REPORT FROM THE NBCE EXECUTIVE VICE PRESIDENT — APRIL 2008

INSIDE THIS REPORT:

1. Practice Analysis Advisory Committee Convenes
2. Part IV Case Development Workshop Committee Meets
3. NBCE Funds ACC-RAC Awards
4. Part IV Standardized Patient Trainers Gather for Workshop
5. Part III and E&B Test Committees Meet
6. NBCE Calendar

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:

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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:

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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.”

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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:

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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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6. NBCE Calendar

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REPORT FROM THE NBCE EXECUTIVE VICE PRESIDENT — FEBRUARY 2008

1. NBCE Holds Student Forum

On May 4, the National Board of Chiropractic Examiners (NBCE) held its Annual Board Meeting in coThe National Board of Chiropractic Examiners (NBCE) held its annual Student Leadership Forum on January 18, 2008. Representatives from the American Black Chiropractic Association (ABCA), Student American Chiropractic Association (SACA), Student International Chiropractors Association (SICA) and World Congress of Chiropractic Students (WCCS) attended. These student leaders represent 10 chiropractic colleges and four associations in the United States, Mexico and New Zealand.

The NBCE hosts the annual forum to increase cooperation, communication and collaboration with the student leaders and the student population around the world. Another goal of the event is to give student leaders the opportunity to engage and share their ideas and goals for chiropractic.

In welcoming the student leaders, NBCE President Dr. Vernon Temple asked the students to guard against any preconceptions they might hold, whether they are institutional, collegial or philosophical. He asked that they keep an open mind throughout the day, especially about the NBCE testing process.

“This forum has become a tradition here at the NBCE, an important opportunity to promote a better understanding of our organization as well as to open the doors of communication,” said Dr. Temple. “I feel it is incumbent on me as president of the board to cultivate an atmosphere of open, honest and direct communication and I want to include you in this environment.”

The student leaders listened to an in-depth orientation about the National Board’s processes for development and administration of the written and practical exams, as well as methods used in scoring exams. They also toured the NBCE facility and met staff members.

“We were most impressed by the staff morale and were overwhelmed by their sincere hospitality,” said WCCS Chairperson Jaime Pinillos Montano. “The meticulous structure and organization along with the clear vision of NBCE’s goals is outstanding and should provide certainty and assurance to all students partaking in the examinations.”

At the end of the day, the students expressed their gratitude for the in-depth presentations as well as their commitment to help promote improved communications between their student bodies and the NBCE.
“I believe we had an excellent meeting with the students and they will better understand the National Board in the future and will be able to share an accurate and positive view with their fellow students,” said NBCE Executive Vice President Horace Elliott.

The student forum attendees included:

ABCA:
Charmaine Herman, National Student Representative, Sherman College of Straight Chiropractic
Bryant Harris, Western Region Representative, Life College Chiropractic West
Jermaine Ware, Central Region Representative, Logan College of Chiropractic
Alaric Diggs, Eastern Region Representative, Life University, College of Chiropractic

SACA:
Julie Potter, Ph.D., National Chair, Northwestern Health Sciences University
Peter L.C. Hicks, National Vice-Chair, New York Chiropractic College
Jason Godbout, National Legislative Chair, University of Bridgeport, College of Chiropractic
Courtney Centrelli, National Legislative Vice-Chair, New York Chiropractic College

SICA:
Eva Sepulveda, SICA Congress Chair, Southern California University of Health Sciences
Brandon Schultz, SICA Congress Vice-Chair, Cleveland Chiropractic College–Kansas City
Barbara Kaiser, SICA Congress Secretary, Northwestern Health Sciences University

WCCS:
Jaime Pinillos Montano, Chair, 2006 Graduate–Universidad Estatal del Valle de Ecatepec
Ali Postles, Vice-Chair, New Zealand College of Chiropractic

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2. NBCE 2008 Annual Meeting

During the week of April 28-May 3, the NBCE Board of Directors will hold its annual board and state delegates meeting in conjunction with the Federation of Chiropractic Licensing Boards’ 82nd Annual Educational Conference in Atlanta, Georgia.

At the business meeting on Friday, May 2, the NBCE Board of Directors will present a progress report on current NBCE programs, along with the 2007 financial report. Delegates will also consider action on proposed bylaws changes and the election of the District IV Director. Each state board must have designated its delegate and alternate delegate to the meeting by March 3, 2008.

For more information about the business meeting, please contact the NBCE Executive Department at 1-800-887-4320 or by e-mail to elliott@nbce.org.

Annual Meeting Timeline:

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3. Test Administrators Receive Training

With test sites around the world, the NBCE relies on its trained test administrators to ensure secured, uniform and standardized testing conditions. Being an NBCE test site administrator (TA) and assistant test site administrator (ATA) therefore requires continuous training. On December 3-5, 2007, administrators from Australia, New Zealand and Texas attended a three day seminar in Greeley covering test site protocols and procedures.

Pam Kurtz, Director of Administration, led the training seminar. “I am confident that these new TA’s and ATA’s have been given the knowledge and tools to be organized and to run a successful NBCE exam administration,” Kurtz said. “They were very attentive and enthusiastic about their new roles with the NBCE.”

NBCE test administrators all have previous experience in the exam administration and testing processes, either with the NBCE or at other institutions.

These administrators oversee every aspect of exam administration at their respective test sites. They have the authority to uphold and enforce the rules and regulations of the NBCE regarding the administrations of their exams. Therefore, the NBCE routinely trains them on new policies and procedures that are required to administer a successful test.

The TA/ATA’s primary responsibilities include:

• To recruit, train and supervise competent proctors as needed.
• To inspect test site facilities and designate examinee seating arrangements.
• To receive and inventory all exam materials.
• To guard the security of the exams.
• To supervise the exam administration.
• To account for and return all exam materials to the NBCE headquarters.
• To report any irregularities or conditions of the exam.

In addition to the training at new test sites in Australia and New Zealand, administrators in the United States who are new to their positions received training at Greeley headquarters. The NBCE is very proud of and most appreciative of the excellent skills of the following new administrators who were in attendance:

Kevin Collins, Test Administrator, RMIT University, Australia
Peggy Hartness, Test Administrator, Parker College of Chiropractic, Texas
Jenny Keenan, Test Administrator, New Zealand College of Chiropractic, New Zealand
Joshua Mohr, Assistant Test Administrator, Parker College of Chiropractic, Texas
Shana Mohr, Assistant Test Administrator, Parker College of Chiropractic, Texas
Glenys Wood, Chief Invigilator, Murdoch University, Australia

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4. Part II and Physiotherapy Meet

The Part II and Physiotherapy Test Committee gathered for its annual meeting on October 19-20, 2007, at the NBCE headquarters.

The test committees are composed of faculty members from various chiropractic colleges who are selected based on their expert knowledge in specific subject areas. During the meeting, the test committees create examinations according to the guidelines provided by the test plans that the NBCE will administer in 2008.

The Part II Examination tests clinical science areas which include general diagnosis, neuromusculoskeletal diagnosis, diagnostic imaging (X-ray), principles of chiropractic, chiropractic practice, and associated clinical sciences that candidates must pass prior to becoming licensed doctors of chiropractic.

Physiotherapy is an elective examination that assesses patient evaluation, physiotherapy modalities, their indications, contradictions and applications of modalities, and therapeutic exercise and rehabilitation. Individuals who obtained physiotherapy instruction while in chiropractic college may take this exam to demonstrate their competency in the subject to state licensing boards.

“The fall Part II and Physiotherapy Test Committee members did an outstanding job of selecting and editing the subject test questions; I believe their efforts will be evident when these exams are administered next year,” said NBCE Director of Written Testing Dr. Ray Townsend.

Part II attendees were:

General Diagnosis:
C. Robert Humphreys, D.C., National University of Health Sciences
Renee M. Prenitzer, D.C., Sherman College of Straight Chiropractic
Jonathan C. Williams, D.C., Northwestern Health Sciences University
Maya Dokson, D.C., NBCE Moderator

Neuromusculoskeletal Diagnosis:
Michael W. Hall, D.C., Parker College of Chiropractic
Karen L. Numeroff, D.C., Life University, College of Chiropractic
Dorrie M. Talmage, D.C., Texas Chiropractic College
Heather Kauffman, D.C., NBCE Moderator

Diagnostic Imaging:
Beverly L. Harger, D.C., Western States Chiropractic College
Dominick J. Scuderi, D.C., Palmer College of Chiropractic, West Campus
Greg Crawford, D.C., NBCE Moderator

Principles of Chiropractic:
Karen M. Dishauzi, D.C., Logan College of Chiropractic
Keith A. Wells, D.C., New York Chiropractic College
Ray Townsend, D.C., NBCE Director of Written Examinations and Moderator

Chiropractic Practice:
Michael L. Bovée, D.C., Palmer Chiropractic College, Davenport Campus
Stephen A. Foster, D.C., Texas Chiropractic College
David M. Sikorski, D.C., Southern California University of Health Sciences
Chad Maola, D.C., NBCE Staff Chiropractic Specialist and Moderator

Associated Clinical Sciences:
James H. Guest, D.C., Parker College of Chiropractic
Julie A. Plezbert, D.C., New York Chiropractic College
Robert C. Shiel, Ph.D., National University of Health Sciences
Michelle Clark, D.C., NBCE Moderator

Physiotherapy attendees were:

Julia D. Bartlett, D.C., Northwestern Health Sciences University
James W. George, D.C., Logan College of Chiropractic
Craig Kawaoka, D.C., Southern California University of Health Sciences
Dean Vandergon, D.C., NBCE Moderator

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5. Part IV Standardized Patient Trainers Gather for Workshop

The NBCE hosted 18 patient trainers who were selected based on their expertise in the chiropractic profession or previous experience as standardized patients for the annual Part IV Standardized Patient Trainers Workshop on September 15, 2007, in Greeley.

Staff Chiropractic Specialist Dr. Judi Gerstung welcomed the patient trainers. NBCE Part IV consultants Dr. John Hyland and Dr. Margaret Seron led the workshop. The patient trainers reviewed DVDs and manuals, and discussed procedures regarding the training and consistency the standardized patients must employ at chiropractic colleges administering the November Part IV Examination.

Standardized patient trainers prepare and train standardized patients in simulating specific conditions commonly encountered in practice. Standardized patients are used during the case management portion of the exam. The examinee will address or interact with the standardized patients as though that patient actually has the condition that he or she is simulating and diagnose the patient’s condition. The patient trainer is also responsible for the orderly rotation of standardized patients as well as their safety and debriefing on the day of the exam.

The use of standardized patients has been a key feature of the National Board’s practical exam since its inaugural administration in January 1996. Members of the NBCE Department of Practical Testing attended the 2007 Association of Standardized Patient Educators conference in Toronto in June 2007. Director of Practical Testing Research and Development Dr. Paul Townsend participated in an interdisciplinary panel discussion concerning the use of standardized patients, and made a presentation about Part IV to the general audience.

Those who attended the workshop were:

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6. NBCE Calendar

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REPORT FROM THE NBCE EXECUTIVE VICE PRESIDENT — SEPTEMBER 2007

1.  Online CCAT Available Soon

The first Web-based Chiropractic College Assessment Test (CCAT) will be launched in September 2007 on the National Board of Chiropractic Examiners (NBCE) Web site for individuals who are interested in a health-related career.

The NBCE specifically designed the assessment as a tool for the student to use in conjunction with academic counseling to make proactive academic or remedial decisions. The CCAT is an optional and comprehensive tool for a prospective student’s self-assessment; the results are highly correlated with success in chiropractic college.

On June 23-25, the National Board launched CCAT to the American School Counselors Association (ASCA) at its annual convention in Denver. The convention hosted 2,100 counselors from across the United States. NBCE District II Director Dr. Donna Craft and the NBCE Professional Relations and Communications Department introduced counselors to the CCAT exam, describing its use in counseling students who have an interest in chiropractic or other allied health careers.

The CCAT:

• Is optional; it is useful to assess a student’s academic preparation for a chiropractic college curriculum.
• Provides a tool for students and academic counselors in making proactive academic decisions or suggesting areas for further study.
• Measures the prospective student’s ability in problem-solving skills, mathematics (quantitative reasoning skills), biology, chemistry and physics.
• Correlates highly with success in chiropractic college.
• Is a Web-based, multiple-choice examination, available at www.ncbe.org/ccat.
• Requires approximately one and one half hours to complete.
• Provides examinees the option to request that their scores be sent to the chiropractic colleges of their choice.

The CCAT is for:

• Those who are considering a career in chiropractic.
• Those who want to know if they have the problem-solving and reasoning skills necessary for successful completion of a rigorous scientific curriculum.
• Those who want to know if there is a particular subject that requires additional preparation.
• Those who would like an assessment that highly correlates with successful completion of chiropractic college.
• Those who would like an assessment before committing to substantial time and student loan obligations.

When to take the CCAT:

• When a prospective student is considering a career in a health care profession and wants to assess his/her aptitude and/or academic preparation.
• When a prospective student decides that chiropractic is his/her career choice and is completing prerequisites prior to applying to chiropractic college.
• When a prospective student applies or has been accepted to a chiropractic college and has not yet completed his/her first academic term.

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2. Part III and Part IV Evolution

The National Board of Chiropractic Examiners (NBCE) finds it necessary to continually review and update exams as changes take place in testing and scoring methods, as technology offers opportunities to provide better content in exams, and as curricula in chiropractic colleges change to respond to advances in diagnostic and treatment techniques.

In May, the Parts III and IV Exam Committee (whose members are Dr. Richard Cole and Dr. Oliver Smith, co-chairs, Dr. Donna Craft, Dr. Robin Lecy, and Dr. Mary-Ellen Rada) recommended to the NBCE Board that staff pursue a new format of questioning directed towards testing at a higher level of understanding versus the traditional recall configuration. That initiative will be furthered on September 22 as experts in clinical case management gather to select questions for a Part III Pilot Examination.

Part III test committee members have been selected to include practicing state board representatives from all five districts and chiropractic college faculty. This group of experts will choose items for the pilot examination to adequately and fairly test on currently utilized practice techniques while still assuring the content covers what is taught in colleges.

If the new Part III Pilot Exam is successful, future administrations will move away from the solely traditional multiple choice format revolving around a single concept and instead test the students via a battery of questions pertaining to a single case. There will be more than one correct answer to a single question. Examinees must select the correct answers from a list of choices that are applicable to the case.

After the test committee develops items for the prototype exam, the updated Part III will be piloted at selected chiropractic colleges to determine the effectiveness and validity of the new format. Assuming pilot exams are successful, the new format will be introduced in 2009.

The Part IV staff is also looking at ways to update the practical exam. Dr. Clarence Kreiter, an expert in the field of education and professor at the Medical/Graduate Schools of the University of Iowa, recently analyzed the May 2007 Part IV Exam. The NBCE is proud to report that Dr. Kreiter indicated that the NBCE’s present pass/fail decisions are highly reliable and may rank among the best in the industry.

Although psychometric characteristics have been useful in the past for measuring the internal characteristics of multiple choice type questions, conversion to the generalization theory will afford the Part IV department the opportunity to more extensively examine variables associated with a performance-type exam. Generalization theory refers to the accuracy of generalizing from a person’s observed score on a test to the average score that person would have received under all possible conditions. In short, the NBCE wants to do an even better job evaluating the clinical skills of licensure candidates.

The process will involve researching new station formats that will assess clinical decision-making in greater depth. The first stage of this process will be to develop checklists with input from chiropractic educational institutions and subject experts. In the second stage of field testing, patient training, rater training and administration of prototype stations will be addressed. Then, with results in hand, recommendations will be made to the NBCE Board for possible implementation.

The Board will keep you informed of any decisions regarding examination development in future issues of this report.

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3. Part IV Test Committee Selects Exams

Selected chiropractic experts gathered for the 13th annual Part IV test committee meeting on June 15-16, 2007, at the National Board headquarters in Greeley, Colo.

NBCE President Dr. Vernon Temple welcomed the test committee. “Thank you for being here and giving up this weekend,” he said. “The example you set in giving up a day of practice, a weekend with your family and a Father’s Day to work for the profession is truly appreciated. Your efforts are the reason the NBCE has excelled in producing exams that your state board can depend upon—we could not do it without you.”

Twenty participants from across the United States were chosen to review patient case scenarios and select case-related questions for the Part IV Practical Examination to be administered in November 2007 and May 2008. Part IV assesses clinical skills in diagnostic imaging, chiropractic technique and case management for applicants seeking state licensure.

The NBCE Part IV Examination was administered for the first time in January 1996 and has been administered twice yearly to more than 39,000 doctors. Part IV is presently accepted by 48 states and the District of Columbia for initial licensure in chiropractic.

Part IV attendees were:

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4. WFC Research Awards

On May 19, NBCE President Dr. Vernon Temple, NBCE Executive Vice President Horace Elliott and WFC Research Council Chair Dr. Scott Haldeman presented original research competition awards at the WFC Congress and the ECU Convention in Vilamoura, Portugal.

These annual awards are sponsored by the Foundation for Chiropractic Education and Research (FCER) which is based in the United States; awards are administered by the International Conference on Chiropractic Research.

The NBCE contributed a total of $15,000 to fund the awards as follows:

• First Prize, Scott Haldeman Award, $7000: Predictors of Adverse Reactions following Chiropractic Care for Patients with Neck Pain : Sidney Rubenstein, Charlotte Leboeuf-Yde, et al – the Netherlands and Denmark.
• Second Prize, $4,000: Economic and Resource Status of the Chiropractic Profession in Ontario, Canada: A Threat or an Opportunity: Silvano Mior and Audrey Laporte – Canada.
• Third Prize, $2500: Altered Sensorimotor Integration with Cervical Spine Manipulation: Heidi Haarik Taylor and Bernadette Murphy – New Zealand.
• Private Practice Award, $1500: The Effect of Sports Chiropractic on the Prevention of Athletic Injuries in Elite Athletes: A Randomized Controlled Trail: Wayne Hoskins, Henry Pollard and Rod Bonello – Australia.

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5. NBCE Calendar

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REPORT FROM THE NBCE EXECUTIVE VICE PRESIDENT — JUNE 2007

1. NBCE Annual Meeting, St. Louis, Mo.

On May 4, the National Board of Chiropractic Examiners (NBCE) held its Annual Board Meeting in conjunction with the Federation of Chiropractic Licensing Boards’ (FCLB) 81st Annual Educational Conference in St. Louis, Mo.

During the annual meeting, District Directors were elected for Districts I, II and V, two Directors-at-Large were elected and two FCLB-Appointed Directors were seated. After these elections, the Board elected officers to form the Executive Committee. The following comprise the new Board:

Earl Wiley, D.C., Director-at-Large and Chairman of the Board
Vernon Temple, D.C., Director-at-Large and President
N. Edwin Weathersby, D.C., Director-at-Large and Vice President
Theodore Scott, D.C., District IV Director and Treasurer
Mary-Ellen Rada, D.C., District III Director and Secretary
Rick Cole, D.C., Director-at-Large
Donna Craft, D.C., District II Director
Robin Lecy, D.C., District I Director
Norman Ouzts, Jr., D.C., District V Director
Daniel Saint-Germain, D.C., FCLB Vice President
Oliver Smith, Jr., D.C., FCLB President

In addition to the elections, 15 proposals for bylaws changes were presented to the delegate body for approval. Three of the 15 proposals presented to the delegate body failed. Comments on the defeated proposals will be reconsidered by the Bylaws Committee in the coming year. For more information on the bylaws changes, please visit our Web site at www.nbce.org. Also, a few annual meeting pictures can be found on Page 5.

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2. 2007 WFC Congress and ECU Convention, Portugal

On May 13-19, a delegation representing the National Board of Chiropractic Examiners (NBCE) and furthering the development of the International Board of Chiropractic Examiners (IBCE) attended the joint 9th Biennial World Federation of Chiropractic (WFC) Congress and the 75th Annual European Chiropractic Union (ECU) Convention in Vilamoura, Portugal. 

The delegation members from the NBCE/IBCE included Dr. Vernon Temple, President; Dr. N. Edwin Weathersby, Vice President; Dr. Jerry Blanchard, former NBCE Director; Mr. Horace Elliott, Executive Vice President; and Dr. Martin Kollasch, International Operations Manager.

Each member country was given an opportunity to address the World Federation of Chiropractic Council meeting. Representatives from Costa Rica, Sweden and Japan reported on the status of chiropractic legislation and education in their countries. Dr. Temple and Dr. Kollasch presented information on IBCE formation and goals to the assembly on May 15.

“With chiropractic exploding worldwide, we recognize that governments around the world will influence and shape the future of chiropractic,” said Dr. Temple. “The IBCE therefore welcomes this opportunity to discuss standards for chiropractic that can be universally accepted and not be in conflict with specific jurisdictions.”

On May 19, Dr. Temple and Mr. Elliott presented the Foundation for Chiropractic Education and Research (FCER) original research awards, which were funded by the NBCE, which will be highlighted in the next newsletter.

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3. Life Chiropractic College West Holds National Board Day

On May 18, 2007, NBCE Chairman of the Board Dr. Earl Wiley and Director of Administration Pamela Kurtz hosted National Board Day at Life Chiropractic College West in California.

Dr. Wiley introduced the program with a description of chiropractic licensure before the development of national exams. Kurtz reviewed the history of licensing in chiropractic and the current eligibility guidelines for NBCE exams. She also reviewed the process of developing exam questions and reporting of results, the status of computerization, and national (and state-by-state) requirements. 

Later in the presentation, students’ questions were addressed. The greatest number of questions concerned the new NBCE security procedures and the optional Chiropractic College Assessment Test (CCAT).

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4. Part I and Acupuncture Test Committees Meet

The annual Part I and Acupuncture test committees were held on April 20-21, 2007, at the headquarters of the National Board of Chiropractic Examiners (NBCE) in Greeley.

NBCE President Dr. Vernon Temple welcomed the test committee members. “I want to thank you all for your commitment to this organization and for creating an exam that reflects well on our profession.  Your generous contributions go far toward achieving our goal of excellence in chiropractic testing.”

Before the committees convened, Dr. Ray Townsend expressed his appreciation to the test committee members, “I encourage you to really focus on each individual question to make sure that these are the best possible items that will create the fairest standardized exam.”

During the two-day meeting, the test committees selected items that they felt would best assess an examinee’s knowledge and composed questions to add to the NBCE’s item pool for future exams.

NBCE test committees create examinations according to the guidelines provided by the test plans. To ensure the fairness of the examination, these committees are composed of college instructors, subject matter experts and state licensing board members selected based on their expert knowledge of the subject matter.

The NBCE examinations are offered twice yearly at chiropractic colleges across the United States and in several foreign countries. The Part I Examination is part of a battery of tests that candidates must pass prior to becoming licensed doctors of chiropractic. Acupuncture is an elective exam for individuals who have received acupuncture instruction while in chiropractic college or those who have already graduated from chiropractic college and want to demonstrate their knowledge of the subject matter.

Part I attendees were:

General Anatomy:
Steve W. Kirk, D.D.S., ParkerCollege of Chiropractic
Sheldon P. Clayton, Ph.D., ShermanCollege of Straight Chiropractic
Kim L. Swineheart, D.C., Northwestern HealthSciencesUniversity
Chad Maola, D.C., NBCE Moderator

Spinal Anatomy:
James D. Hawkins, M.A., LifeChiropracticCollege West
John H. Romfh, Ph.D., LifeUniversityCollege of Chiropractic
James R. Carollo, M.S., WesternStatesChiropracticCollege
Heather Kauffman, D.C., NBCE Moderator

Physiology:
Louis J. Freedman, D.C., PalmerCollege of Chiropractic
Katie A. Burns Ryan, D.C., Northwestern HealthSciencesUniversity
James B. Parker, Ph.D., ParkerCollege of Chiropractic
Kathleen Jones, Ph.D., NBCE Moderator

Chemistry:
Marc P. McRae, D.C., NationalUniversity of Health Sciences
David C. Lin, Ph.D., Southern CaliforniaUniversity of Health Sciences
Verena Van Fleet, Ph.D., Northwestern HealthSciencesUniversity
Jim Schreck, Ph.D., NBCE Moderator

Pathology:
Medhat Alattar, D.C., MB, BCh, PalmerCollege of Chiropractic—FL
Mark Mattie, Ph.D., University of Bridgeport, College of Chiropractic
Gary E. Sanders, Ph.D., LoganCollege of Chiropractic
Greg Crawford, D.C., NBCE Moderator

Microbiology and Public Health:
Gyan P. Khare, Ph.D., ClevelandChiropracticCollegeLos Angeles
Kim B. Khauv, D.C., LifeChiropracticCollege West
Mohan K. Menon, Ph.D., PalmerCollege of Chiropractic West
Michelle Clark, D.C., NBCE Moderator

Acupuncture attendees were:

Joseph R. Carter, D.C., South Carolina
John R. Dixon, D.C., California
Mary M. Jennings, D.C., NationalUniversity of Health Sciences
Patrick B. Kennedy, D.C., LoganCollege of Chiropractic
Denise C. Natale, D.C., Vermont
Gary Rosquist, D.C., Utah
Tricia F. Schwartz, D.C., South Dakota
Charles M. Ventresca, D.C., New YorkChiropracticCollege
Martin Kollasch, D.C., NBCE Moderator
Bruce Shotts, D.C., NBCE Moderator

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5. Part IV Technique Workshop

On April 14, the National Board of Chiropractic Examiners hosted 21 college representatives from national and international chiropractic colleges for the Part IV Chiropractic Technique Workshop. The participants (listed below) reviewed techniques that currently appear on Part IV exams.

In addition, the technique workshop focused on the development of a more holistic approach to measuring competency in chiropractic patient assessment and adjusting. Director of Practical Testing Research and Development Dr. Paul Townsend stated that the average score for technique ranges from 82-86 percent. “We currently have a nice set of skills to test, but we would like to see if we can improve measurement in this important area of chiropractic practice,” he said.

Workshop attendees were:

Dr. Tom Bergmann, Northwestern HealthSciencesUniversity
Dr. Karen Bobak, New YorkChiropracticCollege
Dr. Daryl Capen, ClevelandChiropracticCollege—L.A.
Dr. Robert Cooperstein, PalmerChiropracticCollege West
Dr. Scott Donaldson, LifeChiropracticCollege West
Dr. Joseph Donofrio, ShermanCollege of Straight Chiropractic
Dr. Terry Elder, NationalUniversity of Health Sciences
Dr. Linda Elkins, LifeChiropracticCollege
Dr. James Fuller, ParkerCollege of Chiropractic
Dr. Brian Gleberzon, CanadianMemorialChiropracticCollege
Dr. Chris Good, University of BridgeportCollege of Chiropractic
Dr. David Hayes, University of Quebec at Trois-Rivieres
Dr. Deric Jacobs, PalmerCollege of Chiropractic—FL
Dr. Ali Jafari, D’Youville College of Chiropractic
Dr. Hunter Mollin, New YorkChiropracticCollege
Dr. Lester Partna, WesternStatesChiropracticCollege
Dr. Kevin Paustian, PalmerCollege of Chiropractic
Dr. Michael Ramcharan, ClevelandChiropracticCollege —K.C.
Dr. Daryl Ridgeway, LoganChiropracticCollege
Dr. David Sikorski, Southern CaliforniaUniversity of Health Sciences
Dr. Kenneth Sorrels, TexasChiropracticCollege

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6. NBCE Calendar

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REPORT FROM THE NBCE EXECUTIVE VICE PRESIDENT — MARCH 2007

1.  NBCE Holds Student Forum
The National Board of Chiropractic Examiners (NBCE) held its annual Student Leadership Forum on January 12. Representatives from the Student American Chiropractic Association (SACA), Student International Chiropractors Association (SICA) and World Congress of Chiropractic Students (WCCS) attended.

In welcoming the student leaders, NBCE President Dr. Vernon Temple said he hoped they would leave with a better understanding of the NBCE and the testing process. He also emphasized the significance that testing has on the chiropractic profession and its future.

The NBCE hosts the annual forum to increase its communication and collaboration with the student leaders and the student population. Another goal of the event is to give student leaders the opportunity to share their ideas and goals for chiropractic.

“We appreciate your role as leaders who will some day stand here,” said Dr. Temple. “Good leaders develop through a never ending process of self study—every experience helps you to move forward. Your desire to help others and to offer to do extra work qualifies you for a special kind of leadership, which is just the kind of leader we need in our profession.”

The student leaders listened to an in-depth orientation about the National Board’s processes for development and administration of the written and practical exams, as well as methods used in scoring exams. They also toured the NBCE facility and met staff members.

In describing the staff, Dr. Temple said, “We are truly proud of the staff of the NBCE. They have become a testing organization that is considered to be the gold standard in the testing industry—not just in chiropractic.”

At the end of the day, the students expressed their gratitude for the in-depth presentations as well as their commitment to help promote improved communications between their student bodies and the NBCE.

The student forum attendees included:

SACA:
Jason Mavor, National Chair
Western States Chiropractic College
Nathaniel Tiplady, National Vice-Chair
New York Chiropractic College
Molly Robinson Masis, National Legislative Chair
Northwestern Health Sciences University
Kristi Perillo, National Legislative Vice-Chair
D’Youville College

SICA:
Joshua Thompson, Chapter President
Life Chiropractic College-West
Alex Rodnick, Chapter President
Life University, College of Chiropractic
Brandon Schultz, Chapter President
Cleveland Chiropractic College—Kansas City

WCCS:
Dylan Herwill
University of Johannesburg, South Africa

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2. IBCE Offers Exam in Cyprus

The International Board of Chiropractic Examiners (IBCE) has prepared an exam for chiropractic registration/licensure to be administered in Cyprus in the Greek language.

Cyprus currently accepts the NBCE examinations Parts I, II, III and IV or the Special Purposes Examination for Chiropractic (SPEC) to assess the clinical competency and licensing eligibility of chiropractors who move into the country. Because the Cypriot Registrar of Professions also requires that licensure applicants demonstrate competency in the Greek language, the IBCE has now translated the SPEC Exam into Greek.

The application process for the Cyprus SPEC will be the similar to the United States. The exam will be delivered on demand at the requirement of the Cyprus Chiropractic Association. The Cypriot Registrar of Professions will recognize only those practitioners who are approved by the chiropractic association.
The IBCE has worked closely with Cyprus Chiropractic Association President Dr. Efstathios Papadopoulos on this project. He is also a voting member of the NBCE’s International Affairs Committee. Dr. Papadopoulos was instrumental in the initiative in 1991 to register chiropractors in Cyprus. Dr. Papadopoulos says that since that time the profession has gained more respect and credibility in Cyprus, thereby improving the confidence of the general public. The use of the SPEC Exam in Cyprus will further the goal of protecting the public in that country.

The IBCE was formed in 2003 by the NBCE to further worldwide acceptance of chiropractic education and practice. The IBCE assists chiropractic associations, organizations and colleges in addressing concerns held by members of regulatory authorities and the general public throughout the world.

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3. International Affairs Committee Meets

The International Affairs Committee (IAC) of the NBCE met on March 14-15. Chaired by District I Director and NBCE Vice President Dr. Jerry Blanchard, the IAC is developing the IBCE into an organization with a truly global focus.

Meeting participants included committee members NBCE President Dr. Vernon Temple, NBCE Director and FCLB President Dr. Ed Weathersby, and President of the Cyprus Chiropractic Association Dr. Efstathios Papadopoulos. NBCE Executive Vice President Horace Elliott, NBCE Director of Testing Dr. Mark Christensen, and IBCE Manager of International Operations Dr. Martin Kollasch also attended.

In addition, a new member of the IAC was welcomed, Dr. Susan King. Dr. King is head of the Welsh Institute of Chiropractic. She is a member of the U.K. General Chiropractic Council, the New Zealand representative for Chiropractic International Student Assessment, the New Zealand Chiropractic Board, and serves on the editorial committee of the European Journal of Chiropractic.

Together with Dr. Papadopoulos, Dr. King's expertise will keep the IAC up-to-date on chiropractic in other parts of the world as well as provide direction in IBCE goal setting. According to IAC Chair Dr. Blanchard, “Drs. King and Papadopoulos have been granted full voting privileges on the committee; we are looking forward to their participation in bylaws revisions that will develop the IBCE into an organization distinctly separate from the NBCE.”

Drs. King and Papadopoulos received full orientations of exam development and administration at the NBCE Greeley headquarters prior to this meeting. Dr. Temple said, “We would like for you as our international experts to hear the sentiment of a U.S. organization that has a service to offer—that of competency assessment. We need your help in uncovering opportunities to provide this service worldwide.”

Recommendations from this IAC meeting will be presented to the full NBCE Board of Directors in May.

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4. Part IV Standardized Patient Trainers Gather for Workshop

The annual Part IV Standardized Patient Trainers Workshop was held at the NBCE on March 10 in Greeley.

Executive Vice President Horace Elliott and Director of Practical Testing Research and Development Dr. Paul Townsend welcomed the patient trainers. Mr. Elliott said, “Our Board of Directors, Dr. Townsend and I appreciate the job you do to ensure a standardized Part IV Examination.”

Dr. Townsend emphasized to the trainers that, “This is the examination that this organization is measured by.”

Staff Chiropractic Specialist Dr. Judi Gerstung led the workshop. Standardized patient trainers reviewed DVDs and manuals, and discussed procedures regarding the training and consistency the standardized patients must employ at chiropractic colleges administering the May Part IV Examination.

Standardized patient trainers prepare and train standardized patients in simulating specific conditions commonly encountered in practice. Standardized patients are used during the case management portion of the exam to assess examinees’ interactions with the simulated patient and their ability to recognize and diagnose the patient’s condition. The patient trainer is also responsible for the orderly rotation of standardized patients as well as their safety and debriefing on the day of the exam.

The standardized patient trainers are selected based on their expertise in the chiropractic profession or for their previous experience as standardized patients for other professions.

Those who attended the workshop were:

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5. Test Administrators Learn to Boost Security Measures at Test Sites

Exam security screening, test site procedures and other administrative issues were the focus of a two-day seminar for NBCE test site administrators and assistant test site administrators in Greeley on March 2-3.

These administrators oversee every aspect of exam administration at their respective test sites, including supervision of the proctors who remain in the room with test takers at all times. It is therefore imperative that they are routinely and uniformly trained on new policies and procedures of the NBCE.

The NBCE has always been vigilant about exam security and views prevention as the best way to combat cheating. New security measures such as metal detection and security wand screening are aimed at keeping electronic items completely out of testing areas.

Within the past year, new exam security measures have been implemented at the written and Part IV Practical Exam testing sites due to increased threats of modern technology such as cell phones, digital cameras and personal digital assistants. The NBCE first piloted the Part IV metal detector screening at Logan College in November 2005. Metal screening was also added at Western States Chiropractic College in May 2006 and at Parker College of Chiropractic in November 2006. The NBCE will implement metal screening at Palmer College of Chiropractic, Life University, College of Chiropractic, and Northwestern Health Sciences University in May 2007. Cleveland Chiropractic College Los Angeles, Southern California University of Health Sciences and Life Chiropractic College West will be implementing the metal screening in November 2007.

NBCE Director of Practical Testing Research and Development Dr. Paul Townsend listed these reasons for implementing metal detection screening at test sites:

• Advances in high tech electronics during the past decade have made it possible to scan and store large amounts of information onto electronic devices as small as credit cards.
• Devices as common as cell phones can be used to capture audio and visual images and to transmit text messages during exams, and the process is virtually undetectable.
• The National Board has recently experienced increasing problems with students taking cell phones and iPods into the testing areas during exams. These devices can be used to electronically capture questions or transmit the answers to questions to other students.
• The National Board is committed to giving every student the same opportunity to pass its exams and must therefore take all necessary precautions to prevent cheating at the written and Part IV test sites.

Any electronic devices found using the detection wands and/or metal detectors must be surrendered before candidates can enter the testing area. Any candidate who refuses to submit to screening will be denied entrance into the testing area. The consequences of cheating on NBCE exams are serious and range from invalidating a test result to barring the candidate from taking all future NBCE examinations. NBCE Director of Administration Pam Kurtz expressed to the administrators in attendance, “You are the key to a successful test administration. Your ongoing training and excellent tenure provides the basis for yours and the NBCE’s success,” she said.

Those who attended the seminar included:

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6. Part III and Ethics and Boundaries Test Committees Convene

The annual Part III and Ethics and Boundaries (E&B) Test Committees met on Feb. 23-24, 2007, at the headquarters of the NBCE in Greeley.

Test committee members are nominated by members of the NBCE Board of Directors or by their chiropractic colleges based on their expertise in clinical practice. During the meeting, the committee members developed exams that will appear on the Part III Examination in fall 2007 and spring 2008, and future administrations of the E&B Examination.

“We were privileged to have an outstanding group of clinicians and college faculty members from across the United States participate in this test committee,” NBCE Director of Written Examinations Dr. Ray Townsend said.

The Part III Exam is part of a battery of tests that candidates must pass prior to becoming licensed doctors of chiropractic. The NBCE Part III Exam consists of 200 multiple choice questions that address nine clinical knowledge areas: case history, physical examination, neuromusculoskeletal examination, roentgenologic (X-ray) examination, clinical laboratory and special studies examination, diagnosis or clinical impression, chiropractic techniques, supportive techniques, and case management.
The optional E&B Exam is a computerized exam offered to licensed or previously licensed chiropractors who are required by their state licensing boards to demonstrate their knowledge of ethics and boundaries issues, including ethical misconduct, sexual misconduct and sexual harassment situations that are potentially encountered in chiropractic practice.

The E&B consists of 100 multiple-choice questions, organized into two sections: 1) questions that address the application of general knowledge and understanding required for ethical chiropractic practice, and 2) questions relating to boundaries issues including sexual misconduct and sexual harassment.

Those in attendance were:

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7. 2007 National Board Days
Each year the NBCE invites schools to participate in National Board Days (NBD). To date, the NBCE has scheduled:

• Western States College of Chiropractic on April 17
• Life Chiropractic College West on May 18
• Southern California Health Sciences University on July 13

National Board Day is facilitated by a member of the NBCE Board of Directors along with a management team member from the NBCE. The NBD presentation focuses on:

• History of licensing in chiropractic
• Current eligibility guidelines for NBCE exams
• Development of exam questions, scoring and reporting of results
• Status of computerization and national (and state-by-state) requirements
• Services available for students

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8. Calendar

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