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Consistency and the triad of trust

The themes of the 2022 World Federation of Chiropractic’s Education Conference were levelling up and creating consistency in the chiropractic profession. Levelling up is critical as we seek to advance as a profession.

While a lofty goal, ensuring equity and equality of opportunity for those aspiring to enter chiropractic education is one which we must continue to champion. Until such time as the membership of the global chiropractic profession resembles the communities it seeks to serve, we will never be able to truly celebrate diversity of representation, nor are we likely to succeed in the WFC's vision, a world where all people, of all ages, in all nations enjoy access to chiropractic services so that populations may thrive and reach their full potential.

Some may question why it is that consistency is so important in health professions education. After all, is diversity in teaching and learning not to be celebrated? The answer is yes, but when it comes to assuring public confidence and ensuring that core competencies are omnipresent, consistency of outcomes is critical.

Inconsistency makes people feel uneasy. It results in a loss of confidence. It leads to a loss of trust and makes people question whether they can rely on a product or service.

Let's take air travel. Walking across a jet bridge into a metal tube that is going to take you up to 38,000 feet and propel you at over 500 miles per hour has to be one of the biggest leaps of faith that a human can take. We literally trust our lives to the manufacturers who build these metal tubes, engineers who maintain them and pilots who fly them. Yet as we all know, regardless of which airline we choose, there are consistent elements with every component of air travel. Cockpit checklists, safety video content, procedures for take-off and landing - we become so familiar with them that we can almost recite them.

What is it that consistency creates? First of all, it is an assurance of safety and competence. We see these routines being played out time and time again and understand they are being done because they are tried and tested methods of reducing the risks of failure and harm.

The second thing that these routines create is confidence. Confidence that regardless of which airline we choose, these routines are consistent to all and are constants throughout the whole airline industry.

The third factor is trust. There is nothing sexy about consistency and these unvarying protocols do not take us to the edge of our seats. But even the most unconventional of us value consistency over anything else in many parts of our lives. Ask any sporting champion. They will all say that consistency - in their training, in their attitudes and behaviours, in their diet - is fundamental to their success. An oft-repeated quote states, "If you want to be taken seriously, be consistent."

Let's turn back to consistency in chiropractic education. We all agree that patients are our reason for being as chiropractors and that everything begins and ends with the people we serve. Meeting their expectations is therefore of paramount importance. We are, quite rightly, tried in the court of public opinion. It is the public, whose expectations are formed by context, culture and the social determinants of health, who set the expectations against which we are measured. They invariably include consistency, high standards of education and training, and a culture of honesty, trustworthiness and integrity. The degree to which we meet these expectations determines the credibility of where we sit as a profession.

The second factor in our triad of trust is professionalism. Unsurprisingly, the public expects chiropractors to act professionally. Professionalism is a key component of the triad of trust and there is an expectation that chiropractors should be trustworthy and behave ethically. When stories of misconduct surface, trust is impacted and the reputation of the profession suffers. To behave in the manner expected of health professionals is an inviolable duty and as chiropractors we owe it to our peers, our patients and the public to consistently uphold the trust placed in us.

The third part of our triad is partnerships. There is no doubt that (thankfully) the era of siloed professions and siloed specialties in healthcare is coming to an end. Patients are demanding joined-up care and this means professionals in different disciplines talking to each other. As a profession, we must actively seek out partnerships and, once established, we must nurture them to ensure healthy growth and sustainability.

As chiropractic education continues to evolve - and we are at such an exciting time of unprecedented opportunity - I urge all involved in teaching and learning to commit to consistency in meeting public expectations through an unwavering focus on patients, professionalism and partnerships. The WFC education conference in St Louis was a resounding success because educators from around the world came together and shared ideas, thoughts and beliefs. Consistency will be the glue that cements credibility and helps us all to advance together.

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