Description of integrated competency examination: tools to assess the chiropractic curriculum effectiveness and students' competency levels.

Los Angeles College of Chiropractic (LACC) has developed a variety of methods to monitor the effectiveness of its competency based/problem-centered curriculum. The College introduced two Integrative Competency Examination courses (ICE I and ICE II) to assess the chiropractic program's effectiveness and students' competency levels. The ICE courses are pass/fail examinations that use a multistation, objective structured clinical examination (OSCE) format that involves standardized patients along with cognitive assessment of basic science information as methods of evaluation. ICE I requires students to perform psychomotor skills and interpret clinical data; ICE II requires students to perform at a higher level. They are directed to select, perform and interpret clinical data appropriately and correlate this data with relevant basic science information. Through these two levels of evaluation, the educational program, the individual courses and the competency level of each student are assessed. This paper describes the format, content and evaluation tools used in the ICE courses as well as the potential benefits of the courses.

Effectiveness of chiropractic management for patellofemoral pain syndrome's symptomatic control phase: a single subject experiment.

Chiropractic management of patellofemoral pain syndrome has not been well documented. A time-series experimental design was employed to assess the effectiveness of chiropractic care during the symptomatic control phase in a patient with bilateral knee pain. Treatment consisted of long axis tibiofemoral adjustment, passive patellofemoral mobilization, and continuous ultrasound. Mediating variables, derived from physical examination findings, were subject to periodic randomized observation sampling by a second observer who was blinded to the first observer, but unblinded to the experimental phases. Strong interexaminer reliability (K = 0.78, p less than .005) was observed for patellar tracking jitter. Poor agreement (K = 0.31, NS) was observed for the patellar grinding test graded on an oridinal scale, but moderate interexaminer agreement (K = 0.52; p less than .01) was obtained with the test on a nominal scale. Clinical outcome measures of pain, patellar tracking, and patellar grinding tests were observed to visually covary throughout the experiment. A reliable 3-4 wk lag was observed between treatment phases and demonstrable changes in the patient's signs and symptoms.

Interexaminer reliability and concurrent validity of two instruments for the measurement of cervical ranges of motion.

The reliability of measurement of cervical ranges of motion (ROM) has rarely been studied. The current study evaluated the interexaminer reliability and concurrent validity of two instruments (rangiometer and goniometer) for measuring cervical ranges of motion. Twenty-four consenting subjects were assigned to random orders of examiners, instruments and planes of motion. Thirteen measurements of cervical motion and neutral positions were evaluated by two examiners using each instrument. Interexaminer reliability coefficients were generally greater than interinstrument coefficients, and both were higher than a combination of interexaminer/interinstrument predictions. The r values for rangiometric objectivity were higher than those of the goniometer in 9 of 10 cervical ranges of motion. The rangiometer is a moderately reliable instrument for measuring cervical ranges of motion.