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Criterion 8.7 Clinical training
The program must provide a clinical education program of sufficient
volume, variety, and quality to fulfill its educational purposes.
Clinical instruction and practice must consist of didactic courses
and practical clinical training, and must include supervised care
of patients which leads the student through gradually increasing
levels of responsibility for patient care.
Guideline: Program-approved supervisors should be sufficient
to ensure the safe and competent care by students of a variety
of patients.
Guideline: A supervised herbal dispensary should be
available in clinics when herbal training is being offered as
part of the curriculum.
Guideline: Appropriate emphasis should be placed on the
safe, ethical, social, and economic aspects of the system of delivery
in acupuncture and/or Oriental medicine.
Guideline: Students should be taught sanitary measures
for infection control prior to their entry into the clinic portion
of the program. Written protocols should be provided to allow
students to comply with NCCAOM guidelines on sanitation, asepsis,
and clean-needle handling.
Guideline: When a large percentage of the students' clinical
experience is gained at off-campus clinical sites, there should
be written agreements with the sites, specifying how the program's
objectives and the program's requirements and standards for clinical
training are to be carried out.
Criterion 8.8 Clinical observation The program must assure
that each student fulfill at least 150 hours observing acupuncturists
and senior student interns performing acupuncture and/or Oriental
medicine therapies in a clinical setting.
Guideline: Observation is defined as learning experiences
in which the student observes a clinician performing acupuncture
or Oriental medicine treatments to patients. This may involve
assisting the practitioner.
Guideline: A clinical setting is defined as a place where
patients are regularly treated.
Guideline: If observation is conducted outside of a clinical
setting, an educationally justifiable reason for considering it
to be observation is necessary. Clinical observation may take
place after supervised clinical practical training has begun if
it is educationally justifiable to do so.
Criterion 8.9 Supervised clinical practice The program
must assure that each student participate a minimum of 500 hours
in the supervised care of patients using acupuncture and/or Oriental
medicine therapies. This portion of the clinical training, conducted
under the supervision of program-approved supervisors, must consist
of a least 250 student-performed treatments where students conduct
patient interviews, participate in diagnosis and treatment planning,
perform appropriate acupuncture and/or Oriental medicine treatments,
and follow-up on patients’ responses to treatment. The supervised
clinical practice must be an internship (see definition of "internship"
in Glossary) and must be conducted in a teaching clinic operated
by the institution or in a clinical facility with a formal affiliation
with the institution where the institution exercises academic
oversight substantially equivalent to the academic oversight exercised
for teaching clinics operated by the institution, where: (1) Clinical
instructors’ qualifications meet school requirements for
clinical instruction; (2) Regular, systematic evaluation of the
clinical experience takes place; and, (3) Clinical training supervision
procedures are substantially equivalent to those within the teaching
clinic operated by the institution. Student interns must receive
training from a variety of clinical faculty in order to ensure
that interns are exposed to different practice styles and instructional
methods
Guideline: Supervised Clinical Practice is defined as learning
experiences in which the student intern provides all phases of
patient care, i.e., full diagnosis, treatment plan and delivery
of treatment (in an Oriental medicine program, this includes writing
up herbal formulas) leading to the ability to function independently
by graduation.
Guideline: Learning Experiences are defined as situations
in which specific objectives are to be met and a means for measuring
the achievement of those objectives is indicated.
Criterion 8.10 Professional Competencies The acupuncture program
of study must lead to the following professional competencies
(#1-7) to be attained through learning experiences included in
the curriculum. The Oriental medicine program of study must lead
to the following professional competencies (#1-10) to be attained
through learning experiences included in the curriculum.
1. Collecting Data and Using the Following Examinations of
the Patient in Order to Be Able To Make a Diagnosis:
Observation noting the spirit, color, body structure, tongue,
symptom site and complexion of the patient
Olfactory examination -- noting the general odor of the patient's
body and of the patient's secretions, discharges and breath
Audio examination -- listening to the sound of the patient's voice,
abdominal sounds, sounds of respiration and cough quality
Palpation noting the temperature, moisture, texture, sensitivity,
tissue structure, rhythms and qualities of the abdomen, the chest,
the ear, the channels and points, and the radial and regional
pulses
Enquiry asking general questions, questions about medical history,
chief and secondary complaints, sleep patterns, excretions, thirst
and appetite, digestion, nutritional levels and patterns, medications,
chills and/or fever, perspiration, pain, emotional state, life
style, exercise, use of alcohol, tobacco and drugs, reproductive
cycles and menstruation, leukorrhea, sensations of heat, cold,
dizziness, tinnitus, palpitations and chest constriction
Physical examination adjuncts such as akabane and electrical stimulation
2. Formulating a Diagnosis by Classifying the Data Collected
and Organizing It According to Traditional Oriental Medical Theories
of Physiology and Pathology. This Skill Implies Comprehensive
Understanding of the Following Fundamental Theories and Concepts:
Five Phases Theory
Yin-Yang Theory
Channel Theory
Organ Theory
Causes of Disease, including the exogenous, endogenous and independent
factors
Stages of Disease Progression, including the six-stage and four-aspect
disease progressions
Triple Warmer Theory
The natural progression of untreated disease
3. Determining Treatment Strategy Based on the Diagnosis Formulated:
The availability of additional appropriate modalities for patient
referral
The ability to communicate with other health professionals regarding
patient care, utilizing commonly understood medical terminology
The functions of the acupoints
4. Performing Treatment by Applying Appropriate Techniques,
Including Needles, Moxa, Manipulation, Counseling, and the Utilization
of Skills Appropriate For Preparation of Tools and Instruments:
Proper sterilization and aseptic procedures
Preparation of the patient, including proper positioning for application
of techniques
Effective communication with the patient regarding the nature
of the illness and the treatment plan
Accurate location of acupoints
Safe and effective needle insertion techniques based upon the
function of the point, the recommended needling depths, the underlying
anatomy at the site, the desired effect of needling, and the nature
of the illness
Accepted clean needle insertion practices, including protocols
adequate to allow compliance with NCCAOM guidelines on sanitation,
asepsis, and clean needle handling
Safe and effective application of adjunctive techniques, including
moxibustion, electrical stimulation and manipulation
Effective control of emergency situations
5. Assessing the Effectiveness of the Treatment Strategy and
its Execution:
By reexamination of the patient
By comparison with previous conditions and expectations
By modification of the treatment plan, if required, based upon
that assessment
6. Complying with Practices as Established by the Profession
and Society at Large Through:
Application of a code of ethics
Practice of responsible record keeping and patient confidentiality
Maintenance of professional development through continuing education
Maintenance of personal development by continued cultivation of
compassion
7. In order to be able to:
Recognize situations where the patient requires emergency or additional
care or care by practitioners of other health care (or medical)
modalities, and to refer such patients to whatever resources are
appropriate to their care and well-being;
Appropriately utilize relevant biomedical clinical science concepts
and understandings to enhance the quality of Oriental medical
care provided;
Protect the health and safety of the patient and the health care
provider related to infectious diseases, sterilization procedures,
needle handling and disposal, and other issues relevant to bloodborne
and surface pathogens; and
Communicate effectively with the biomedical community;
The Student Must Have an Adequate Understanding of:
Relevant biomedical and clinical concepts and terms;
Relevant human anatomy and physiological processes;
Relevant concepts related to pathology and the biomedical disease
model;
The nature of the biomedical clinical process including history
taking, diagnosis, treatment and follow-up;
The clinical relevance of laboratory and diagnostic tests and
procedures, as well as biomedical physical examination findings;
Relevant pharmacological concepts and terms including knowledge
of relevant potential medication, herb and nutritional supplement
interactions, contraindications and side effects.
8. Making A Diagnosis/Energetic Evaluation by:
Identifying position, nature and cause of the dysfunction,
disorder, disharmony, vitality and constitution. This evaluation
is based on the 13 concepts below plus knowledge of distinctive
patterns of herbal combinations and recognition of medical emergencies.
9. Planning and Executing an Herbal Treatment using the following
knowledge:
Identification of most commonly used raw and prepared substances
in Materia Medica
Use of common foods as healing modalities
Properties of substances in Materia Medica:
Taste, temperature, entering meridians, actions and clinical applications.
Identification of common biochemical constituents and common dosage
guideline.
Contraindications of individual herbs:
Toxicity; both traditional and biochemical, rules of combination,
effect of preparation, dosage variance, and possible side effects.
Traditional strategies of herbal formulation:
Sweating (sudorific), Clearing, Ejecting (emetic), Precipitating
(purgative), Harmonizing, Warming, Supplementing (tonic), Dispersing.
Composition of formulas:
Hierarchy of ingredients, internal dynamics of ingredients, changes
in hierarchy of ingredients by modification of ingredients or
dosage.
Preparation and administration of formulas:
Dosage, timing, frequency, duration, extraction times, etc.
Indications and functions of representative herbal formulas.
Selection, modification and development of appropriate formulas
consistent
with the pattern of disharmony and treatment plan.
Current types of prepared formulations available (pills, powder,
tincture,
etc.)
-Dosage variances, side effects and toxicity associated with usage,
timing, frequency, duration, extraction times, etc.
-Understanding the issues surrounding non-traditional additives
to prescriptions.
Selection of the appropriate modality or modalities for treatment:
-Acupuncture, herbs, Oriental manual therapy, exercise, breathing
therapy, and diet counseling.
Consultation with patient regarding treatment plan, side-effects,
outcomes,
and healing process.
Biomedical considerations of herbal preparations:
Contraindications, drug interactions, etc.
10. Understanding Professional Issues Related to Oriental Herbs:
The ethical considerations with respect to prescribing and selling
herbs to patients.
How and when to consult and refer with appropriate biomedical
or allied health practitioners regarding drug interactions and
herbal therapy.
The appropriate management, care and storage of herbs and herbal
products.
Criterion 8.11 - Continuing Education When continuing education
programs and
special instructional activities are offered either on or off
campus, they must be integral components of the institution’s
commitment. Provision for such activities must include an adequate
administrative structure, a competent faculty, a sound financial
base, and appropriate facilities. Continuing education courses
cannot be converted to usable credits that will meet the program’s
graduation requirements.
Criterion 8.12 - Licensure and Certification Exam Rates
If the program’s licensure exam pass rate falls below sixty
percent (60%) or it its NCCAOM certification exam pass rate falls
below seventy percent (70%), ACAOM shall review the program to
determine if it remains in compliance with the accreditation criteria.
(In trial status)
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