REPORT FROM THE NBCE EXECUTIVE VICE PRESIDENT — APRIL 2008

1. Practice Analysis Advisory Committee Convenes

The National Board of Chiropractic Examiners (NBCE) hosted a Practice Analysis Advisory Committee meeting on April 3-5 to develop a list of critical tasks performed by chiropractic practitioners.

Participants in the three-day meeting included national and international doctors in full-time chiropractic practice, either as private practitioners or academicians. Their input about the critical tasks of a chiropractor will help form the basis for part of a survey instrument that will be mailed to randomly selected practitioners throughout the United States. The information will then be analyzed and published as the Practice Analysis of Chiropractic 2010.

The meeting was facilitated by Ray Talke, president of Minds in Action, Inc., who has worked with over 100 occupational groups in the development of professional task analysis descriptions.

Mr. Talke led committee members in an intense and time-consuming exercise that defined practice environments, responsibilities, tasks, and overall competency requirements to practice chiropractic, including the knowledge, skills and attitudes important to each task of a chiropractor’s daily practice. The committee also identified critical tasks that represented a skill gap, or an important area which might have been overlooked in a typical chiropractic college curriculum. The results of the committee’s three-day process will provide content for the survey instrument.

The Practice Analysis of Chiropractic 2010 will be the fourth edition of a document that was first published in 1993 called Job Analysis of Chiropractic. It is the only publication of its kind that contains the results of a survey of practitioners to identify the role of a typical full-time chiropractor. The practice analysis presents distinguishing statistics about demographics, patient ailments and treatment procedures, as well as notations about recent studies on the efficacy of chiropractic. The job analysis report was previously published in 1993, 2000 and 2005.

The practice analysis is the foundation of the Part III and Part IV clinical and practical skills assessments administered by the NBCE to ensure that exam content directly pertains to the practice of chiropractic. Additionally, the published report of the practice analysis is often used by educators, legislators, state licensing boards, insurance companies, practitioners and others who need a reference concerning the chiropractic profession.

Committee members were:

2. Part IV Case Development Workshop Committee Meets

The NBCE Department of Practical Testing hosted a Case Development Committee workshop with 16 participating clinicians representing U.S. and Canadian chiropractic colleges on March 28-29 in Greeley.

The purpose of this workshop was to develop clinical testing stations that will be piloted on chiropractic college campuses during 2008 and 2009.  The results of the pilot study will then be used to determine the feasibility of introducing new approaches to assessing clinical competencies on the NBCE Part IV Examination.

NBCE Director of Practical Testing Research and Development Dr. Paul Townsend hosted the workshop. “I was impressed with the expertise and professionalism of the workshop participants, and I feel that their work with the standardized patient stations will ensure that our expectations of performance on the pilot exam are closely matched with the education and experience levels of chiropractic students,” said Dr. Townsend.

Part IV assesses clinical skills in diagnostic imaging, chiropractic technique and case management for applicants seeking state licensure. The case management portion of Part IV consists of 20 stations with five minutes allotted to complete each station. At each station, the examinee is required to perform at least one of the following activities: perform a brief case history, perform a brief physical examination, perform a brief orthopedic/neurological examination, choose the most likely diagnoses and/or clinical impressions, choose the most appropriate case management procedures, choose the neurological signs most likely to be present, and choose the most appropriate orthopedic/neurological tests to perform.

The faculty clinicians were enthusiastic about the workshop experience, commenting that it exceeded all of their expectations, that they were impressed by the case development process, and that it was a wonderful experience and they hope to be included in future workshops.

Committee members were:

3. NBCE Funds ACC-RAC Awards

The NBCE was represented by several board and management team members at the most recent meeting of the Association of Chiropractic Colleges (ACC) Research Agenda Conference (RAC), which was held in Vienna, Va., on March 12-15.

In addition to the presentation by NBCE President Dr. Vernon Temple on the redevelopment of Part III and IV exams as well as exam security issues, the NBCE proudly funded the presentation of research awards. The goal of the RAC is to concentrate and reward the development of scientific knowledge, skills and attitudes. Congratulations to the following winners of the RAC competition:

1. Heidi Haavik-Taylor ($2,000): “Altered central integration of dual somatosensory input following cervical spine manipulation.”
2. Robert Powell ($2,000): “A pilot mixed methods study of patient satisfaction with chiropractic care for back pain.”
3. Chris Meseke ($2,000): “Does collaborative testing lead to an increase in student performance in the chiropractic college setting?”
4. Shawn Her ($1,000): “The innervation of the knee joint of a guinea-pig.”
5. Debra Bisiacchi ($1,000): “Self-perceived skills confidence: An investigative study of students entering a chiropractic college’s clinic program.”
6. Don Murphy ($1,000): “A non-surgical approach to the management of pregnancy-related lumbopelvic pain.”
   
   

4. Part IV Standardized Patient Trainers Gather for Workshop

The annual Part IV Standardized Patient Trainers workshop was held on March 8 at the NBCE headquarters.

NBCE Staff Chiropractic Specialist Dr. Judi Gerstung, along with NBCE Part IV Consultant Dr. Peg Seron, led the workshop. The standardized patient trainers reviewed and discussed procedures regarding the training of the standardized patients. These trainers require instruction in teaching the standardized patients how to simulate a detailed condition normally encountered in chiropractic practice.

The goal is to establish consistency in the way standardized patients present cases as part of the Part IV Examination, administered at chiropractic colleges nationwide. These standardized patients are used during the case management portion of the exam to evaluate examinees’ interactions with the pseudo-patient, testing an examinees’ ability to recognize and diagnose the patient’s condition.

Those who attended the workshop were:

5. Part III and E&B Test Committees Meet

The Part III and Ethics and Boundaries (E&B) test committees gathered for their annual meeting on February 22-23, 2008, at the NBCE headquarters.

NBCE Secretary and District III Director Dr. Mary-Ellen Rada was an observer for the E&B test committee meeting. “As is always the case, the committees worked diligently and effectively to enhance the quality and quantity of our available items,” she said. “It is very important for the state board members to observe the processes involved with testing, especially the foundational step of item writing.”

Test committees are nominated by NBCE District Directors or by chiropractic colleges based on the nominee’s expert knowledge of chiropractic practices, procedures and clinical practice.

Part III measures clinical competency for entry level practitioners in nine areas: case history, physical examination, neuromusculoskeletal examination, roentgenologic examination, clinical laboratory and special studies examination, diagnosis or clinical impression, chiropractic techniques, supportive techniques, and case management. The test committee developed exams that the NBCE will administer in fall 2008 and spring 2009 administrations.

NBCE Director of Written Examinations Dr. Ray Townsend moderated the Part III test committee. “The Part III test committee workshop was very well received by the participating state board members and college faculty,” said Dr. Townsend. “NBCE Staff Chiropractic Specialist Dr. Chad Maola and I were very impressed with the overall expertise and commitment of the committee members.”

The NBCE E&B Examination gives state boards a method to discern a doctor’s knowledge of ethics and boundaries issues as they relate to the chiropractic practice. E&B is an optional computerized examination that covers issues including ethical misconduct, sexual misconduct and sexual harassment.

As moderator of the E&B test committee, NBCE Staff Chiropractic Specialist Dr. Judi Gerstung said, “This year’s test committee is to be commended on their attention to detail and hard work in selecting the upcoming E&B exam as this is not an easy task to accomplish.”

Dr. Rada applauded the test committee’s commitment saying, “The E&B exam is particularly difficult to write questions for because of the nature of the material. This year’s committee lived up to all expectations and goals of previous committees by putting forth some of the most diverse and delicate issues surrounding ethics, boundaries, fraud, etc. To be able to have such an important and useful test for use by our state boards is extremely rewarding. It is a great deal of work but worth every minute of it.”

Part III test committee members were:

E&B test committee members were:

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