Dr. Paul Townsend, D.C.Director of Practical Testing, Research & DevelopmentNBCE Part IV Practical ExaminationDuties of a Part IV ExaminerDr. LeRoy Otto, D.C.Part IV Chief Examiner, NWHSU Test Site

Part I Basic Sciences ExaminationsPart II Clinical Sciences ExaminationsPart III Written Clinical CompetencyPart IV Practical Examination for Licensure

To provide a testing format in which the candidate demonstrates his or her ability to perform occupational tasks in a clinical setting:

Developing Test ItemsNBCE Workshops Chiropractic College Clinical InstructorsTechnique InstructorsCertified Content ExpertsStaff Consultants

Cases and questions selected by state licensing board representatives

A panel of expertsState Licensing Board RepresentativesContent Experts

HIERARCHY OF CLINICAL SKILLSDOSHOW HOWKNOW HOWKNOWLEDGEPARTS I & IIPART IIIPART IVPRACTICE

Content AreasDiagnostic ImagingChiropractic TechniqueChiropractic Case Management

CAM 67%TEC 17%DIM 16%

10 Four-minute StationsCandidate identifies radiological signs on plain film x-raysCandidate determines most likely diagnosesCandidate makes most appropriate initial case management decisions

5 five-minute stationsCandidate demonstrates two adjusting techniques per stationCervical spineThoracic spineLumbar spineSacroiliac articulationsExtremity articulations

10 five-minute patient encounter stations10 linked post-encounter probe (PEP) stations Candidate performs focused case historiesCandidate performs focused physical examinationsCandidate evaluates patient clinical databaseCandidate makes differential diagnosesCandidate makes initial case management decisions

Use of standardized patientsUse of OSCE format and protocols

Successful candidates use organized approach while obtaining case history informationSuccessful candidates communicate effectively with patientsSuccessful candidates respect patient dignitySuccessful candidates elicit adequate historical information

Post-Encounter Probe Station

44,419

Part IV provides a highly reliable assessment of the chiropractic clinical skills required for licensureThe dependability of the pass/fail decision is consistently at or above .90The inter-rater reliability across the 15 rated stations is .93 - .96The key to these high correlations is adherence to NBCE scoring protocols and consistent performance by the Part IV examiners

Must have been in licensed chiropractic practice for a minimum of 5 yearsChiropractic license must be in good standing with the FCLB (vis a vis Cin-Bad) and with the state chiropractic licensing boardThere cannot be any outstanding actions against the chiropractors licenseChiropractors serving on state chiropractic licensing boards may be nominated by their boards to participate on Part IV test committees or as chiropractic examiners during Part IV exam administrationsPart IV examiners may not be currently serving on Chiropractic College Boards of Trustees, be chiropractic college faculty members, or serve as preceptors for students enrolled in the Part IV exam

Reports to the Chief ExaminerFollows instructions of the Chief ExaminerConducts himself/herself in a professional mannerStrives to be fair and objective in the assessment of examineesDoes not prompt or give unfair advantage to any examineeHas no contact with students/examinees prior to or following the examAvoids any appearance of impropriety or conflict-of-interestConsults with the Chief Examiner when any question about the exam or exam content arisesAccepts the Chief Examiners decision as final

Part IV Examiners must:Attend the Friday evening Examiner Orientation & TrainingExaminers receive training in areas that impact test site personnel relations and examinee assessmentSexual HarassmentGender and Racial Bias

Examiners receive training in candidate skills assessment and checklist markingExaminers receive feed back on errors made in previous exam administrationsIt is absolutely essentially essential that examiners understand the NBCE scoring protocols, and how examiner errors affect student scoresIt is absolutely essential that examiners adhere to the standards set by the NBCE

Friday night training 50.003 Saturday rotations @ $125/rotation 375.003 Sunday rotations @ $125/rotation 375.00$800.00

Currently 47 states including Washington, DC recognize participation in the Part IV for CE creditCE credit ranges from 12 to 30 credits per yearLetters are mailed to participating examiners by the NBCE Department of Practical TestingExaminers must keep these letters on file in case they are auditedIf the letter from the NBCE is not received within four weeks following the exam, the examiner should contact Debora Beeman at dbeeman@nbce.org or call 1-800-964-6223 Ext. 154

Questions?If you would like to know more about the NBCE Part IV examination, contact Paul Townsend, D.C. at ptownsend@nbce.org

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