CAGEN
Study Guide:
Chiropractic Neurology Board Examination Study Guide:
The following guide will assist you in preparing for the Board Examination of
the ACNB. The examination is divided into two main sections (written and practical).
Written:
The written examination is a twelve hour examination based on twelve domains
of the neuraxis at eight percent (8%) of the examination falling to each of the
domains with the additional four percent (4%) of the examination referencing
ethics and techniques (see Blueprint).
Within each domain a series of objectives guide the format for the test.). The
Topics list further refines each domain (see Topics).
Just over five percent (5.11%) of the questions relate to general knowledge in
the domain area. The majority of the remaining questions will be case related.
All cases will use the Case Template (see Case
Template). Please refer to the Blueprint for the objectives and the percentages
attached to each objective. The References are those used in the educational
process you have just completed (See References).
Tools and Modalities list the tools and testing/treatment modalities that the
candidate is expected to know how to use (See Tools & Modalities).
All questions are in a multiple-choice format.
2009 Practical Update:
The practical is a simulation of patient interaction in a clinical setting. The practical is videotaped for review. The candidate is instructed to ignore the videotaping. Many candidates find it helpful to practice doing procedures in front of a camera or recorder in order to feel more relaxed during the examination. The videotaping is necessary for examination documentation, review, etc. Candidates are randomly assigned to an examination room.
Upon entering the examining room, the candidate finds a "patient", two board examiners, and a trained video photographer, as well as all necessary examination tools.
The 2009 ACNB Practical Examination will be case based. Each candidate will be given a description of symptoms. The candidate will be evaluated on his/her ability to obtain pertinent history on the presenting complaint/symptom as well as a complete and thorough general health history. The candidate will perform a thorough head-to-toe neurological/physical examination. The successful candidate will be able to derive a diagnosis and differential diagnoses as well as therapeutic meth odology for the case presentation. The history will draw out specifics for the presenting case symptoms but a complete health history will be expected in addition to the presenting complaint. The physical/neurological examination will follow the history. The time allotted for this portion of the practical examination is thirty (30) minutes.
The history includes but is not limited to:
- 1) Present health care status and complaint
- 2) Past history
- 3) Family history-first & second degree relatives
- 4) Social history
- 5) Review of systems
The candidate addresses all questions to the patient, speaking loudly enough to allow both the examiners and the camera to "hear" your questions and the answers. Each candidate is graded on the completeness of the history and the ability to ask questions that provide leads toward a diagnosis and uncover pertinent information. The candidate then performs a complete physical examination and is graded on the completeness of the examination and the accuracy in the psychomotor skills performed. The candidate states aloud what he/she is examining. For example: candidate performs the sensory pen wheel exam for trigeminal nerve and states "trigeminal nerve sensory test using pen wheel"; candidate performs popliteal reflex and states "popliteal reflex text of nerve root S1 using a reflex hammer at the patellar-tibia l (popliteal fossa) junction eliciting a reflex arc".
It is advised that candidates conduct a comprehensive head-to-toe physical examination including but not limited to:
- 1) Vital signs (will be given to by examiners on request of candidate)
- 2) Cranial nerve evaluation
- 3) Sensory evaluation
- 4) Motor evaluation
- 5) Cerebellar evaluation
- 6) Palpatory or provocative (orthopedic/chiropractic type) testing
- 7) Cardiovascular and visceral evaluation
- 8) Other neurological evaluation (optokinetic etc.)
All physical examinations are performed on the patient to demonstrate the psychomotor skills involved.
Once that portion of the examination is completed, the candidate proceeds to a simulation examination where he/she is randomly assigned a set of video clips to view and respond to the questions regarding the findings. These clips will be of physical examination findings such as eye movements, gait, reflexes, blind spots, etc. At the conclusion of the clips, the candidate reviews the written notes may ask for one or more to be repeated. Only verbal answers will be scored. The written response is for the candidate's use in asking for a repeat only. Candidates will not take any materials away from the exam. This portion of the examination is allotted thirty (30) minutes (see Practical
Blueprint).
The practical examination will include a five (5) to ten (10) minute question-answer session from the blueprint of neurological domains and objectives.
The total time for the practical examination may approximate 1 1/2 hours.
In Conclusion:
The candidate should be able to demonstrate competency in obtaining a case
history, obtaining complete physical findings, performing special tests
and accurately identifying physical findings on video clip.