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Dynamic Chiropractic – July 1, 2018, Vol. 36, Issue 07

Transforming Exam Delivery

Editor's Note: This article is exclusive to DC courtesy of the National Board of Chiropractic Examiners. Read our news piece in this issue for additional information.


The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students.

Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams. The challenge has been a computerized exam delivery that meets all of these requirements.

Through recent restructuring of our project management process, the NBCE is better able to define requirements, evaluate options, and complete projects on time and most importantly, within budget.

During the 2018 annual meeting in Dallas, the NBCE Board of Directors approved a five-year strategic partnership with Prometric. The board's deliberations included a thorough review of alternatives, which led the board to make a decision to collaborate with a third-party testing vendor.

NBCE testing and examinees alike will benefit from state-of-the-art technology. Prometric was the obvious choice as a partner, administering more than 7 million tests each year in more than 180 countries. In health care assessment and certification, Prometric has demonstrated expertise in the delivery of licensing exams in professional areas such as medicine, podiatric, osteopathic and dental exams.

NBCE Board President Dr. Salvatore LaRusso said of the significance of the board's action: "This decision ensures that NBCE will continue as a leader in professional testing. We are confident that examinees and NBCE's exam administration services alike will benefit from Prometric's vast experience in high stakes testing."

NBCE's longtime promise has been the delivery of secure, reliable testing, combined with the convenience of an on-campus testing lab. The partnership with Prometric will deliver on that promise. Through training and certification of test sites and testing personnel, Prometric has committed to an excellent testing experience with emphasis on consistency and predictability from location to location.

For examinees, the partnership with Prometric will mean better communication, registration and scheduling for exams. Examinees who require test accommodations will have easy access to enlarged print and audio recordings. The Prometric delivery model will maximize exam security while minimizing interruptions and lag time in loading items.

To maximize campus computer lab time and increase testing opportunities, the NBCE has committed to administer exams nine times a year for the writtens and twice a year for the practical exam.

Again, with an eye on technology and providing an improved testing experience, the Part IV team has just announced the use of digital diagnostic images for the November 2018 Part IV exam. A survey of radiology faculty found that all U.S. chiropractic programs have been moving to the predominant use of digital diagnostic imaging, both for teaching radiographic interpretation and in their clinics.

This study led to a pilot testing of digital-based interpretation examinations at five schools – Parker University, Life University, Southern California University of Health Sciences, and the Palmer Davenport and Florida campuses in 2016 and 2017. The participants reported a high level of satisfaction with the new process and equipment.

To further ensure equivalence in this testing process, NBCE's psychometrician statistically analyzed the impact on scores of using digital images in place of films on view boxes and found no statically significant difference.

In early summer, the Part IV team will meet with test committee members to review and select images. Then, in July 2018, exam administration staff will receive comprehensive training to ensure competence and consistency in making the transition to digital diagnostic images.

It's clear that these innovations reflect the NBCE board's commitment to continuous improvement in test development, test delivery and score analysis. We are excited about the future of NBCE testing.


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