COLUMN PROFESSION Prioritizing rehabilitation T WFC produces new rehabilitation competency framework BY RICHARD BROWN blindness and deafness. As a result of the meeting, stakeholders contributed statements of intent and the WFC was subsequently a contributor and found-ing member organization of the Global Rehabilitation Alliance (GRA). “Our framework will hopefully be incorporated into the education and training of chiropractors around the world, so that we develop a culture where chiropractors are not simply seen as experts in manual therapy, but also as experts in the prevention of disability and in evidence-based reha-bilitation of acute and chronic spinal disorders, ”says CÔté. The framework is underpinned by a set of six core competences: commu-nication, knowledge, technical skills, clinical reasoning, values and reflec-tion. Produced by a sub-committee under the direction of lead author Professor CÔté, the framework groups these competencies into three do-mains: rehabilitation are all critical in opti-mizing outcomes. he World Federation of Chiropractic’s Disability and Rehabilitation Com-mittee (WFC-DRC) has produced a new Rehabilita-tion Competency Framework in re-sponse to a call from the World Health Organization (WHO). The move comes amid increasing recognition of the global unmet need for rehabilita-tion services. With low back pain being the largest single cause of years lived with disabil-ity, countries are now realizing that it is a major contributor to the global burden of disease and are demanding action. Low back pain is now seen as a lifelong condition featuring episodic exacerbations of varying severity. It affects four out of five adults at some point in their lives and while most episodes are short-lived and relatively benign, chronic back pain can lead to serious disability, affecting activities of daily living, fitness for work, and social activities. “Our current knowledge means that talk of a cure for back pain is unreal-istic. What we need to do as a society is prioritize rehabilitation services and support active care by empowering practitioners and patients,” says WFC DRC Chair, Professor Pierre CÔté. The impetus to develop the new framework came after attending a high-level meeting at WHO in Febru-ary 2017. The meeting, Rehabilitation 2030: A Call For Action , brought to-gether experts and government minis-ters from around the world to make a global commitment to prioritize reha-bilitation, not just related to physical disability but also encompassing men-tal health and sensory deficits such as Domain 2: Legal, regulatory and ethical components Knowledge and understanding of human rights, including privacy and confidentiality, ethical considerations of governance and service delivery, and understanding of competing interests are important drivers in this competency domain. Framing the provision of rehabilitation within the context of social, political, and environmental and economic social determinants is also key to optimiz-ing outcomes of care. Rehabilitation should be seen and delivered through a biopsychosocial lens with a view to considering bio-physical elements, psychological com-ponents and social influencers. Opti-mizing function to enable independent Domain 1: Basic concepts of living, participation in education and rehabilitation and disability economic productivity are important The WFC DRC calls on components. Rehabilitation chiropractors to develop a The six core may be provided in dedicated foundational knowledge of competences health care facilities or in the rehabilitation and to under-are: communi-community. stand that disability is a term The final published docu-cation, that includes impairments, ment is the product of consul-knowledge, tation by the authors with the activity limitations, and par-technical ticipation restrictions. Reha-other members of the WFC skills, clinical DRC and with the WFC bilitation competencies are reasoning, Board. This includes partici-based on a basic premise values and pants from each of the WFC’s that culturally appropriate reflection. seven world regions. people-centred care is at the In light of the scale of the basis of all provider-patient interactions. Skills in interprofessional need for rehabilitation globally, it is communication, communication proposed that chiropractors are up-methods, technologies and skilled and that consideration is given to ensuring rehabilitation competen-RICHARD BROWN HAS been the Secretary-General of the World Federation of Chiropractic since 2015 cies are embedded within the educa-and is a past-president of the British Chiropractic Association. He is a graduate of AECC University College tion and training of chiropractors in the U.K., and was in continuous private practice for 25 years before relocating to Canada. around the world. www.canadianchiropractor.ca Domain 3: Rehabilitation management of disability 14 Canadian Chiropractor July/August 2019
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