Modern teaching for clinical education involving manual therapy: a 6-pillar approach

BACKGROUND: Musculoskeletal (MSK) conditions remain a leading source of global disability, and manual therapy (MT) features in multimodal guideline concordant care; however, teaching in clinical programs that involve MT often remains technique-centric and insufficiently aligned with contemporary, person-centred teaching and practice. The present paper synthesizes literature and recent professional discourse to advance an educational framework that operationalizes modern clinical teaching across professions. OBJECTIVE: To present a review-informed, consensus-driven, student centred framework for clinical education involving MT, designed to cultivate safe, effective, culturally responsive, and evidence-based graduates. METHODS: Elements supporting a positive, student-centred learning experience were developed inductively by the lead author, then a narrative review of the literature was conducted on the elements, or pillars as they were designated. This was followed by iterative process to refine and further develop the ideas with a group of international educators, clinicians, and researchers across multiple professions. Consensus was achievedon the core elements of a modern clinical education framework. RESULTS: The framework is anchored in basic sciences and clinical skills, and articulated through six teachable pillars: self-awareness, communication, cultural respect, epistemic humility, intellectual curiosity, and professional identity, delivered via high engagement, student-centred teaching. It provides practical curriculum guidance (crossyear learning outcomes, assessment strategies, and implementation vignettes) to embed person-centred communication, bias mitigation, cultural safety, evidence-based practice competencies, lifestyle medicine integration, and interprofessional collaboration. Together, the six pillars offer a novel approach to student-centred learning. CONCLUSIONS: A six-pillar, multi-profession approach offers actionable guidance for modern clinical education involving MT and supports the development of graduates prepared for contemporary MSK care: technically competent, evidence-based communicators who are culturally responsive and collaborative across healthcare teams.