January 28, 2025 • 24 mins
Discover the transformative changes in chiropractic pre-licensure exams with Dr. Norman Ouzts, CEO of the National Board of Chiropractic Examiners (NBCE). Join us as Dr. Ouzts unveils how computer-based testing has been expanded to offer students greater flexibility, allowing exams to be taken over nine months of the year. Additionally, we discuss the innovative shift of Part 4 exams to a year-round schedule in Greeley, Colorado, creating a fully immersive patient experience. The conversation also highlights the critical role of stakeholders in navigating these changes and ensuring a seamless transition.
We also uncover the strategic move to centralize exam testing as a means of cost management and sustainability, with plans for a new testing center in Greeley set for 2026. This centralization is designed to stabilize exam fees and enhance grading consistency with full-time examiners. Dr. Ouzts shares how the NBCE is reinvesting in the chiropractic community through scholarship support and the invaluable practice analysis data available for legislators and professional associations. Prepare for insights from the upcoming 2025 practice analysis survey, as we explore the NBCE’s forward-thinking approach to adapting within the evolving landscape of chiropractic education.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:05):
Hi, I'm Dr Arlen Foer , the chairman and founder of
Activator Methods International.
Welcome to the podcast Activateyour Practice.
Today I'm honored to have theCEO of the National Board of
Chiropractic Examiners, normanOates, and we're going to talk
about some of the changes thatNBCE has been making in the last
(00:26):
year, so people know what'sgoing on and so they can not
hear some of the things that arenot true.
We want to put out the facts,as Norm said.
So welcome, dr Oates, we'rehappy to have you on board.
Speaker 1 (00:40):
Thank you.
Thank you, so glad to be here.
Thanks for taking your time.
Speaker 2 (00:43):
Thank you, thank you so glad to be here.
Thanks for taking your time.
Well, you're headquartered inGreeley, Colorado, and you held
a variety of roles with theNational Board and now you're
the CEO, and I'm not sure that'sa good position or a bad,
(01:03):
because you seem to have to takeall the heat.
Speaker 1 (01:04):
but how many employees do you have there in
Greeley?
So in Greeley we had just alittle over 40 employees, and
then there's another about 1,250field staff employees that are
around the country foradministering the exams.
Speaker 2 (01:15):
I've seen articles in the press recently regarding
some big changes to thepre-licensure exams.
Can you share what promptedNBCE to make these changes?
Speaker 1 (01:29):
Sure, you know, we recognize that the profession is
changing, we recognize that theeducational landscape is
changing.
So we listened to ourstakeholders the students, the
colleges and the state licensingboards and, as a result of that
(01:49):
effort, there was about threethings that really were
highlighted that we wanted toaddress, and one was a really
overwhelming desire from thestudents wanting more
opportunities to test.
We recognized that we needed toreally find some ways to hold
(02:15):
down our costs, better manageour costs, particularly on the
exam delivery, and then, finally, to really ensure that our
exams align with moderneducational practices.
Speaker 2 (02:28):
Well, stakeholders, you know they can input.
It's essential.
But it can also be diverse andconflicting.
How did you balance these?
You know different perspectives.
Speaker 1 (02:39):
Well, yeah, you know, everybody I guess has their own
perspective right.
Well, yeah, you know, everybodyI guess has their own
perspective right.
But we really we spent yearslistening to our stakeholders.
We were very, very intentionalin involving them in this
process along the way, listeningto their concerns.
(03:04):
Along the way, listening totheir concerns, really trying to
understand how the proposedchanges would affect them, both
positively and negatively, andthen trying to find a common
ground, and I think what camefrom that is a series of updates
that meets their needs andallows us to continue to improve
(03:27):
the quality of our products.
Speaker 2 (03:30):
Now is it mostly the Part 4 that you're changing the
most.
Speaker 1 (03:36):
No, we just most recently rolled out some very
significant changes with ourcomputer-based testing, which is
those of us more seasoneddoctors would recognize as our
written products.
That would be parts one, two,three and PHT.
As a result of the feedbackfrom the students and trying to
(03:57):
find a solution to offer themmore exam opportunities just in
August of this past year, we'veexpanded the offering of all of
our computer-based testingproducts.
Prior to August we offered partone in January, part two in
February, part three in Marchand then we would rotate through
(04:20):
the year.
So it was three times a yearthey could take each of the
tests.
We're now rolling it out towhere we're going to offer all
of the computer-based tests ninemonths out of the year.
The reason why it's only ninemonths is right now we still do
part four in May and Novemberand we don't offer an exam in
(04:42):
December.
As we roll out some of thechanges related to part four,
which we'll talk about here in alittle bit, we really hope to
be able to expand the computerbased testing and offer all of
the written products monthly sothat the students have every
opportunity to take that test,not when we say that they can
take it, but when they feel mostcomfortable taking it, when
they feel most prepared to takethe test.
(05:02):
Not when we say that they cantake it, but when they feel most
comfortable taking it, whenthey feel most prepared to take
the test.
Because, you know, at the endof the day, we really want to
set the students up, to make itconvenient for them and set them
up for success.
Speaker 2 (05:17):
What challenges have you faced in implementing the
changes, the changes forcomputer-based testing?
Well, no, for all of the newstuff, like Part 4, where they
come to Greeley Colorado.
I think that's what I'm hearingthe most.
Speaker 1 (05:34):
Yes, we'll back up and we'll talk a little bit
about the Part 4 changes.
We are in the process of movingthe Part 4 exam to a year-round
testing calendar there inGreeley Colorado and we're also
changing the format of the testfrom being a single-point exam
(06:00):
station to a full patientexperience.
So instead of going into theroom and being given a list of
things to do, which you wouldthen perform on that
standardized patient, and thenyou go to another room and
answer a series of questions asit relates to that patient
encounter, this will be movingto a candidate-led station which
(06:24):
will better measure acandidate's clinical
decision-making.
So they would walk into a room,there'll be a standardized
patient there and they will takethat standardized patient
through the whole patientexperience.
They'll do the history, thephysical exam, they will come up
(06:45):
with a working diagnosis and atreatment plan and then there
will be another stationdedicated to chiropractic
adjusting.
Speaker 2 (06:56):
What challenges have you faced in implementing the
changes?
Speaker 1 (07:00):
Well, you know, as you can imagine, change is hard.
You know, change is oftentimesmet with resistance, and what
we've really tried to do is toinvolve the stakeholders in this
process along the way, to letthem be part of the conversation
(07:21):
and to, you know, have somecandid conversations with them
and find out what their likesand dislikes are and what their
pain points may be, for example,you know we recognize that
having the students come toColorado does create some
concern for the travel costsrelated to coming there, to
(07:45):
Colorado.
I can tell you that the boarddid not take this decision
lightly.
We spent a significant amountof time reviewing lots of
different models, lots ofdifferent possibilities,
including staying on the collegecampuses, which is where we
(08:08):
currently administer tests, andat the end of the day, it really
came down to sustainability,fairness and long term benefit.
Speaker 2 (08:20):
Well, it seems to me like each campus would have
different people and so it had avariable.
Am I correct?
Speaker 1 (08:28):
Yes, yes, as I said before, it was delivered across
14 locations and required about1,250 field staff on any given
exam weekend to administer thattest.
That has to be expensive.
Speaker 2 (08:45):
It's very expensive.
How do you do it in Colorado?
Do you have people that arefull-time, then testers?
Speaker 1 (08:52):
So what we're hoping to be able to do and what we
feel confident that we're goingto be able to do and the primary
motivation behind centralizingis just that to be able to
better manage our cost.
You know the current exam modelis just not financially
sustainable, as you can imagine.
(09:14):
Trying to maintain that across14 different locations it's just
getting more and more expensiveand it's also getting more and
more expensive and it's alsogetting more and more difficult
from a staffing standpoint aswell.
So by being able to move itthere to a centralized location,
we can leverage our currentresources, we can leverage our
(09:36):
current staff and theirexpertise and ability to
implement this exam and we canalso better control those costs
long term.
You know one thing we know forsure is the current model,
although we're very excited, theboard has worked hard, staff
(09:59):
has worked hard to really holdcosts down and we've been able
to not raise exam fees for sixout of the last seven years in
spite of record inflation.
But we know that's notsustainable.
Exam increases on a fairlyregular basis and what we're
(10:24):
really hoping to be able to doand feel confident that we're
going to be able to do uh is isis control those costs and
stabilize those exam fees sothat students will not have to
absorb, uh, those types ofincreases going forward when?
Speaker 2 (10:41):
do you anticipate opening the new center?
And really, going forward?
Speaker 1 (10:45):
When do you anticipate opening the new
center in Greeley?
So our plan is to open it inthe first of 2026.
However, you know we are justnow on the end phases of the
design phase for the buildingand, as you can imagine I know
you've been in the processbefore of building a nice
(11:06):
building.
I've gone and had anopportunity to see the Four
Science Center there at Logan.
It's a spectacular, beautifulbuilding and, as you can know,
there's, as you know there's atremendous amount of preparation
that goes involved in thedesign portion of it before you
ever get to construction.
So we're finishing that up nowwhere we're on track to begin to
(11:28):
begin construction February Imean March or early April and
we're hoping that we'll be ableto to have it open and ready to
do some field testing first partof 2026, with the first exam
being administered in March of2026.
(11:48):
Now, because we're going to bedelayed a little bit into the
year, we will still offer in Mayof 2026 the on-campus testing.
We have to do that in order tobe able to get everybody tested
in 2026 that needs to be testedfor licensure.
(12:10):
So we'll begin the on-campustest.
I mean we will begin thecentralized testing.
Our plan is March, but we willalso still have that May 2026
exam on college campuses, andthat will be the last one.
Speaker 2 (12:26):
How does the medical profession test their people?
Speaker 1 (12:31):
The medical profession.
It depends if you're talkingabout.
You know when you say medicalprofession, you know if you're
talking just specifically aboutMDs.
But you know you have.
MDs, dos podiatrists,optometrists, just do the MDs.
The MDs they historically did aregional testing, a very
(12:58):
similar OSCE type test withstandardized patients, osce type
tests with standardizedpatients.
After COVID they did do awaywith their OSCE testing, their
version of Part 4.
I don't want to speak for them,I can't speak for them, but I
think the primary reason istheir instrument is used
(13:18):
differently than ours.
Their version of the Part 4exam was used for entrance into
the residency program.
So you know they took the test,they used that for entrance
into the residency program wherethey then went into.
You know, in essence, aneveryday OSCE, but they were
(13:38):
working on real patients, so itwas a very a continuation of
their education, so to speak.
Where in the chiropracticprofession, this is a true
licensure exam and once you passour licensing exam you then
have the ability to get licensedin any 50 states and you can go
(13:59):
to work the very next week andstart treating patients.
Optometrists still use acentralized testing location.
I think the podiatrists use acentralized testing location and
the osteopaths are in theprocess of going back and doing
(14:20):
some of the OSCE exam for thecolleges.
Speaker 2 (14:23):
So this centralized thing is not new.
Speaker 1 (14:28):
No, it's not new at all.
Actually, what we were doing isvery unique, or what we're
currently doing is very unique.
Speaker 2 (14:34):
Shouldn't this standardize things too, I mean?
Speaker 1 (14:39):
Oh, yes, I mean you can imagine the standardization
when you're looking at just onelocation versus 14 locations and
we go.
An extreme amount of effort andtraining goes into ensuring the
standardization to the extentthat we can.
But there's no way we can makeit.
(14:59):
You know, the same, exact sameexperience across every location
, particularly when you know thecollege campuses are arranged
different, the clinics lookdifferent, the equipment is
different.
You know, all those things playa role in the standardization.
With the, with the centralizedtesting, we will have full time
(15:22):
patients, opposed to thepart-time standardized patients
that we have now.
So there'll be a constanttraining process for them.
We will have full-timeexaminers where now again we
have part-time examiners andthey have to go through a
regular calibration process inorder to maintain that
(15:43):
standardization process, inorder to maintain that
standardization.
But with the centralizedlocation, we'll have a full team
of examiners.
That is their job, that is whatthey do, and we'll be able to
run regular inter-raterreliability studies to make sure
that the examination, that thegrading, is being consistent
(16:03):
across all examiners andeverybody will be spot checked.
So we will be grading thegraders, so to speak, on a very
regular basis to ensure that itis fair and equitable across
exams and across days.
Speaker 2 (16:18):
Now we've talked all about how you examine students.
Let's talk about what you dofor students, because until I
did this interview I had no ideayou were doing this.
I see here you're giving a lotof scholarships.
Can you give us just a quickrundown on those?
Speaker 1 (16:35):
Yeah, you know our board feels that it's important
to invest back in the students.
You know we recognize that thestudents are the future of this
profession.
One example is the.
(16:55):
We believe that the futureresearchers of the profession
are in school now.
You know they're the peoplethat we're going to count on in
the future to of the professionare in school now.
You know they're the peoplethat we're going to count on in
the future to be the researchersto move this profession forward
.
And as a result of that, theboard recently appropriated the
(17:16):
last couple of years $50,000student scholarships to send two
student representatives fromevery DCP program in the country
to the Association ofChiropractic Colleges Research
Agenda Conference or the ACC RAC.
It's a very unique opportunityfor them to be there, to get
(17:36):
exposed to that, to network and,you know, hope to get the bug
and really stimulate that nextwave of researchers.
It's been exciting to watch.
You know I go there and I seethem, I meet with those students
and then we get a lot of reallyyou know nice emails and
(17:57):
letters back from them aboutwhat a valuable experience it
was and how they're interestednow in learning more about
research.
What a valuable experience itwas and how they're interested
now in learning more aboutresearch.
We give to all the student,national student groups.
We have a ten thousand dollaraward that we offer for an essay
(18:18):
competition that we do and wedo.
I think it's a thousand dollarswe give to every DCP program
for a scholarship that they canoffer at their discretion.
So you know, we really try todo our part to give back to the
students.
Speaker 2 (18:37):
Also, you're developing new exams.
Can you tell me a little bitabout it?
The one is that chiropracticeducation readiness assessment,
cirsa or CIRA, yeah.
Speaker 1 (18:48):
Yes, it's the CERA.
It stands for chiropracticeducation readiness assessment
and it's an exam that you knowwe all of our new exams that we
develop we really the goal of itis to meet the need of the
(19:10):
profession, is to meet the needof the profession and this is an
exam that came from acollaboration with the colleges.
We had 18 of the USDCP programsparticipate in the development
of this exam.
It's a two-part exam.
It's got both cognitive andnon-cognitive items on the test.
(19:32):
So the cognitive items measuretheir competency in basic
sciences and then thenon-cognitive portion measures
self-awareness, grit andemotional intelligence and it's
designed to assess thatcandidate's readiness for the
(19:57):
rigor of the DCP program.
Speaker 2 (19:59):
Now that activators taught in 38 different colleges,
I always ask you the questionwhen is there going to be some
activator questions on thenational board?
And you say, well, they don'tall require, but we have it in
the core curriculum now,probably over half.
So is that a possibility nowthat some questions might be
submitted?
Speaker 1 (20:20):
So I'm going to give you the very general answer,
right, because this is, you know, I've got a team of people that
are involved in the wholeprocess, but I'll give you the.
And there's a lot behind whatgoes in the test and how things
get on to the test, right, andit's different whether it's part
one and two or whether it'spart three and four, right?
(20:42):
So I'm gonna probably take itdown a little bit of a rabbit
hole, but it is interesting, Ithink people ask a lot of times
where the questions come from.
So part one and two, thequestions come from a Delphi
study.
So we have a very objectiveprocess that we go through,
(21:04):
where we study what is beingtaught in the college curricula.
It's a back and forthinteractive process with the
colleges and that's whatdetermines what's going to be on
the test.
As far as the written exams,part three and four is highly
anchored to the practiceanalysis which we do every five
(21:28):
years, so it should reflectwhat's actually being taught in
the profession.
So that, all being said,particularly on part four and to
address your questioncompletely, you know it needs to
make sure that every singlestudent has access to the
(21:48):
information and every singlestudent has the same opportunity
to be successful on thatparticular aspect of the test,
right?
So you know, as Activator getsmore and more into the college
curricula, across all thecolleges, to where every single
(22:13):
school, regardless of where youwent to school, you have access
to the information and have thesame chance of being successful,
then that's a conversation wecan have for sure.
Speaker 2 (22:25):
Last question you know you used to put out a
survey.
I love the survey, you know,because it talked about what
techniques were being used andit talked about who did this and
who did that.
Is that being resurrected?
Speaker 1 (22:39):
We are in the process right now.
We just sent the survey out endof the year last year.
The 2025 practice analysis isbeing finalized.
Practice analysis is beingfinalized.
As a matter of fact, I justspoke with Dr Himmelfarb, who is
our director of psychometricsand research and is the chief
author on that.
(22:59):
It is scheduled to go in twoweeks to the printer to be put
together.
We're not going to have a printversion of it, but we say the
printer and it should bereleased early March.
So yes, you will have itshortly.
Speaker 2 (23:20):
Well, I really appreciate that and I've heard a
lot of people in the professionsay what happened to that
survey and I said I'll ask DrOates today because I'm
interviewing him and so I'mhappy to see that it's back,
because it gave a lot of realgood demographic information and
talked about what people wereusing and so forth.
So it was valuable.
Speaker 1 (23:37):
Yes, so it's an extremely valuable instrument.
It is used, you know, by bylegislatures, is used by state
licensing boards.
Exactly it is used byassociations.
A lot of people use it.
There's a tremendous amount ofdata in there and we actually
have them all archived on ourwebsite.
(23:57):
If you go to wwwnbceorg, youwill be able to find the archive
list of all the practiceanalysis.
They're all word searchable, soit makes it really easy for you
to find what you're looking for.
And again, we'll have the 2025one there real shortly.
Speaker 2 (24:19):
Well, it sounds like change.
You know, nobody likes changeand it's always difficult to do
change, but it sounds likeyou're on top of it.
And so, Dr Norman Oates, theCEO of NBCE, we're really happy
that you could come on today sowe can get the word out to the
profession.
Thank you so much for having me.
You're very welcome.
Hi, I'm Dr Arlen Foer , the chairman and founder of
Activator Methods International.
Welcome to the podcast Activateyour Practice.
Today I'm honored to have theCEO of the National Board of
Chiropractic Examiners, normanOates, and we're going to talk
about some of the changes thatNBCE has been making in the last
(00:26):
year, so people know what'sgoing on and so they can not
hear some of the things that arenot true.
We want to put out the facts,as Norm said.
So welcome, dr Oates, we'rehappy to have you on board.
Speaker 1 (00:40):
Thank you.
Thank you, so glad to be here.
Thanks for taking your time.
Speaker 2 (00:43):
Thank you, thank you so glad to be here.
Thanks for taking your time.
Well, you're headquartered inGreeley, Colorado, and you held
a variety of roles with theNational Board and now you're
the CEO, and I'm not sure that'sa good position or a bad,
(01:03):
because you seem to have to takeall the heat.
Speaker 1 (01:04):
but how many employees do you have there in
Greeley?
So in Greeley we had just alittle over 40 employees, and
then there's another about 1,250field staff employees that are
around the country foradministering the exams.
Speaker 2 (01:15):
I've seen articles in the press recently regarding
some big changes to thepre-licensure exams.
Can you share what promptedNBCE to make these changes?
Speaker 1 (01:29):
Sure, you know, we recognize that the profession is
changing, we recognize that theeducational landscape is
changing.
So we listened to ourstakeholders the students, the
colleges and the state licensingboards and, as a result of that
(01:49):
effort, there was about threethings that really were
highlighted that we wanted toaddress, and one was a really
overwhelming desire from thestudents wanting more
opportunities to test.
We recognized that we needed toreally find some ways to hold
(02:15):
down our costs, better manageour costs, particularly on the
exam delivery, and then, finally, to really ensure that our
exams align with moderneducational practices.
Speaker 2 (02:28):
Well, stakeholders, you know they can input.
It's essential.
But it can also be diverse andconflicting.
How did you balance these?
You know different perspectives.
Speaker 1 (02:39):
Well, yeah, you know, everybody I guess has their own
perspective right.
Well, yeah, you know, everybodyI guess has their own
perspective right.
But we really we spent yearslistening to our stakeholders.
We were very, very intentionalin involving them in this
process along the way, listeningto their concerns.
(03:04):
Along the way, listening totheir concerns, really trying to
understand how the proposedchanges would affect them, both
positively and negatively, andthen trying to find a common
ground, and I think what camefrom that is a series of updates
that meets their needs andallows us to continue to improve
(03:27):
the quality of our products.
Speaker 2 (03:30):
Now is it mostly the Part 4 that you're changing the
most.
Speaker 1 (03:36):
No, we just most recently rolled out some very
significant changes with ourcomputer-based testing, which is
those of us more seasoneddoctors would recognize as our
written products.
That would be parts one, two,three and PHT.
As a result of the feedbackfrom the students and trying to
(03:57):
find a solution to offer themmore exam opportunities just in
August of this past year, we'veexpanded the offering of all of
our computer-based testingproducts.
Prior to August we offered partone in January, part two in
February, part three in Marchand then we would rotate through
(04:20):
the year.
So it was three times a yearthey could take each of the
tests.
We're now rolling it out towhere we're going to offer all
of the computer-based tests ninemonths out of the year.
The reason why it's only ninemonths is right now we still do
part four in May and Novemberand we don't offer an exam in
(04:42):
December.
As we roll out some of thechanges related to part four,
which we'll talk about here in alittle bit, we really hope to
be able to expand the computerbased testing and offer all of
the written products monthly sothat the students have every
opportunity to take that test,not when we say that they can
take it, but when they feel mostcomfortable taking it, when
they feel most prepared to takethe test.
(05:02):
Not when we say that they cantake it, but when they feel most
comfortable taking it, whenthey feel most prepared to take
the test.
Because, you know, at the endof the day, we really want to
set the students up, to make itconvenient for them and set them
up for success.
Speaker 2 (05:17):
What challenges have you faced in implementing the
changes, the changes forcomputer-based testing?
Well, no, for all of the newstuff, like Part 4, where they
come to Greeley Colorado.
I think that's what I'm hearingthe most.
Speaker 1 (05:34):
Yes, we'll back up and we'll talk a little bit
about the Part 4 changes.
We are in the process of movingthe Part 4 exam to a year-round
testing calendar there inGreeley Colorado and we're also
changing the format of the testfrom being a single-point exam
(06:00):
station to a full patientexperience.
So instead of going into theroom and being given a list of
things to do, which you wouldthen perform on that
standardized patient, and thenyou go to another room and
answer a series of questions asit relates to that patient
encounter, this will be movingto a candidate-led station which
(06:24):
will better measure acandidate's clinical
decision-making.
So they would walk into a room,there'll be a standardized
patient there and they will takethat standardized patient
through the whole patientexperience.
They'll do the history, thephysical exam, they will come up
(06:45):
with a working diagnosis and atreatment plan and then there
will be another stationdedicated to chiropractic
adjusting.
Speaker 2 (06:56):
What challenges have you faced in implementing the
changes?
Speaker 1 (07:00):
Well, you know, as you can imagine, change is hard.
You know, change is oftentimesmet with resistance, and what
we've really tried to do is toinvolve the stakeholders in this
process along the way, to letthem be part of the conversation
(07:21):
and to, you know, have somecandid conversations with them
and find out what their likesand dislikes are and what their
pain points may be, for example,you know we recognize that
having the students come toColorado does create some
concern for the travel costsrelated to coming there, to
(07:45):
Colorado.
I can tell you that the boarddid not take this decision
lightly.
We spent a significant amountof time reviewing lots of
different models, lots ofdifferent possibilities,
including staying on the collegecampuses, which is where we
(08:08):
currently administer tests, andat the end of the day, it really
came down to sustainability,fairness and long term benefit.
Speaker 2 (08:20):
Well, it seems to me like each campus would have
different people and so it had avariable.
Am I correct?
Speaker 1 (08:28):
Yes, yes, as I said before, it was delivered across
14 locations and required about1,250 field staff on any given
exam weekend to administer thattest.
That has to be expensive.
Speaker 2 (08:45):
It's very expensive.
How do you do it in Colorado?
Do you have people that arefull-time, then testers?
Speaker 1 (08:52):
So what we're hoping to be able to do and what we
feel confident that we're goingto be able to do and the primary
motivation behind centralizingis just that to be able to
better manage our cost.
You know the current exam modelis just not financially
sustainable, as you can imagine.
(09:14):
Trying to maintain that across14 different locations it's just
getting more and more expensiveand it's also getting more and
more expensive and it's alsogetting more and more difficult
from a staffing standpoint aswell.
So by being able to move itthere to a centralized location,
we can leverage our currentresources, we can leverage our
(09:36):
current staff and theirexpertise and ability to
implement this exam and we canalso better control those costs
long term.
You know one thing we know forsure is the current model,
although we're very excited, theboard has worked hard, staff
(09:59):
has worked hard to really holdcosts down and we've been able
to not raise exam fees for sixout of the last seven years in
spite of record inflation.
But we know that's notsustainable.
Exam increases on a fairlyregular basis and what we're
(10:24):
really hoping to be able to doand feel confident that we're
going to be able to do uh is isis control those costs and
stabilize those exam fees sothat students will not have to
absorb, uh, those types ofincreases going forward when?
Speaker 2 (10:41):
do you anticipate opening the new center?
And really, going forward?
Speaker 1 (10:45):
When do you anticipate opening the new
center in Greeley?
So our plan is to open it inthe first of 2026.
However, you know we are justnow on the end phases of the
design phase for the buildingand, as you can imagine I know
you've been in the processbefore of building a nice
(11:06):
building.
I've gone and had anopportunity to see the Four
Science Center there at Logan.
It's a spectacular, beautifulbuilding and, as you can know,
there's, as you know there's atremendous amount of preparation
that goes involved in thedesign portion of it before you
ever get to construction.
So we're finishing that up nowwhere we're on track to begin to
(11:28):
begin construction February Imean March or early April and
we're hoping that we'll be ableto to have it open and ready to
do some field testing first partof 2026, with the first exam
being administered in March of2026.
(11:48):
Now, because we're going to bedelayed a little bit into the
year, we will still offer in Mayof 2026 the on-campus testing.
We have to do that in order tobe able to get everybody tested
in 2026 that needs to be testedfor licensure.
(12:10):
So we'll begin the on-campustest.
I mean we will begin thecentralized testing.
Our plan is March, but we willalso still have that May 2026
exam on college campuses, andthat will be the last one.
Speaker 2 (12:26):
How does the medical profession test their people?
Speaker 1 (12:31):
The medical profession.
It depends if you're talkingabout.
You know when you say medicalprofession, you know if you're
talking just specifically aboutMDs.
But you know you have.
MDs, dos podiatrists,optometrists, just do the MDs.
The MDs they historically did aregional testing, a very
(12:58):
similar OSCE type test withstandardized patients, osce type
tests with standardizedpatients.
After COVID they did do awaywith their OSCE testing, their
version of Part 4.
I don't want to speak for them,I can't speak for them, but I
think the primary reason istheir instrument is used
(13:18):
differently than ours.
Their version of the Part 4exam was used for entrance into
the residency program.
So you know they took the test,they used that for entrance
into the residency program wherethey then went into.
You know, in essence, aneveryday OSCE, but they were
(13:38):
working on real patients, so itwas a very a continuation of
their education, so to speak.
Where in the chiropracticprofession, this is a true
licensure exam and once you passour licensing exam you then
have the ability to get licensedin any 50 states and you can go
(13:59):
to work the very next week andstart treating patients.
Optometrists still use acentralized testing location.
I think the podiatrists use acentralized testing location and
the osteopaths are in theprocess of going back and doing
(14:20):
some of the OSCE exam for thecolleges.
Speaker 2 (14:23):
So this centralized thing is not new.
Speaker 1 (14:28):
No, it's not new at all.
Actually, what we were doing isvery unique, or what we're
currently doing is very unique.
Speaker 2 (14:34):
Shouldn't this standardize things too, I mean?
Speaker 1 (14:39):
Oh, yes, I mean you can imagine the standardization
when you're looking at just onelocation versus 14 locations and
we go.
An extreme amount of effort andtraining goes into ensuring the
standardization to the extentthat we can.
But there's no way we can makeit.
(14:59):
You know, the same, exact sameexperience across every location
, particularly when you know thecollege campuses are arranged
different, the clinics lookdifferent, the equipment is
different.
You know, all those things playa role in the standardization.
With the, with the centralizedtesting, we will have full time
(15:22):
patients, opposed to thepart-time standardized patients
that we have now.
So there'll be a constanttraining process for them.
We will have full-timeexaminers where now again we
have part-time examiners andthey have to go through a
regular calibration process inorder to maintain that
(15:43):
standardization process, inorder to maintain that
standardization.
But with the centralizedlocation, we'll have a full team
of examiners.
That is their job, that is whatthey do, and we'll be able to
run regular inter-raterreliability studies to make sure
that the examination, that thegrading, is being consistent
(16:03):
across all examiners andeverybody will be spot checked.
So we will be grading thegraders, so to speak, on a very
regular basis to ensure that itis fair and equitable across
exams and across days.
Speaker 2 (16:18):
Now we've talked all about how you examine students.
Let's talk about what you dofor students, because until I
did this interview I had no ideayou were doing this.
I see here you're giving a lotof scholarships.
Can you give us just a quickrundown on those?
Speaker 1 (16:35):
Yeah, you know our board feels that it's important
to invest back in the students.
You know we recognize that thestudents are the future of this
profession.
One example is the.
(16:55):
We believe that the futureresearchers of the profession
are in school now.
You know they're the peoplethat we're going to count on in
the future to of the professionare in school now.
You know they're the peoplethat we're going to count on in
the future to be the researchersto move this profession forward
.
And as a result of that, theboard recently appropriated the
(17:16):
last couple of years $50,000student scholarships to send two
student representatives fromevery DCP program in the country
to the Association ofChiropractic Colleges Research
Agenda Conference or the ACC RAC.
It's a very unique opportunityfor them to be there, to get
(17:36):
exposed to that, to network and,you know, hope to get the bug
and really stimulate that nextwave of researchers.
It's been exciting to watch.
You know I go there and I seethem, I meet with those students
and then we get a lot of reallyyou know nice emails and
(17:57):
letters back from them aboutwhat a valuable experience it
was and how they're interestednow in learning more about
research.
What a valuable experience itwas and how they're interested
now in learning more aboutresearch.
We give to all the student,national student groups.
We have a ten thousand dollaraward that we offer for an essay
(18:18):
competition that we do and wedo.
I think it's a thousand dollarswe give to every DCP program
for a scholarship that they canoffer at their discretion.
So you know, we really try todo our part to give back to the
students.
Speaker 2 (18:37):
Also, you're developing new exams.
Can you tell me a little bitabout it?
The one is that chiropracticeducation readiness assessment,
cirsa or CIRA, yeah.
Speaker 1 (18:48):
Yes, it's the CERA.
It stands for chiropracticeducation readiness assessment
and it's an exam that you knowwe all of our new exams that we
develop we really the goal of itis to meet the need of the
(19:10):
profession, is to meet the needof the profession and this is an
exam that came from acollaboration with the colleges.
We had 18 of the USDCP programsparticipate in the development
of this exam.
It's a two-part exam.
It's got both cognitive andnon-cognitive items on the test.
(19:32):
So the cognitive items measuretheir competency in basic
sciences and then thenon-cognitive portion measures
self-awareness, grit andemotional intelligence and it's
designed to assess thatcandidate's readiness for the
(19:57):
rigor of the DCP program.
Speaker 2 (19:59):
Now that activators taught in 38 different colleges,
I always ask you the questionwhen is there going to be some
activator questions on thenational board?
And you say, well, they don'tall require, but we have it in
the core curriculum now,probably over half.
So is that a possibility nowthat some questions might be
submitted?
Speaker 1 (20:20):
So I'm going to give you the very general answer,
right, because this is, you know, I've got a team of people that
are involved in the wholeprocess, but I'll give you the.
And there's a lot behind whatgoes in the test and how things
get on to the test, right, andit's different whether it's part
one and two or whether it'spart three and four, right?
(20:42):
So I'm gonna probably take itdown a little bit of a rabbit
hole, but it is interesting, Ithink people ask a lot of times
where the questions come from.
So part one and two, thequestions come from a Delphi
study.
So we have a very objectiveprocess that we go through,
(21:04):
where we study what is beingtaught in the college curricula.
It's a back and forthinteractive process with the
colleges and that's whatdetermines what's going to be on
the test.
As far as the written exams,part three and four is highly
anchored to the practiceanalysis which we do every five
(21:28):
years, so it should reflectwhat's actually being taught in
the profession.
So that, all being said,particularly on part four and to
address your questioncompletely, you know it needs to
make sure that every singlestudent has access to the
(21:48):
information and every singlestudent has the same opportunity
to be successful on thatparticular aspect of the test,
right?
So you know, as Activator getsmore and more into the college
curricula, across all thecolleges, to where every single
(22:13):
school, regardless of where youwent to school, you have access
to the information and have thesame chance of being successful,
then that's a conversation wecan have for sure.
Speaker 2 (22:25):
Last question you know you used to put out a
survey.
I love the survey, you know,because it talked about what
techniques were being used andit talked about who did this and
who did that.
Is that being resurrected?
Speaker 1 (22:39):
We are in the process right now.
We just sent the survey out endof the year last year.
The 2025 practice analysis isbeing finalized.
Practice analysis is beingfinalized.
As a matter of fact, I justspoke with Dr Himmelfarb, who is
our director of psychometricsand research and is the chief
author on that.
(22:59):
It is scheduled to go in twoweeks to the printer to be put
together.
We're not going to have a printversion of it, but we say the
printer and it should bereleased early March.
So yes, you will have itshortly.
Speaker 2 (23:20):
Well, I really appreciate that and I've heard a
lot of people in the professionsay what happened to that
survey and I said I'll ask DrOates today because I'm
interviewing him and so I'mhappy to see that it's back,
because it gave a lot of realgood demographic information and
talked about what people wereusing and so forth.
So it was valuable.
Speaker 1 (23:37):
Yes, so it's an extremely valuable instrument.
It is used, you know, by bylegislatures, is used by state
licensing boards.
Exactly it is used byassociations.
A lot of people use it.
There's a tremendous amount ofdata in there and we actually
have them all archived on ourwebsite.
(23:57):
If you go to wwwnbceorg, youwill be able to find the archive
list of all the practiceanalysis.
They're all word searchable, soit makes it really easy for you
to find what you're looking for.
And again, we'll have the 2025one there real shortly.
Speaker 2 (24:19):
Well, it sounds like change.
You know, nobody likes changeand it's always difficult to do
change, but it sounds likeyou're on top of it.
And so, Dr Norman Oates, theCEO of NBCE, we're really happy
that you could come on today sowe can get the word out to the
profession.
Thank you so much for having me.
You're very welcome.
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