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TCC News & Events

TCC Names Dr. Brad McKechnie President

PASADENA, Texas – The Texas Chiropractic College (TCC) Board of Regents has named Brad McKechnie, DC, DACAN as the institution’s 14th president, after serving as the interim president since April 2014.

An honor graduate of TCC in 1985, Dr. McKechnie returned to his alma mater as an assistant professor in the department of clinical sciences. He also twice served as a dean during his tenure, managing postgraduate education and later overseeing external affairs for the college. In 2009, Dr. McKechnie was named to the TCC Board of Regents and he served on the Board’s Academic Affairs Committee, Postgraduate Committee, and the Finance Committee.


TCC Names Dr. Stephen A. Foster As Provost

PASADENA, Texas – Brad McKechnie, DC, DACAN, president of Texas Chiropractic College (TCC), is pleased to announce the promotion of Stephen A. Foster, DC, FICC to the position of provost, effective December 8, 2014.

According to Dr. McKechnie, “Dr. Foster’s responsibilities as provost include coordinating TCC’s academic programming, infrastructure and budgetary matters with the president’s office. Dr. Foster will work methodically to administer the resources, training and services that students, faculty and staff need to promote excellence in the education of doctors of chiropractic.”




The goal of Texas Chiropractic College’s Quality Enhancement Plan is to improve teaching and student learning outcomes in clinical reasoning. The topic was chosen based on input from students, faculty, the President’s Cabinet, the Board of Regents and college alumni; institutional objectives set forth in the TCC Graduate document; and student performance on both internal and independent external examinations. The QEP title is “From Student to Clinician: Enhancing Clinical Reasoning Across the Curriculum.”

After the thorough review of the literature on clinical reasoning, a working definition was developed to guide the QEP process: “Clinical reasoning is a problem-solving process that enhances the development of clinical thinking and decision making in patient care. It involves the movement from accumulation of knowledge to the incorporation of skill, expertise and evidence leading to sound clinical judgment.”

Programmatic outcomes related to clinical reasoning focus on integration and application of basic science knowledge with the clinical presentation; introduction and application of clinical reasoning strategies in the pre-clinical setting; and application of clinical reasoning skills in the patient care setting. Evaluation methods were identified to monitor the programmatic outcomes. These methods include, but are not limited to, student course evaluations, Diagnostic Thinking Inventory, Clinical Skills Competency Exams I and II, Core Concept Exams, Health Sciences Reasoning Inventory, National Board Exams parts I, II, III and IV, and faculty interviews.

The full curriculum was reviewed and four pilot courses were selected. The pilot courses are Spinal Anatomy, Clinical Case Applications, Clinic I, and Orthopedics III. The pilot courses will be implemented during the Summer 2009 trimester.

For successful QEP implementation, new courses are being added to the curriculum.  The new courses are Clinical Case Applications I (trimester 3), Basic Communication and History-Taking Skills (trimester 3), Clinical Case Applications II (trimester 4), Advanced Communication and History-Taking Skills (trimester 4), and Clinical Case Applications III (trimester 5). Full implementation will be on a two-track basis.  The full track for incoming trimester one students begins in Fall 2009 and runs from trimesters one through ten.  The second track encompasses the clinical experience and continues through Clinic II, Clinic III and Clinic IV for those students enrolled in the pilot course, Clinic I, culminating in graduation from the Doctor of Chiropractic degree program.

Teaching strategies to enhance clinical reasoning are being integrated into courses by means of standardized patients, case-based learning, team-based learning, faculty modeling, SNAPPS, reflective practice and electronic real-time student feedback.

Assessment of clinical reasoning will be conducted through extended matching, key features and script concordance questions; electronic real-time student feedback; standardized patient encounters; case-based discussions; student self-evaluation; Intern Global Rating; objective structured clinical evaluation; and Diagnostic Thinking Inventory.


QEP - Table of Contents

Chapter 1: Introduction and Description of Texas Chiropractic College

  • History of TCC    2
  • Mission, Vision, and Strategic Plan of TCC    3
  • Educational Environment    3
  • TCC Today    4

Chapter 2: History and Description of the QEP Topic Focus

  • Introduction    5
  • Process for Topic Identification    5
  • QEP Title and Definition    8
  • Delegation of Responsibilities    8
  • Anticipated Benefits of the QEP    9

Chapter 3: Literature Review

  • Introduction    10
  • Theories and Models of Clinical Reasoning    10
  • Curricular and Course Models of Clinical Reasoning    12
  • Instruction Strategies to Enhance Clinical Reasoning    15
  • Assessment Methods    16
  • Summary    18

Chapter 4: Developing the QEP

  • Introduction and Conceptual Model    19
  • Steps to Clinical Reasoning    20
  • QEP Design Plan    21
  • Programmatic Outcomes    21
  • Student Learning Outcomes    21
  • Table 4.1 Courses in the QEP Curriculum    23
  • Table 4.2 Teaching Strategies    24
  • Clinical Reasoning Design Plan for Pilot Courses    25
  • Spinal Anatomy    26
  • Clinical Case Applications    28
  • Clinic I    29
  • Orthopedics III    31
  • Implementation of the QEP Across the Curriculum    34
  • Implementation Timeline    44

Chapter 5: Assessment Methods

  • Introduction    46
  • Course Assessment    46
  • Written Examinations    46
  • Electronic Real-Time Student Feedback    49
  • Standardized Patient Encounters    49
  • Case-Based Discussion    49
  • Student Self-Evaluation    50
  • Global Rating Assessment    51
  • Objective Structured Clinical Evaluation    52
  • Programmatic Evaluatio    53
  • Student Course Evaluations    53
  • Diagnostic Thinking Inventory    54
  • Clinical Skills Competency Examinations I and II    54
  • Health Sciences Reasoning Test    55
  • National Board Examinations, Parts I, II, III and IV    55
  • Faculty Interviews    55
  • Core Concept Examinations (Capstone Examinations)    56
  • Knowledge-Based Inference Tool (KBIT)    56
  • Case-Based Discussion    56
  • Assessments and Criteria for Determination of Programmatic Success    57
  • Table 5.3 – Programmatic Outcome # 1    58
  • Table 5.4 – Programmatic Outcome # 2    59
  • Table 5.5 – Programmatic Outcome # 3    60
  • Programmatic Evaluation Schedule    61

Chapter 6: Faculty Development

  • Introduction    62
  • Table 6.1 - Faculty Development Outcomes    62
  • Faculty Development    63
  • Table 6.2 - Previous QEP Faculty Development Activities    63
  • Table 6.3 - Faculty Development of Teaching Strategies    64
  • Table 6.4 - Faculty Development of Assessment Strategies    66

Chapter 7: Institutional Capability for Initiation and Continuation of the QEP

  • Introduction    67
  • Management Structure    67
  • QEP Communications and Marketing    69
  • Project Timeline    69
  • QEP Budget    69

Conclusions 72

References 73


  • Appendix I – QEP Steering Committee    77
  • Appendix II – QEP Subcommittees    78
  • Appendix III – President’s Cabinet    79
  • Appendix IV – Promotional and Educational Materials    80
  • Appendix V – Communications Timeline    81
  • Appendix VI – Project Timeline    82

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