprotective or not
• Summarize the effect of exercise on motor performance

• Identify how the sciatic nerve and adjacent nervous structures respond to tensioning and sliding techniques
• Appraise the potential benefit of adding forward head posture corrective exercise to the management of lumbosacral radiculopathy
• Compare clinical and muscle function outcomes of patients randomized to one of two early multimodal rehabilitation programs following single-level lumbar discectomy
• Analyze the influence of neck strength and muscle activation status on resultant head kinematics after impulsive loading to the head/neck
• Assess the efficacy of corrective exercise interventions for reducing thoracic hyper-kyphosis

• Recognize and document preferred outcomes that result from properly executed active care techniques
• Establish rehab protocols for both cervical and lumbar conditions with suggested core exercise recommendations
• Properly advance a patient through their customized exercise protocol in a systematized fashion
• Identify and document progress on a routine visit basis for patients participating in active care rehab

• Evaluate the long-term effect of exercise therapy in addition to patient education on a patient’s need for total hip replacement (THR)
• Integrate clinical and laboratory research on the function and assessment of abductor muscles about the hip and pelvis 
• Understand how hip weakness can potentially contribute to knee pain and altered running mechanics
• Outline the nomenclature, definition, diagnosis, imaging and management of inguinal disruption (‘Sportsman’s Groin’) 
• Assess the efficacy of exercise interventions for lateral ankle sprains, Achilles tendinopathy and plantar fasciitis 

• Recite 3 risk factors for developing rotator cuff tendonosis
• State the purpose of the scapula reposition and scapula assistance test.
• Explain how to perform the external rotation lag sign and recall the purpose of this test
• Paraphrase one evidence - based test cluster for diagnosing a rotator cuff tear.
• Recall two indications/goals for performing posterior glenohumeral joint mobilizations.
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for rotator cuff disorders
• Identify two criteria for phase I rehabilitation exercises for rotator cuff disorders

• Recall 3 potential reasons, based on expert opinion, that may contribute to the high re-tear rate following rotator cuff repair.
• Recite 4 factors that impact the rehabilitation program for patients following rotator cuff repair.
• Summarize the DeOrio classification for rotator cuff tear size.
• State 3 appropriate exercises during weeks 0-2 following rotator cuff repair
• Provide 2 appropriate exercises during weeks 6-8 following rotator cuff repair
• Name 3 appropriate exercises during weeks 8-12 following rotator cuff repair

Hour 1:

• Describe common biomechanically terminology related to rehabilitation such as work, force, mass, vector, strength and power.
• Comprehend the functional biomechanics of the lunge, and squat.
• Identify regressive and progressive nature to common squat and lunge exercises.
• Describe the appropriate standard of care and the process associated with the doctor-patient encounter regarding the evaluation, and management of patients using rehabilitative exercises.   

Hour 2:

• Classify the “McGill Big 3,” and discuss their clinical significance with those with spinal pain.
• Describe an appropriate hip hinge technique for your patients.
• Describe the differences between abdominal bracing and hallowing techniques.
• Review common evidence-based exercise procedures for spinal pain.

• Apply the scientific foundations of neuromuscular re-education, and explore major guidelines and evidence-based practices for spinal pain.
• Construct a treatment plan and exercise script for patient centered care.
• Describe a case scenario involved spinal degeneration and how to create a treatment plan.
• Synthesize the justification and efficacy of evidence-based exercises for different axial spine protocols.

• Enumerate three physical / clinical examination findings associated with rupture of the quadriceps tenon.
• List 3 patient specific factors that need to be considered when following a rehabilitation program following repair of the quadriceps or patella tendon.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following repair of the quadriceps or patella tendon.
• Identify three goals during phase 3 of a rehabilitation program following repair of the quadriceps or patella tendon.
• Cite five return to play criteria that need to be met following repair of the quadriceps or patella tendon.

• Summarize the key difference between the cartilage restoration vs cartilage reparation procedures.
• List 3 personal (health and demographic) factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Enumerate 3 lesion-specific factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following cartilage restoration/reparative procedures.
• Cite five return to play criteria that need to be met following cartilage restoration/reparative procedures.
• Summarize the evidence-based outcomes for the 3 most common cartilage restoration/reparation techniques.

Hour 1

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow
• Describe 1 clinical test to evaluate anterior and posterior shoulder instability
• List the 3 components of an evidence -based test cluster  to assess rotator cuff pathology in the overhead athlete
• Identify 2 components in the rehabilitation program for shoulder instability
• List and define the 3 types of shoulder impingement
• Recall 2 Performance factors in pitching
• Cite 2 return to play criteria for the overhead athlete
• Identify one advantage of weighted ball holds
• Identify one disadvantage of weighted ball programs

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.
• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.
• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

Hour 1

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.

Hour 2

• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.

Hour 3

• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

• Recall two important functions of the fascial system.
• Cite 3 factors which impact the mechanical properties of fascia.
• State one structural/ anatomical difference between the fascia of young vs. older individuals.
• List two ways that fascial training can cause remodeling of the fascia.

• Appraise the latest research in terms of the incidence of ACL tears and re-tears.
• Identify the factors associated with higher ACL tear and re-tear rates based on gender and age.
• Describe the importance of “Prehabilitation” programs and their significance on outcomes.
• Analyze the reasons why non-contact knee injuries are the bulk of the problem while listing the biomechanical reasons why non-contact injuries are more prevalent.
• Discuss the objectives of early Phase 1 and Phase 2  rehabilitation protocols while outlining the criteria to be achieved for satisfactory transition from one phase to the next 
• List the objectives of Phase 3 of the rehabilitation protocol and be able to identify potential common faulty movement patterns and compensatory strategies.
• Assess, identify, and address potential limitations in mobility and stability of key core and lower extremity body regions to normalize faulty movement patterns and compensatory strategies.
• List the objectives for phase 4 of the rehabilitation protocol and provide examples of the higher-level movement patterns and compound strengthening exercises incorporated into the program.
• Identify the four common motor performance/neuromuscular imbalances associated with jumping and landing resulting in increased risk
• Describe the identifiable and modifiable risk factors associated with knee injuries and understand how to correct them via exercise and training.
• Recognize the criteria associated with the Return to Sports phase of the rehabilitation program
• Be aware of the complications and adverse events after ACL reconstruction
• Appraise the latest research in terms of common and uncommon complications/adverse events.
• Identify risk factors for the various complications.
• Describe the evaluation and assessment elements needed to identify the various complications
• Based on the evaluation/assessment data, identify and address intervention strategies for each of the complications/adverse events

• Outline the evidence regarding rehabilitation interventions following anterior cruciate ligament (ACL) or meniscal injury
• Evaluate the effectiveness of rehabilitation interventions for patients who have undergone anterior cruciate ligament reconstruction surgery 
• Examine the comparative effectiveness of surgery versus rehabilitation treatments after an anterior cruciate ligament (ACL) rupture 
• Compare the effectiveness of exercise therapy with non-steroidal anti-inflammatories (NSAIDs) and opioids for the management of pain in patients with knee osteoarthritis 
• Determine the patellofemoral joint reaction forces during everyday activities, therapeutic exercises, and physical interventions in healthy individuals and those with patellofemoral pain or osteoarthritis

• Identify exercise physiology concepts related to core conditioning
• Determine the anatomy related to the core and its function in core strength
• Design and implement a core conditioning program
• Summarize the role of psychological motivation in core conditioning
• Examine the various movements associated with core conditioning

• Construct a list of four specific compliance risk areas for physicians
• Establish internal control mechanisms
• Distinguish aspects of Quality Assurance
• Develop Documentation Principles
• Identify documentation warning signs and components of SNOCAMP

• Review important laws, rules and regulations related to the Georgia Workers' Compensation Act
• Develop an understanding of the rights and responsibilities of the parties and a working knowledge of the Georgia Workers' Compensation Act
• The Georgia chiropractor will expand and/or update current knowledge base relating to the Georgia Workers' Compensation Act and treatment

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to malpractice
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions
• Identify action steps for minimizing risks of malpractice actions

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to informed consent
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions by utilizing properly executed informed consent
• Identify action steps for minimizing risks of malpractice actions

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to malpractice actions from neural injury
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions by utilizing proper manipulative procedures, recognizing post-operative complications and risks, and identifying and managing a complication.
• Identify action steps for minimizing risks of malpractice actions from neural injury

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify various ingredients found in a typical judicial opinion
• Discuss what each chiropractic provider should look for when they read an opinion
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to legal opinions
• Encourage development and nurturing of skill sets in reading legal opinions by utilizing case method

• Describe each of the four elements of malpractice
• Differentiate between a bad treatment result and malpractice
• Define Duty, Dereliction of Duty, Direct causation, and Damage
• Search out a case report on-line or in a law library by using the case citation

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Evaluate sample healthcare employment agreement
• Explain the components of a well drafted healthcare employment agreement
• Relate likely enforcement of provisions included in healthcare employment contract
• Assess non-compete provisions through a judicial balancing test
• Distinguish the various methods by which a court will rehabilitate certain contract provisions and selectively enforce others
• Explain what kinds of contract provisions may run afoul of state and federal laws, including fee splitting and kickback prohibitions

• Evaluate a sample sale agreement and sample letter issued to patients upon dissolution of practice
• Explain components of any well drafted buy-sell agreement including non-competes
• Identify how to handle patient records vis-à-vis the sale
• Understanding forms and laws relating to the transfer of logos, trademarks and Internet Domain Names
• HIPAA Considerations
• Acquaint oneself with the tax consequences of particular types of practice sales
• Discuss valuation methods used for determining an appropriate practice sales price
• Identify legal concerns associated with the dissolution of a healthcare practice
• Recognize how sales can trigger violations: fee splitting, patient abandonment, kickback, and anti-trust

• Identify "high risk" patients
• Design protection strategies for telephone "advice."
• List the "4 D's" of malpractice
• Differentiate clinical from administrative malpractice risks
• Distinguish malpractice from an adverse patient outcome
• Describe how a non-office encounter can create a dr/patient relationship
• Give examples of statutory duties beyond clinical care
• Explain how you can be guilty of malpractice without being negligent
• Assess office equipment hazards
• Discuss malpractice cases where patient was never given an adjustment

• Discuss problems created by leaving blank spaces in records
• Create practice appropriate SOAP note format to reduce risk exposures
• Recognize Health Questionnaire “red flag” responses

• Integrate protective “rules for recordkeeping"
• Monitor records release authorizations
• Individualize pre-printed forms to conform with your practice and reduce risk exposures

• Identify and document significant patient non-compliance
• Generate appropriate X-ray warning labels
• Identify “bad” forms
• Incorporate protective letters-writing protocols

• Recognize “exposure events” in area's of potential risk management
• Discuss proper communication of a potential exposure event with a malpractice carrier
• Maintain a healthy practice while in litigation
• Prepare staff for dealing with the publicity of litigation

• Prepare for a deposition
• Identify “informed consent” compliance
• Analyze your website for potential risk management issues
• Recognize deposition “tricks & traps”

• Properly prepare for a trial
• Prepare for lawyers questioning techniques
• Avoid detrimental body language in front of a jury
• Prepare for the phases of trial and the "down time" associated with trial

• Find and Analyze Chiropractic Malpractice Court Opinions
• Justify referral protocols
• Plan staff training to avoid "vicarious liability"
• Interpret "lawyer-speak" like "vicarious liability"
• Assess equipment risk
• Differentiate between good PR & sexual harassment
• Generate HIPAA compliance strategies w/o paranoia
• Appraise partnership, independent contractor and doctor/associate risks
• Implement Table safety procedures
• Recognize "exposure events"

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one’s working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider’s practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.
• Verify how certain discount practices may be legally actionable as “improper inducements.”
• Evaluate federal Stark legislation and the discouragement of corruption in sound professional healthcare decision-making.
• Identify distinctions between federal anti-kickback and the federal Stark legislation.
• Critique state anti-kickback laws.
• Recognize the role the FTC played, and continues to play, in discouraging the fraudulent marketing of discount health care programs.
• Draw associations between co-pay requirements, consumer habits and federal healthcare expenditures.
• Assess how "professional courtesy" discounts may raise enforcers' concerns under the federal anti-kickback statute.
• Diagram how prepaid fee arrangements often resemble health insurance to unwitting patients.
• Illustrate pitfalls that advertising discounts visit on the practitioner.

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one's working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider's practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.

• Assess how state scopes of practice affect chiropractic treatment of nutrition-related health problems.
• Identify the roles the FDA and FTC play in the administration of nutritional healthcare.
• Distinguish between a "food" and a "drug" for purposes of nutritional supplementation.
• Demonstrate how the various states' ban against the practice of medicine affects other disciplines' approach to nutritional healthcare.
• Explain aspects of nutrition labeling.
• Identify issues associated with current performance-enhancing supplementation.
• Explain the significance of distinguishing "treatment" from "informing" as it relates to nutritional counseling.

• Assess the relationship between the implementation of efficient office systems, accurate record keeping, patient communication, and adherence to professional standards of conduct within the context of malpractice allegations by patients who engage in sports.
• Identify actions suggestive of malpractice negligence and conduct that fails to live up to the standard established by law for the protection of others.
• Demonstrate a professional relationship can spring into existence when the healthcare professional is hired by a third party to oversee the health of athletic participants.
• Distinguish the duties an examining physician has regarding informing those athletes he examines about abnormal test results.
• Explain the legal concept of “assumption of the risks” within the context of sports participation and how it affects a healthcare professional’s liability.
• Identify “therapeutic exceptions” to providing informed consent excusing the practitioner from fully disclosing matters where they might unfavorably affect the outcome of a patient’s treatment.
• Explain a healthcare professional’s duty to warn patients engaged in sports regarding injury prevention following treatment.
• Examine a practitioner’s duties regarding athletes’ return to play in instances when head injury and concussion may be a factor.

• Assess the role the doctor-patient relationship plays in allegations of Patient Abandonment
• Identify the components to any successful Patient Abandonment charge
• Discuss court cases evaluating whether the doctor-patient relationship had been terminated lawfully
• Distinguish between proper and improper considerations a doctor may rely upon to either refuse to undertake, or to terminate, a doctor-patient relationship
• Explain the role notice plays in lawfully terminating a doctor-patient relationship
• Evaluate the role consent plays in the establishment of the doctor-patient relationship, and in subsequent treatment

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the practice of forensic science
• Identify a new dimension of chiropractic practice that will minimize risks and failure in court appearances as a practitioner
• Construct skill sets in forensic examination and document review

• Acquire a current knowledge base relating to medicolegal issues
• Identify risks and liabilities that may be encountered by examiners with electronic communications
• Develop a level of understanding of the medicolegal system as it relates to Junk Science

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the ethical expert witness
• Introduce a new dimension of chiropractic practice that will minimize risks and failure in court appearances as an ethical expert witness.
• Encourage development and nurturing of skill sets in forensic examination and appearing as an expert witness through certification.
• Develop a level of understanding of the medicolegal system as it relates to the ethical expert witness.

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify Daubert criteria
• Discuss what each chiropractic expert should look for when preparing for the opposing attorney
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Daubert challenges
• Encourage development and nurturing of skill sets in proving expert opinions

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify the basics of a deposition
• Discusses the tricky question types and suggested responses
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the deposition process
• Encourage development and nurturing of skill sets in responding to questions posed in a deposition

• Perform professional advertising and marketing that passes state and federal legal restriction.
• Comprehend requirements for advertising testimonials, press releases, television, radio, Internet, personal solicitation and other marketing initiatives.
• Comprehend the limits of commercial speech (advertising) within the arena of professional healthcare marketing and dissemination of information.
• Train staff and implement policies associated with marketing initiatives and materials vis-a-vis state rules, regulations and statutes.
• Comprehend issues associated with signage, listings, letterhead, and other matters of ostensible agency that may lead to liability.
• Administer professional marketing such that it neither misleads, confuses nor exploits members of the public.
• Discuss how nutritional supplementation labeling and HIPAA affects professional healthcare marketing efforts.
• Undertake a review of marketing materials and initiatives so as to ensure compliance with relevant state rules, regulations and statutes.
• Administer coverage decisions, professional referrals, and communicate same in a manner that limits professional liability.

• Analyze charges and documentation on a daily or per visit basis to ensure accuracy and compliance
• Compile accurate and comprehensive responses to documentation or record requests
• Recognize and avoid confusing HIPAA privacy issues that can cost you time and money
• Identify key areas that lack written policies causing increased risk in the practice
• Evaluate your current written procedures and appraise the need for additional content

Hour 1

• Identify various types of billing irregularities and impact on healthcare expenditures.
• Distinguish upcoding from bundling within the context of irregular billing schemes.
• Demonstrate how and when exceeding a state’s scope of practice becomes “the unauthorized practice of medicine.”
• Explain the restrictions states’ scopes of practice place on healthcare providers’ authority to treat and diagnose patients.
• Discuss how invoicing unrendered medical services impacts third-party payers.
• Interpret chiropractic boards’ positions on testimonial advertising and how best to comply.

Hour 2

• Identify what constitute a false claim under the False Claims Act.
• Discriminate a kickback from a self-referral.
• Trace how anti-kickback legislation arose and examine its prohibitions.
• Explain the enactment of Stark legislation arising on the heels of anti-kickback bans.
• Assess providing nutritional counsel within the context of “the practice of medicine.”
• Evaluate identity theft and its impact on patients, providers and the cost of healthcare.
• Discriminate between illegal copayment waivers from proper hardship waivers.
• Discuss court cases instancing successful prosecution of healthcare fraud.

• Identify the 18 PHI Identifiers
• Awareness of other HIPAA related documentation and the appropriate retention period
• How to confirm retention period for healthcare records
• Recognize required security measures and their value to practice risk management
• Implement policy and protocol for compliant and secure disposal of records

• Be able to identify the definitions of Fraud, Waste and Abuse and how they may show up in day-to-day practice
• Become aware of the source of overpayments, including not-medically necessary care, maintenance care, and active treatment
• Apply the guidance from the OIG to your state and carrier regulations since they are a resource to these groups
• Recognize insufficient documentation and incorrect coding before the billing takes place
• Implement the action steps recommended by the OIG to eliminate incorrect documentation, billing and coding practices to reduce compliance risk

• Distinguish between fraud, waste and abuse
• Review and properly utilize your Medicare Local Coverage Articles (LCA)
• Integrate critical compliance requirements for minimum, mandatory, annual self-audits  
• Detect common billing protocols that are red-flags for third-party auditors and chiropractic boards of examiners

• Identify the expected standards of a compliant and complete patient medical record
• Audit documentation to ensure the most important details are present
• Analyze and correct for the four most commonly missed components of appropriate documentation
• Apply the federal requirements for Medicare documentation and use this knowledge to initial and routine patient visit documentation

• Assess limits of state, federal and board authority regarding the prohibition of solicitation of patients by, and on behalf of, chiropractors. 
• Explain distinctions between general marketing and intrusive solicitation, and the reasons for the regulation of each
• Demonstrate how the courts protect businesses’ right to advertise and how they discourage deceptive practices. 
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services. 
• Examine criminal and civil laws associated with overly aggressive chiropractic advertising.

• Classify circumstances that trigger Good Samaritan laws for chiropractors.
• Restate duties imposed upon people in the United States to render aid to others in dire circumstances.
• Compare a doctor’s versus a lay person’s duty to render aid to someone in distress.
• Explain principles and philosophical underpinning Good Samaritan laws.
• Discuss the Bystander Effect.and scientific studies that unearth reasons why people are reluctant to render aid/assistance to others in emergency situations.
• Summarize the role compensation, expecting to get paid, plays in the operation of Good Samaritan laws.
• Locate states that impose a duty to render assistance, and those states that remove Good Samaritan law protection from hospitals.
• Identify protections offered under various states’ Good Samaritan Laws.
• Express the relaxation of professional standards, and what behaviors are shielded from liability, under Good Samaritan laws.

• Recognize and execute the rules to avoid inducement violations
• Define what you CAN give away for a first visit that will not break the rules. 
• Implement compliant initial visit screening services as part of a new patient offer
• Apply risk management rules to avoid offering free services to some and not others
• Modify your current marketing strategy to attract new patients while being compliant

• Identify ethical and legal prohibitions against patient deception, misinformation, exaggerating healthcare cures, guaranteeing treatment results, and dishonesty.
• Distinguish between appropriate and inappropriate communications and medical file entries describing patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' attitude and mental states to healthcare outcomes.
• Illustrate placebo-enhancing doctor-patient interactions that comply with states' prohibitions against deception and misinformation.
• Give examples where ethical patient encouragement authentically fosters positive mental states that promote desired patient outcomes.
• Express why patient communications must be consistent with medical file entries regarding prognoses and patient progress.
• Explain office procedures and staff training likely to optimize health-promoting ethical patient communication and the documentation thereof.

• Identify which portion of the complex regulation applies to their practice
• Recognize proper use of a Good Faith Estimate vs Balance Billing Protection form
• Formulate customized forms and training tools to meet regulatory guidelines
• Adopt best practices and regulation standards during the patient intake process

• Discuss the public’s increased use of health data-gathering devices and its effect on dispensing healthcare by professional healthcare providers.
• Identify sources for state authority to regulate the practice of healthcare in the various states.
• Explain states’ prohibition against the unauthorized practice of medicine and identify points where data collection and subsequent evaluation may encounter this prohibition.
• Compare courts’ interpretations of state scopes of practice laws as they relate to the various stages of a doctor-patient encounter.
• Distinguish data collection from activities that may include preliminary evaluation, diagnosis, and treatment - while identifying their relevance to state scopes of practice.
• Analyze how courts interpret activities that may constitute the unauthorized practice of medicine, as distinguished from those that do not.
• Discuss obligations to refer people to other healthcare providers based upon determinations and/or diagnoses related to observation, examination, and evaluation of collected data.
• Distinguish boundaries regarding data collection versus the unauthorized practice of medicine.
• Recognize the public's rights to information and free speech protections.

 Part 1

• Discuss the costs of fraud and financial crime
• Review the technology trajectory and how this affects fraud
• Quote Honesty studies
• Identify behaviors related to cheating

Part 2

• Review the criminological and behavioral theories of fraud in healthcare
• Explain key aspects of the psychological of fraud
• Identify aspects of sociology related to fraud
• Examine: Biological school of criminology

Part 3

•  Examine victimology and victim behavior
• Discuss internal fraud and trends
• Examine opportunity reduction
• Be aware of red flag and fraud indicators

 Part 4

• Apply human based preventative and detection strategies to avoid fraud
• Use technology based preventative and detection strategies to avoid fraud
• Use vulnerability assessment preventative and detection strategies

• Compare the various Responsibilities that patients owe to the doctor-patient relationship
• Describe the doctor-patient relationship as a dynamic one that relies on the active participation of patient and doctor alike, and enlists aspects of trust in order for the interaction to render optimal benefits.
• Recognize how the Hippocratic Oath contributed significantly to the development of chiropractic patient rights
• Discuss the historical evolution of Patients' Rights in the United States and their application to chiropractic
• Explain the various Patients’ Rights
• Present case studies to illustrate how patient rights and responsibilities can be applied in practice.
• Analyze how Patient Obligations contribute to the success of the doctor-patient interaction and can favorably impact patient outcomes.
• Explain how chiropractors’ efforts to enhance profitability could negatively impact both public perception and the bottom line.

• Appreciate the significance of Artificial Intelligence (AI) in transforming the healthcare industry.
• Recognize the potential benefits of AI in improving diagnosis accuracy and treatment outcomes.
• Identify how AI can streamline administrative processes, such as scheduling appointments, billing, forms, and managing patient records.
• Explore compliance with laws and regulations when using AI and chatbots in advertising, including rules around data collection and use
• Understand the challenges of determining who owns the copyright for content generated by AI systems
• Evaluate the importance of keeping up-to-date with technological advancements in healthcare for quality patient care and practice management
• Comprehend the challenges regarding patient data privacy and security associated with AI.

• Recognize different forms of social media and how clinics can benefit from using social media
• Appreciate the risks of using social media and how to avoid any pitfalls
• Develop policy and procedures to protect patient information when using social media
• Ability to identify commonly overlooked risks when communicating to patients on third-party software platforms

• Distinguish Constitutionally-protected expression contributing to a healthy marketplace, from defamatory reviews that damage doctors and impede intelligent consumer activity.
• Explain what triggers patient complaints and discuss how their constructive information improves healthcare services.
• Identify how patient complaints can compromise doctors’ health, devastate their businesses, impede professional performance, and compromise patient outcomes.
• Express how doctors may shape doctor-patient relationships so as to reduce the likelihood and frequency of patient complaints.
• Illustrate how a doctor's proactive remedial behavior can mitigate the incidence and severity of formal disciplinary actions and litigation generally.
• Explain the power traditionally ascribed to word-of-mouth recommendations and how current social media review systems leverage this power.
• Discuss how the Consumer Review Fairness Act restricts prohibitions against posting negative reviews.
• Describe how a complaint navigates a state Board disciplinary process and factors regarding appeal.
• Illustrate the financial and reputational costs that attend doctors responding to negative complaints and/or initiating litigation against patients.

• Evaluate sample forms including contract, informed consent, treatment plan and intake - and draft forms that clearly distinguish between standard care and potential contractual guarantees.
• Identify the key elements that can transform a doctor's statement into a contractual guarantee (e.g., specific results, use of positive language like "cure" or "fix").
• Define the concept of a doctor-patient contract and distinguish it from the standard of care in medical malpractice.
• Describe the legal ramifications of a doctor breaching a contract with a patient (e.g., damages, potential for longer statute of limitations compared to malpractice).
• Analyze case studies to identify instances where a doctor's communication with a patient may have created a contractual obligation.
• Effectively communicate treatment options and limitations to patients, avoiding language that could be misconstrued as a contractual guarantee.
• Apply your knowledge of doctor-patient contracts to real-world scenarios, such as consultations, advertising materials, and treatment plans.
• Critically assess the advantages and disadvantages of relying on formal contracts in the doctor-patient relationship.

Hour 1:    Anatomy Review 

• Emphasize the unique anatomy of the cervical spine as related to spinal trauma.
• Point out the importance of the uncinate process joints as related to disc herniation, the nerve root, the vertebral artery, and the spinal cord.
• Explain how cervical spine injury may manifest clinically as low back and leg pain.

Hour 2:    Define Sleep Hygiene

• Explain the role for sleep and sleep’s influence on the ability to safely operate a motor vehicle.
• Summarize the influence of sleep on brain neurochemistry.

Hour 3:    Awareness and Soft Tissue Injury

• Explain the influence of awareness on an impending collision and the muscles ability to protect joints.
• Explain how being “caught by surprise” by a collision is related to a poor prognosis for full recovery.

Hour 4:    Whiplash History

• Summarize the history of whiplash injuries, including mechanical mechanisms, biological mechanisms, pathology, diagnostics and management.
• Define the issues that the early whiplash literature got wrong.
• Emphasize the issues that early whiplash literature got correct.

Hour 5:    Whiplash Today

• Summarize recent advances in the understanding of whiplash injuries, emphasizing anatomy, diagnostics, pain production and pain suppression.
• Integrate whiplash trauma, chronic pain, and chiropractic care.

Hour 6:    Low Speed Collisions and Minor Vehicle Damage

• Point out the mathematics of how a low speed vehicle to vehicle collision can result in passenger injury.
• Explain why vehicle damage should not be used as a proxy for passenger injury.
• Integrate the concepts of awareness, rotation, and pre-accident spondylosis in injury magnitude and prognosis.

Hour 7:    Soft Tissue Injury and Repair

• Define the three phases of soft tissue healing and point out the time sequence for each phase.
• Justify the clinical interventions that have a positive therapeutic influence on each phase of soft tissue injury healing.
• Emphasize the concept of motion in the healing of injured soft tissues, especially spinal adjusting (specific manipulation) motion.
• Quantify acute injury and ultimate recovery(prognosis) by using measurement outcomes.

Hour 8:    Treatment Duration, Frequency, and Prognosis

• Summarize the biology and published data on treatment frequency and duration for whiplash spinal trauma.
• Point out published studies relating to recovery and prognosis.
• Reference the incidence of acceleration of spondylosis in long-term studies following a whiplash injury.

Hour 1:     Low Back and Leg Pain Following Whiplash Injury

• Point out the probable mechanisms for direct injury to the lower back during motor vehicle collisions.
• Distinguish between radiculopathy, neuropathy, and sclerogenic referral of extremity pain.

Hour 2:     Whiplash Injury and the Vertebral Artery

• Review the anatomy of the vertebral-basilar vascular systems.
• Distinguish between the anterior and posterior circulation.
• Summarize the signs and symptoms of a cervical spine vascular injury.
• Solidify the knowledge as to when the suspected vascular injury patient should be referred to diagnostic imaging or emergency services.

Hour 3:     Whiplash Injury and Traumatic Brain Injury

• Explain the differences between a blow brain injury and an inertial brain injury.
• Define the pathoanatomic and patho-biochemistry of traumatic brain injury.
• Justify clinical interventions that have a positive therapeutic influence on traumatic brain injury.

Hour 4:     Cervical Disc Herniation

• Point out the anatomical differences between lumbar and cervical discs.
• Explore the pathoanatomical and therapeutic differences between lumbar and cervical discs lesions.

Hour 5:     Examinations and Evaluations

• Explain the minimum examinations that should be performed.
• Explain the minimum requirements for charting the daily patient contact.

Hour 6:     Informed Consent

• Define the legal requirements for informed consent for chiropractic care.
• Review common entities for an informed consent and the rational for each.

Hour 7:     Reports

• Make recommendations for re-evaluations.
• Make recommendations for interim reports contents.
• Explore common academic terminology and concepts in effective report writing.

Hour 8:     Testimony

• Distinguish between a percipient witness and an expert witness.
• Explain what a subpoena is and what it means to the treating chiropractor.
• Explain what a deposition is for the treating chiropractor. Summarize the basic rules of a treating expert deposition.
• Summarize the mechanics of a personal injury trial from the perspective of the treating chiropractor.

Hour 1 

• Point out the probable mechanisms for direct injury to the lower back during motor vehicle collisions.
• Distinguish between radiculopathy, neuropathy, and sclerogenic referral of extremity pain.

Hour 2 

• Define the parameters for cervical and lumber spine central canal stenosis.
• Utilize both the Torg/Pavlov and the ratio radiographic methods for assessing cervical spine central canal stenosis.
• Explain the critical relationship between central canal stenosis and hyperextension spinal injuries.
• Demonstrate a practical method for the clinical assessment of cervical spine central canal stenosis.

Hour 3

• Identify differences seen between a blow brain injury and an inertial brain injury.
• Define the pathoanatomic and patho-biochemistry of injury.
• Explore the relationship between cervical spine injury and TBI

Hour 4

• Discuss the concept of how the systemic inflammatory profile affects local injury.
• List 8 systemic inflammatory factors that should be considered and co-managed on whiplash-injured patients.

Hour 5 

• Discuss the anatomy of the thoracic outlet.
• Demonstrate a management protocol for thoracic outlet syndrome.
• Define cervical angina.
• Demonstrate the single most important test to distinguish cervical angina

Hour 6

• Draw the anatomical basis for cervicogenic headache.
• Integrate cervicogenic headache and the temporomandibular joint (TMJ).
• Define inertial injury and the TMJ articulation.
• Demonstrate a practical assessment and management of TMJ injury.

Hour 7

• Distinguish between a percipient witness and an expert witness.
• Explain what a subpoena is and what it means to the treating chiropractor.
• Explain what a deposition is for the treating chiropractor. Summarize the basic rules of a treating expert deposition.
• Summarize the mechanics of a personal injury trial from the perspective of the treating chiropractor.

Hour 8 

• Demonstrate a typical soft tissue direct examination.
• Show the two most common drawings to support chiropractic care for soft tissue injuries.

• Discuss a common origin of lumbar disc pain
• Describe the orientation of lumbar facet joints
• Identify the effect of lordosis on the position of the nucleus pulposis
• Establish how injuries of the annulus fibrosus can cause nerve root changes
• Identify the dynamic stenosis of the lumbar spine

• Identify anatomical structures of the knee involved with anterior knee pain
• Diagnose fat pad and bursitis syndromes
• Establish pathologies of the patellar tendon in adults and children
• Differentiate different causes of patellofemoral pain
• Match clinical syndromes of knee pain with radiological appearances

• Identify the general anatomy of the knee joint
• Develop an intimate knowledge of the anatomy of the menisci and ligaments of the knee using gross dissection and cross-sectional imaging
• Understand the functional anatomy of the menisci of the knee and define the type and grade of meniscal tears
• Establish the conditions discoid lateral meniscus and meniscal cyst and understand the spectrum of treatment available
• Identify what type treatment is available for meniscal injuries and when it would be prudent to reevaluate a post-op patient with new knee pain

• Outline the physical basis of magnetic resonance imaging
• Identify patients that are candidates for an MRI
• Recognize categories of pathology in the spine that are imaged well with MRI
• Recognize cases that require contrast
• List contraindications for an MRI

• Identify and classify injuries to the anterior cruciate ligament
• Diagnose and develop treatment for injuries to the posterior cruciate ligament
• Diagnose and develop treatment for injuries to the medial collateral ligament
• Diagnose and develop treatment for injuries to the lateral collateral ligament
• Describe and classify ostochondritis dissecans of the knee

• Differentiate ossification from calcification
• Identify the categories of ossification
• Differentiate myositis ossificans progressiva from myositis ossificans traumatica
• Discuss imaging utilization with regards to ossification
• Review common and uncommon entities predisposed to ossification or calcification

• Recognize and identify important key factors for interpreting plain film x-rays of the spine and pelvis
• Recognize important medical/legal issues regarding interpreting plain films of the spine and pelvis and be able to apply appropriate radiographic documentation requirements when charting x-ray findings in the medical record
• Identify, analyze and interpret normal and abnormal anatomical osseous structures, common congenital and acquired pathologies, common normal radiographic variants and soft tissue calcifications/structures of the cervical, thoracic, lumbar, lumbosacral spine and pelvis

• Alert your clinical consciousness to prevent complacency
• Explain ways to identify the most common aneurysms clinically and on x-ray in the abdominal aorta, thoracic aorta, and splenic artery
• Differentiate aneurysm from dissection and pseudoaneurysm

• Identify the source of metastatic lesions
• Determine an advanced imaging protocol once a metastatic lesion is found
• Discuss how to identify on radiographs the two most common primary malignancies of bone - multiple myeloma and osteosarcoma

• Discuss the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it
• Identify, describe, and classify fractures by both direct & indirect radiographic signs
• Review fractures of specific etiologies based upon imaging findings
• Evaluate fracture alignment issues, complications, and healing
• Identify non-accidental injury of childhood, as well as normal structures that mimic fractures

• Understand Osteoporosis - (risk factors, incidence, prevalence, morbidity, etc.)
• Understand the fundamentals of DEXA (dual-energy x-ray absorptiometry), the gold standard in bone density testing
• Explain how to interpret the results
• Investigate the advantages and limitations of DEXA
• Investigate the indications and contraindications for utilization of DEXA

• This contains all courses with the educational objectives listed in Xray 119, and, Xray 123 through 127

• Use plain film to identify imaging findings of common diabetic foot fractures
• Discuss foot ulcers and using diagnostic imaging to rule out secondary osteomyelitis
• Identify diagnostic imaging findings of neuropathic osteoarthropathy (Charcot foot)

• Explain the clinical presentation, physical examination findings, orthopedic tests, laboratory findings, and radiographic findings associated with ankylosing spondylitis
• Discuss the extraskeletal manifestations of ankylosing spondylitis
• Explain the similarities and differences between the spondyloarthropathies
• Discuss the surgical and pharmacological management
• Discuss treatment that promotes spine mobility including the chiropractic adjustment