The transition to digital presentation of the diagnostic imaging domain of the Part IV examination of the National Board of Chiropractic Examiners.

OBJECTIVE: This article introduces changes made to the diagnostic imaging (DIM) domain of the Part IV of the National Board of Chiropractic Examiners examination and evaluates the effects of these changes in terms of item functioning and examinee performance. METHODS: To evaluate item function, classical test theory and item response theory (IRT) methods were employed. Classical statistics were used for the assessment of item difficulty and the relation to the total test score. Item difficulties along with item discrimination were calculated using IRT. We also studied the decision accuracy of the redesigned DIM domain. RESULTS: The diagnostic item analysis revealed similarity in item function across test forms and across administrations. The IRT models found a reasonable fit to the data. The averages of the IRT parameters were similar across test forms and across administrations. The classification of test takers into ability (theta) categories was consistent across groups (both norming and all examinees), across all test forms, and across administrations. CONCLUSION: This research signifies a first step in the evaluation of the transition to digital DIM high-stakes assessments. We hope that this study will spur further research into evaluations of the ability to interpret radiographic images. In addition, we hope that the results prove to be useful for chiropractic faculty, chiropractic students, and the users of Part IV scores.

Variables associated with successful performance on the National Board of Chiropractic Examiners Part IV examination.

OBJECTIVE: The objectives of this study were to (1) identify factors predictive of performance on the National Board of Chiropractic Examiners Part IV exam and (2) investigate correlations between the scores obtained in the Part I, Part II, Physiotherapy, and Part III exams and the Part IV examination. METHODS: A random sample of 1341 records was drawn from National Board of Chiropractic Examiners data to investigate the relationships between the scores obtained on the National Board of Chiropractic Examiners exams. A hierarchical multiple regression analysis related the performance on Part IV to examinee's gender, Part IV repeater status, and scores obtained on the Part I, Part II, Physiotherapy, and Part III exams. RESULTS: The analyses revealed statistical relations among all National Board of Chiropractic Examiners exams. The correlations between Part IV and Part I ranged from r = .31 to r = .4; between Part IV and Part II from r = .34 to r = .45. The correlation between Part IV and Physiotherapy was r = .44; between Part IV and Part III was r = .46. The strongest predictors of the Part IV score were found to be examinees' scores in Diagnostic Imaging, ß̂ = .19, p < .001; Chiropractic Practice, ß̂ = .17, p < .001; Physiotherapy, ß̂ = .15, p < .001; and the Part III exam ß̂ = .19, p < .001. CONCLUSIONS: Performance on the National Board of Chiropractic Examiners Part IV examination is related to the performance in all other National Board of Chiropractic Examiners exams.

Multiple views to address diversity issues: an initial dialog to advance the chiropractic profession.

The purpose of this article is to provide expert viewpoints on the topic of diversity in the chiropractic profession, including cultural competency, diversity in the profession, educational and clinical practice strategies for addressing diversity, and workforce issues. Over the next decades, changing demographics in North America will alter how the chiropractic profession functions on many levels. As the population increases in diversity, we will need to prepare our workforce to meet the needs of future patients and society.

Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older.

BACKGROUND: Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiropractic research center, and to explore the utility of several widely used balance instruments for future studies of the effect of chiropractic care on balance in older adults. METHODS: This descriptive study was conducted from September through December 2004. Participants were recruited through a variety of outreach methods, and all were provided with an educational intervention. Data were collected at each of two visits through questionnaires, interviews, and physical examinations. Balance was assessed on both visits using the Activities-specific Balance Confidence Scale (ABCS), the Berg Balance Scale (BBS), and the One Leg Standing Test (OLST). RESULTS: A total of 101 participants enrolled in the study. Advertising in the local senior newspaper was the most effective method of recruitment (46%). The majority of our participants were white (86%) females (67%). About one third (32%) of participants had a baseline BBS score below 46, the cut-off point for predicting risk of falling. A mean improvement in BBS scores of 1.7 points was observed on the second visit. For the subgroup with baseline scores below 46, the mean change was 4.5 points, but the group mean remained below 46 (42.5). CONCLUSION: Recruitment of community-dwelling seniors for fall-related research conducted at a chiropractic research center appears feasible, and the most successful recruitment strategies for this center appeared to be a combination of targeted newspaper ads and personal contact through senior centers. The BBS and OLST appear to be promising screening and assessment instruments, which might have utility in future investigations of the possible effects of chiropractic care on balance.

Implementation of a course on wellness concepts into a chiropractic college curriculum.

OBJECTIVE: The purpose of this study is to implement and evaluate a course on "wellness concepts" for chiropractic students, emphasizing national goals and evidence-based practices for health promotion and prevention. METHODS: Teaching methods included traditional lecture discussions and experiential activities, including objectives described in Healthy People 2010. Evaluation included pre- and posttests of students' familiarity with and intention to use key concepts, resources, and practices; item analysis of multiple choice exams; and a qualitative survey. RESULTS: Increases in students' self-reported familiarity were statistically significant for all but 2 of the 23 key topics assessed. At baseline, students already expressed intention to use most wellness-related practices listed, and showed significant increases for approximately half the practices listed at the posttest. Item analysis found students less able to correctly answer questions requiring analytic thinking than simple memorization. Students were most satisfied with the experiential portions of the course. CONCLUSION: Although the course was successful at introducing students to national resources and initiatives related to wellness, health promotion, and prevention, these concepts may be more meaningful if integrated into a teaching clinic that encouraged practical application of course concepts.