An Examination of Musculoskeletal Cognitive Competency in Chiropractic Interns

Abstract

Objective This study investigates the cognitive competency of final-year chiropractic students in musculoskeletal medicine. Methods The face, content, and criterion validity of the Basic Clinical Examination (BCE) for musculoskeletal medicine were tested for use in chiropractic education. After validity testing, the BCE was administered in a cross-sectional design to all fourth year students (154) attending the Canadian Memorial Chiropractic College. Results Twenty percent (5 questions) of the BCE was deemed not relevant or outside of the scope of practice by criterion experts. One hundred twenty-three (80%) fourth year chiropractic interns participated in the cross-sectional study. Interns achieved a 51.2% passing rate (mean score, 73.2%; 95% confidence interval, 82%-71.8%) for the 25-item BCE, whereas the criterion experts achieved a 100% passing rate. For the modified 20-item BCE, the interns' mean score was 80.8%, whereas the criterion experts' mean score rose to 92.8%. Conclusions Most final-year chiropractic interns at this college was found to be competent in musculoskeletal medicine as assessed by the Basic Competency Examination. This is in contradiction to previous work with medical students, recent medical graduates, nonorthopedic staff physicians, osteopathic students, and physical therapy students. Chiropractic clinicians with postgraduate training showed considerably better results than chiropractic interns. Problems pertaining to the content validity (relevance and scope of practice for chiropractors) of the BCE need to be addressed.