The evolution of teaching chiropractic skills: part 1 - a narrative review of lessons learned during the 120 collective years of four tutors in the technique trenches at the Canadian Memorial Chiropractic College.

"The only constant is change" - Heraclitus, Greek Philosopher The objective of this article, Part 1 of a two part series, is to provide a narrative review of the evolution of teaching chiropractic manual skills by four tutors who taught in the technique trenches at the Canadian Memorial Chiropractic College collectively for 120 years. Based on their collective memories, this narrative review describes the evolution of: central demonstrations; inconsistency between tutors with respect to demonstrating and grading chiropractic manual skills; determining course content; policy on students providing high velocity, low amplitude thrusts on each other during class time and testing; quantitative versus qualitative grading; remediation; acknowledgment of risk and; changes to technique class due to Covid. The results of a unique survey evaluating students' perception of these changes is presented. The intent of this article is for faculty at other accredited educational programs to learn from our experiences and potentially strengthen their pedagogical approach to teaching chiropractic manual skills.