Performance evaluation of clinical competency for chiropractic practice: The spectrum of decision-making and interdisciplinary cooperation

Objective: To provide the rationale for using a categorization system when designing performance tests of the clinical competency of prospective doctors of chiropractic. Competency testing of health professionals is a critical component in protecting the public's health and safety. Method: To ensure that candidates for chiropractic licensure are evaluated on their clinical decision-making capabilities over a wide range of patient scenarios, a four-level categorization system has been developed at the National Board of Chiropractic Examiners. Each level has discrete clinical management choices and requires a different extent of interdisciplinary cooperation. A test development committee consisting of practicing chiropractors will be presented with this novel system in June, 2010, and will select the clinical scenarios for a portion of the upcoming NBCE Part IV licensure examinations. Results: It is anticipated that using this system will result in performance tests that are more consistent with actual chiropractic practice, while continuing to protect the public's health and safety. Requiring clinical competency and interdisciplinary cooperation to be demonstrated over a wide range of patient management decisions is expected to better evaluate appropriate preparation for chiropractic practice. Conclusion: This system of categorization will help to ensure that each test being developed will represent the entire spectrum of clinical cases seen in chiropractic practice. The result is improved standardization and reliability over multiple test administrations.