Alignment between National Board of Chiropractic Examiners exams, chiropractic curricula and Council on Chiropractic Education meta-competencies: A qualitative study.

Abstract

Objective: The purpose of this study was to evaluate the alignment between chiropractic educational outcomes, the National Board of Chiropractic Examiners (NBCE) prelicensure exams, and the Council on Chiropractic Education (CCE) meta-competencies.

Methods: A qualitative thematic analysis was performed between January 2024 and December 2024. A detailed coding framework was used to systematically assess coherence among the content of NBCE prelicensure exams, the competencies from 4 sample chiropractic educational outcomes, and the CCE meta-competency framework. Data were analyzed to identify the presence and depth of key professional domains.

Results: The thematic analysis revealed a substantial degree of alignment between the NBCE exams and the CCE meta-competencies. The essential domains included assessment and diagnosis, patient case management, disease prevention, communication and documentation, professional ethics, jurisprudence, spinal adjustment and manipulation, interprofessional collaboration, clinical reasoning, and practical skills.

Conclusion: This study provides valuable insight into the degree of alignment among chiropractic educational outcomes, NBCE exams, and the CCE meta-competency framework. The analyses offer a detailed evaluation of the extent to which NBCE exam content reflects the knowledge, skills, and professional behaviors outlined in the CCE competencies. Collectively, the findings contribute to a deeper understanding of how exam standards support the preparation of competent, entry-level chiropractic practitioners.