Paper short abstract:

This paper contributes to unpacking the complex and sometimes paradoxical relationship between standardisation and professionalisation, through a study of the role of educational standards in the evolving status of the chiropractic profession.

Paper long abstract:

Contributing to the sociology of standards (Timmermans and Epstein 2010), this paper explores the relationship between educational standardisation and the professional status of chiropractic. Chiropractic is a manual therapy whose nineteenth century founders held vitalistic beliefs about the role of the spine in health. Following battles for recognition in the twentieth century, chiropractic has received statutory regulation in various countries and access to public higher education systems in order to deliver degrees. Despite these gains, chiropractic is a deeply divided profession, with some sectors adhering to vitalistic concepts such as the chiropractic 'subluxation', and others advocating a 'musculoskeletal' approach founded on scientific evidence. One way the latter agenda has been promoted is by developing standards which prescribe an evidence-based approach in chiropractic education. Drawing on interviews with chiropractic educators and members of professional and regulatory bodies in the UK and Australia, this paper explores the production, content and implementation of the education standards and, importantly, their potential impact on the profession. Although educational standardisation can enhance professional status, this study suggests that imposing standards of evidence in chiropractic education has the potential to reduce the profession's distinctiveness by merging its knowledge base with that of other professions. At the same time, the study identified a number of factors - including the porosity of educational institutions - that, in practice, limit the possibility of standardising the philosophical approach that underpins chiropractic education. The paper helps unpack the complex and sometimes paradoxical relationship between standardisation and professionalisation.