NBCE Results - Palmer College of Chiropractic, Intranet Home Page

NBCE Results – What can we
learn; what can we do
Spring 2012 In-Service
3/5/2012
Kevin W. Paustian D.C., Ed.S.
Dean of Academic Affairs
Palmer College of Chiropractic

CCE Policy 56 NBCE Performance Disclosure, Thresholds and Outcomes
CCE Standards requirements concerning public disclosure of student performance on
national board examinations, DCPs must:
disclose up-to-date student performance on national board examinations for each
campus on the program website.
Scores must be posted, using the format described below, on one of the following
website pages: Admissions, Academics, Prospective Students, Home page or
equivalent page.
The link to the scores from these pages must be direct.
DCPs must update NBCE data for public disclosure within 30 days of the release of
the data by NBCE each year.
The Council on Chiropractic Education, Inc.®
CCE Manual of Policies January 2012
http://cce-usa.org/uploads/2012_CCE_Manual_of_Policies.pdf

CCE NBCE Pass Rate Thresholds
Part 1 – 65% (first attempt) of four most recent examinations
Part 2 – 65% (first attempt) of four most recent examinations
Part 3 – 70% (first attempt) of four most recent examinations
Part 4 – 75% (first attempt) of four most recent examinations
Performance below these thresholds, as derived from data obtained by the CCE
Council, will indicate the need for further review and action as determined by the
CCE Council.
January 2012 Manual of Policies of The Council on Chiropractic Education, Inc.®

College NBCE Pass Rate
Thresholds
NBCE Parts I & II scores range from 0-800 with a national mean of 500 and
a standard deviation of 100;
Part III scores range from 0-800 with a national mean of 450 and a standard
deviation of 100.
The Part IV scores range from 0-800; the mean passing score and standard
deviation vary per test.
College threshold:
Parts I, II, & III - 75% of students will successfully pass all sections on their
first attempt;
PT - 80% of all students will successfully pass all sections on their first
attempt;
Part IV - 90% of all students will successfully pass all sections on their first
attempt.
PCC 2010-11 Program Effectiveness Report: Executive Summary, Dec 2011

CCE Required format for publication
The weighted arithmetic average of first-time candidate pass rates for
the four most recent Part I, II, III, IV and Physiotherapy examinations.
PART X
College Data National
# TESTED # PASS % PASS % PASS
Fall 2009 62 50 80.6% 75.0%
Spring 2009 48 30 62.5% 76.0%
Fall 2008 76 63 82.9% 75.0%
Spring 2008 50 38 76.0% 76.0%
2-YR TOTAL 236 181 76.7% 75.5%
The Council on Chiropractic Education, Inc.®
CCE Manual of Policies January 2012

http://www.palmer.edu/uploadedFiles/Pages/Marketing/Publications/Official_College_Documents/Davenport_Campus_NBCE
_Scores.pdf

First Time Pass Rates
NBCE Part I All Palmer Campuses (2007 - 2011)
100%
95%
90%
85%
80%
75%
PCC Threshold
70%
65%
CCE Threshold
60%
2007 2008 2009 2010 2011
Davenport 79% 71% 76% 71% 73%
Florida 67% 77% 79% 75% 75%
West 77% 69% 65% 74% 62%
National Average 75% 74% 76% 74% 74%

First Time Pass Rates
NBCE Part II All Palmer Campuses (2007 - 2011)
100%
95%
90%
85%
80%
75%
PCC Threshold
70%
65%
CCE Threshold
60%
2007 2008 2009 2010 2011
Davenport 76% 75% 72% 66% 69%
Florida 79% 68% 71% 67% 80%
West 75% 85% 81% 76% 69%
National Average 76% 75% 75% 72% 73%

First Time Pass Rates
NBCE Part III All Palmer Campuses (2007 - 2011)
100%
95%
90%
85%
80%
75%
70%
PCC Threshold
CCE Threshold
65%
60%
2007 2008 2009 2010 2011
Davenport 80% 84% 80% 77% 76%
Florida 79% 83% 84% 87% 82%
West 87% 89% 88% 84% 86%
National Average 82% 83% 83% 81% 81%

First Time Pass Rates
NBCE PTH All Palmer Campuses (2007 - 2011)
100%
95%
90%
85%
80%
75%
PCC Threshold
70%
65%
60%
2007 2008 2009 2010 2011
Davenport 91% 90% 83% 91% 87%
Florida 87% 93% 91% 89% 87%
West 95% 97% 92% 92% 83%
National Average 91% 90% 89% 89% 89%

First Time Pass Rates
NBCE Part IV All Palmer Campuses (2007 - 2011)
100%
95%
90%
PCC Threshold
85%
80%
75%
CCE Threshold
70%
65%
60%
2007 2008 2009 2010 2011
Davenport 96% 94% 95% 93% 90%
Florida 95% 92% 92% 87% 89%
West 95% 88% 92% 88% 80%
National Average 93% 88% 92% 89% 89%

Osteology of the Appendicular Skeleton
500
Osteology of the Appendicular Skeleton (14%)
400
FALL 06 SPR 07 FALL 07 SPR 08 FALL 08 SPR 09 FALL 09 SPR 10 FALL 10 SPR 11 FALL 11 SPR 12 FALL 12
P:\Curriculum\Curriculum Management Committee\NBCE\Part One PCCD Fall 2011

Themes from
Data Review
If you’re not at the table, you’re on the menu.
1. Representation
•“Palmer’s representation on NBCE committees could elevate Palmer student’s
scores. If Palmer does not have strong representation in the future we could see
a decrease in scores.”
•“More representation on the NBCE may help to elevate the scores.”
2. Course Sequencing
•“…the students take the exam before they finish my course.”

Getting selected
1. NBCE considers applicant’s:
Publications (research, textbooks, etc)
Courses taught / Credentials
Focused content (PhD, MS) - Biochemistry
Broad content (DC)– Associated Clinical
Sciences
Years at institution
Test writing ability
2. Send resume to Dean of Academic Affairs

Length of test writing assignment
• Typically 3-years
• May be longer to insure
an experience member
with new writers
• In the past, assignments
were longer.
• NBCE now wants to rotate
more frequently

Test Pool Process
Questions received from
colleges are reviewed by a
test specialist:
1. Specialist categorizes
the questions (Part I, II,
III and section)
2. Edits and formats
3. Places question into
the pool
http://www.nbce.org/pdfs/written_broch.pdf

Test Writing Committee Membership
•Three members (each from different colleges) plus an NBCE moderator
•equally represented across at all tests
•Committee selects questions from the pool provided
•Committee determines questions for all categories (subsections) within
the test section.
•Decides through consensus (no official vote)
•Moderator throws out the question if it lacks consensus
•Committee looking for:
•Well-constructed questions
•Good content
•Not looking for trivia or trick questions
•Select 110 items that test core knowledge
•Committee looks at the pool questions first
•Test writers are required provide 20 questions each
•Entered into pool
•Assigned specific topic due to under representation in the
pool
•The test is not 60 test writer questions plus 50 pool questions

Question submission
Faculty can submit a midterm or final
Doesn’t need references
Must have the test key attached
Can still use the test in class
Submit questions written specific for
NBCE
Must have references cited
Content must be found in
references listed by NBCE
Submitters of questions selected are
not notified
Questions are typically edited
significantly

ASSIGNMENT AND LICENSE
AGREEMENT
WHEREAS, the National Board of Chiropractic Examiners (“NBCE”) prepares and administers
certain examinations for chiropractic students used in state licensure;
WHEREAS, ___________ (“Author”) has prepared certain examination questions for use in
academic training of chiropractic students (“Academic Examination Items”); and
WHEREAS, NBCE wishes to use, and Author wishes to provide NBCE, certain Academic
Examination Items for use in NBCE’s examinations;
NOW, THEREFORE, the parties agree that:
(1) Author assigns any and all right of ownership, title and interest, including all rights under the
U.S. copyright laws, in the Academic Examination Items, attached as Exhibit A, to NBCE for the
exclusive use of such items in NBCE’s examinations. Author further acknowledges that NBCE
may, in its sole discretion, modify and/or incorporate the content of such Academic
Examination Items in items used on its examinations.
(2) NBCE grants Author a personal, perpetual, non-exclusive and free license and right of usage
to Author of the assigned Academic Examination Items for academic purposes only.

References listed
1. Each test committee comments on listed
references
•Add/Keep/Drop
2. Survey of college libraries
•NBCE looks to see number of colleges using text
•5-6 colleges it may make the list
3. Will not use recent journal articles
•Exception is a major article such as Health
People 2020 (Public Health)
4. Texts out of print are usually dropped
5. References found at
http://www.nbce.org/written/reference.html

NBCE Test Committee Members Service
Palmer College of Chiropractic, Davenport Campus
Name Subject Service
Bovée, Michael L. Chiropractic Practice 1991 - 2007
Canterbury, Robin R. Diagnostic Imaging 1990 - 1992
Duray, Stephen M. General Anatomy 2001 - 2005
Firth, Ronnie L. Part III 2002
Freedman, Louis J. Physiology 2006 - 2010
Hong, Se-Pyo S. Spinal Anatomy 2001 - 2004
Littrell, Tracey A. Associated Clinical Science 2009 - 2011
Manley-Buser, Katherine A. General Anatomy 2011 - 2012
McConnell, Elizabeth General Diagnostics 1991
Morter, Jr., Harvey Spinal Anatomy 1990 - 1995
Strang, Victor G. Principles of Chiropractic 2010 - 2011
Tatum, Robert Part III 2007
Taylor, Gregory W. Pathology 1995 - 2001
Indicates Current Year Service
Indicates Service in the last 5 years

Florida and West Faculty
•West
•Thomas Milus – Part II cut-score meeting (March 2011); part II test writing for Associated
Clinical Sciences (September, 2011)
•Susan St. Claire – Physiotherapy (September, 2011)
•Robert Cooperstein – Pathology (2010 and 2011)
•Dan Dugan – Public Health (2010)
•Mohan Menon – Microbiology (2008)
•Florida
• Chris Meseke (Physiology -current)
•Medhat Alattar (Pathology - past)
•Dr. Roger Corbin (NMS Diagnosis - past)
•Dr. Veronica Dishman (Pathology - past)

http://www.cceb.ca/study-guides-instructions/

http://www.cceb.ca/docs/cceb-exam-content.pdf

Frequently Asked Questions
Who develops the questions
Questions are developed by practicing chiropractors who are content area experts. The
questions are not written by any college faculty members. Questions are then
reviewed by CCEB exam and item experts. These experts confirm the content and
ensure that the questions are written in a proper format that meets current standards
of psychometric testing.
How do you select your exam questions
Our blueprint for all three exam components is derived from a job analysis survey of
practicing chiropractors in Canada. The Component A blueprint is also
supplemented with a curriculum survey of Canadian, US, and international
chiropractic colleges. The questions selected for each exam are reviewed by the Item
Review Committee, which is comprised of practicing chiropractors from a variety of
colleges and with varied practice experience.
Who are the examiners
All examiners have been in active practice in Canada for a minimum of 3 years and do
not include college faculty. These examiners have been appointed and trained by the
CCEB and are selected to represent a range of experience, type of practice, region,
and education (Canada, US, International).
http://www.cceb.ca/faq/

Frequently Asked Questions
Does the Canadian graduate have an advantage
Exam statistics indicate a difference in pass percentages between different
colleges; however, the CCEB has taken many steps to ensure that this is not due to
any bias in the exams.
The CCEB exams are designed to test for the competencies required to practice
chiropractic in Canada. Our blueprint for all three exam components is derived
from a job analysis survey of practicing chiropractors in Canada. The Component A
blueprint is also supplemented with a curriculum survey of Canadian, US, and
international chiropractic colleges.
All of our exam committees consist of chiropractors who have been practicing for a
minimum of one year in Canada, and include an equal number of representatives
who have graduated from Canadian and non-Canadian chiropractic colleges.
Component C examiners are also selected to provide an equal representation of
graduates from different schools.
We do not provide any additional study tools or information to any college, beyond
what is posted on the CCEB website. Students or graduates of Canadian colleges
do not receive any further information than that which is provided to all
candidates and posted on the website.
Would studying old CCEB exam questions help me
CCEB exam questions are constantly created, revised, and retired. The chances of
any one question appearing on a current exam is less than 0.05%.
http://www.cceb.ca/faq/

Component A
Consists of multiple‐choice items each with four alternatives, and is based on the
underlying causes of pain and diseases.
The majority of the items are presented in a clinical context (that is, patient‐centered).
However, some items are presented in a factual context stripped of reference to a
patient.
The Component A exam consists of approximately 270 items written
in two sections with three hours to complete each section.
http://www.cceb.ca/docs/cceb-exam-content.pdf

http://www.cceb.ca/docs/cceb-exam-content.pdf

Component B
Tests the candidate’s ability to make decisions and diagnoses in a clinical
context.
Mainly uses a multiple‐choice format with four alternatives per item.
Contains radiographic images with three to four questions pertaining to each
image.
Consists of two sections with a total of approximately 200 items and 3 hours
for the completion of each section.
http://www.cceb.ca/docs/cceb-exam-content.pdf

http://www.cceb.ca/docs/cceb-exam-content.pdf

Component C
Objective Structured Clinical Exam (OSCE) that tests a candidate’s clinical skills in a
clinic‐like environment.
Exam consists of 10, 12‐minute stations and up to 23 different patient presentations.
It uses actors to portray the role of a patient and uses trained examiners to evaluate
each station.
http://www.cceb.ca/docs/cceb-exam-content.pdf

http://www.cceb.ca/docs/cceb-exam-content.pdf

What can we do
1. March 2012 Student Survey
a) How far in advance do students begin studying for the
NBCE exams
b) How many total hours do they estimate preparing for
NBCE exams
c) How effective do they perceive different preparation
methods (class notes, group study, review programs,
etc)
d) What recommendations do they have to improve NBCE
preparation
e) What advice would they give fellow students
2. Faculty submit NBCE questions – deadline April 23, 2012
3. Increase college representation – submit vitae

Thank you
Questions