The Influence of the Accreditation Reports from the European Council on Chiropractic Education (ECCE) on Improvements/Changes to the Chiropractic Programmes that they Evaluate: An Audit study and Thematic Analysis

Abstract Background: The European Council on Chiropractic Education (ECCE) has been in existence since 1981 and currently accredits 10 chiropractic programmes throughout Europe and South Africa. Although it has always been assumed that the ECCE evaluation events and subsequent reports have resulted in improvements and growth to the individual chiropractic programmes, no systematic evaluation as to whether this is true and the extent of any improvements has previously been done. Therefore, the purpose of this study was to collect data from the accredited programmes regarding the degree of changes made to the 10 sections of the ECCE Standards as well as which specific improvements were done.Methods: This was a mixed methods audit study using questionnaires which included 10 closed statements requesting the degree of change (substantial, some, none) to the 10 sections of the ECCE ‘Standards’ based on previous evaluation reports. The proportion of responses falling into the three categorical options for each question was analyzed using descriptive statistics. The second part of the survey collected written responses identifying the specific ‘substantial’ or ‘some’ changes made based on previous evaluation reports. The analysis of the written statements used a modified ‘thematic analysis’ approach. Three researchers independently evaluating all statements and identified ‘themes’ from the written responses. These researchers then met to discuss and agree final themes.Results: There was a 100% response rate. Seven programmes (i.e. 70%) reported ‘some’ or ‘substantial’ changes to 6 or more of the 10 sections of the ECCE Standards. The most common section of the Standards for programmes to report changes was ‘Educational Programme’ (8 of 10 programmes). ‘Educational Resources’ had the largest number of programmes reporting ‘substantial changes’ (4) and was the second most common section of the Standards to have reported changes. The main themes identified emphasized the improvements in ‘infrastructure, equipment and faculty’, ‘increasing the teaching and use of ‘evidence-based practice’, ‘instilling a research culture in faculty and students’.Conclusions: This study documents that ECCE accreditation reports are useful in facilitating improvements to the chiropractic programmes, particularly in the areas of improved infrastructure and faculty as well as research and evidence-based practice.