National Board of Chiropractic Examiners Announces Part IV Exam Advancements
NEWS
Changes increase testing opportunities, stabilize costs and leverage technology to ensure the quality and reliability of the exam.
GREELEY, CO., May 6, 2024 — The National Board of Chiropractic Examiners (NBCE) today announced critical advancements to its Part IV exam as a result of the organization’s Advancement and Development Project. Beginning in 2026, the Part IV exam will be conducted in a state-of-the-art centralized testing facility on NBCE’s campus in Greeley, Colorado to increase testing opportunities, manage costs and ensure the standardization of exam delivery.
The Advancement and Development project was initiated in response to stakeholder feedback around increasing testing opportunities, advancing technology in pre-licensure exams, and managing costs to avoid exam fee increases. To thoroughly address these concerns, NBCE conducted extensive research. This research encompassed studying best practices in other regulated health fields, exploring practical exam technology, and examining clinical assessment methodology. NBCE also visited US-based Doctor of Chiropractic Programs to learn about clinical testing practices in chiropractic education. The goal was to produce more efficient exams while maintaining the fairness, reliability, and validity of the exams and providing more testing opportunities.
Centralizing the Part IV exam allows NBCE to redesign the testing experience to more accurately reflect real-world patient encounters and implement the latest technology to support exam delivery. In addition to directly addressing the needs of examinees, chiropractic colleges and state licensing boards, the solution also provides more flexibility to pilot and implement future innovations.
“An important part of the Advancement and Development project has been collaborative evaluation and we are grateful for the time our many stakeholders have invested to share their feedback and insights with us to inform this next step in the future of chiropractic licensure,” said Dr. Karlos Boghosian, NBCE President. “NBCE is committed to making investments that will empower us to scale more efficiently, innovate faster and ensure professional competency and public safety through excellence in testing.”
The decision to move to a centralized assessment center also addresses several challenges inherent in the current examination model, which will render it unsustainable over time. These challenges include staffing concerns, standardization across multiple locations, limited capacity for innovation, and escalating operational costs.
In the current model, approximately 1,280 staff members are hired across the nation for each administration of the Part IV exam. However, the infrequency of exams, conducted only twice a yearover two days, poses difficulties in finding and retaining reliable, high-quality staff. This results in premium wages and potential inconsistencies in the examination experience across different locations.
Furthermore, the decentralization of the exam hinders the NBCE’s ability to innovate and adapt quickly to evolving standards. Rolling out new technology or processes at 14 test sites is both challenging and cost-prohibitive compared to a centralized approach.
By consolidating the Part IV exam administration to a single location on NBCE’s campus in Greeley, Colorado, these challenges are addressed while delivering several key benefits to examinees and stakeholders:
Enhanced Efficiency: With a dedicated testing facility, the exam will be administered 48 weeks out of the year, significantly reducing waiting times and allowing examinees to take exams when they feel most confident in their abilities. This could also expedite the licensure process by up to three months, enabling future chiropractors to start their careers and earning potential sooner.
Improved Standardization: Centralizing the exam ensures a consistent experience for every examinee.
Cost Savings: The transition to a centralized assessment center will enable the implementation of enhancements such as increased testing opportunities and advanced technology like video recording while, at the same time, lowering monthly expenses by 6%. In contrast, realizing these same benefits at on-campus locations would result in a minimum increase of 64% in NBCE’s Part IV expenses.
Real-World Relevance: The redesigned exam format better reflects real-world patient encounters and clinical examinations offered at Doctor of Chiropractic Programs. This adjustment amis to improve the exam's efficacy in assessing candidates' clinical skills.
The multi-year Advancement and Development Project also yielded important changes to NBCE’s Computer-Based Testing (CBT) exams in direct response to stakeholder feedback. NBCE has tripled the number of testing opportunities and created shorter Part I and Part II formats that utilize one score.
The Part I and Part II changes will be implemented beginning in August 2024 and the Part IV changes are slated for a 2026 implementation. NBCE will be working with all stakeholders to roll out important educational materials over the next several months, ensuring that examinees, chiropractic programs and state licensing boards are aligned and informed.
For more information, please visit nbce. org.
