Part IV
Applicant Eligibility |
Application |
Online Scores |
Test Plans |
Fees |
Transcripts |
Test Plans
Diagnostic Imaging (DIM)
(10 Case Scenarios)
The examinee will be asked to identify radiographic features from the radiograph(s) and/or other diagnostic images presented. A test committee will have selected the cases according to the following criteria:
- cases that are commonly encountered in practice
- cases that present cautions or contraindications to chiropractic case management
- cases that require early detection to preserve life/health of the patient
Examples include:
- Normal radiographic anatomy
- Congenital anomalies, skeletal variants and dysplasias
- Scoliosis and spondylolisthesis
- Intervertebral disc disease and spinal stenosis
- Traumatic skeletal disorders (spine and extremities)
- Arthritic disorders (spine and extremities)
- Tumors and tumor-like processes (spine and extremities)
- Hematological and vascular conditions
- Bone infections and miscellaneous conditions
Chiropractic Technique
(10 Techniques)
The examinee will be given two case scenarios in each of the five adjusting areas listed below for a total of 10 techniques. From the information provided in the case scenario, the examinee will demonstrate patient placement, doctor placement, hand placement, procedure and the line of drive.
Examples include:
- Cervical adjusting
- Thoracic adjusting
- Lumbar adjusting
- Pelvic/sacral adjusting
- Extremity adjusting
Case Management
(10 Simulated Patient Encounters and 10 Post-Encounter Probes)
There will be 10 patient stations which may be divided as follows:
- 6 – Orthopedic and neurologic examinations
- 3 – Case history taking
- 1 – Physical examination
The examinee will address cases that:
- are commonly encountered in practice
- present cautions or contraindications to chiropractic case management
- require early referral to preserve the life/health of the patient
- present significant diagnostic challenges
Each interaction between the case management examinee and the standardized patient is followed by a post-encounter probe (PEP) station. At the PEP station, the examinee is presented with a binder that contains additional clinical information, e.g., additional physical findings and laboratory results. There may also be radiographs and/or other diagnostic images pertaining to the case in the station.
At the PEP stations, examinees will complete two multiple-choice questions based on their interactions with the standardized patients in the previous stations and on the additional clinical information presented. Each multiple-choice question will have 10 choices. The examinee will be required to select three of the most correct answers for each question.
Additional Information
Standardized Patients
Ten of the case management stations will have standardized patients. These standardized patients have been carefully trained to simulate a given condition. The examinee will address or interact with the standardized patient as though that patient actually has the condition that he or she is simulating.
Technique Patients
These individuals will be at five of the stations. They are not trained to simulate a condition. The examinee will demonstrate the placement of the patient, the placement of the doctor, including the doctor’s hands, procedure and the line of drive. No thrust will be applied.
DIM Materials
There is a separate 10-station DIM portion of the Part IV Examination. Radiographs and/or other diagnostic images may also be at post-encounter stations, which the examinee will enter after interacting with a trained patient. The examinee will review radiographs at these stations. After reviewing the radiographs, the examinee will be asked to respond to questions pertaining to the radiographs and additional clinical materials that will be found in a binder placed in the post-encounter station.
