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.
Practical:
Candidates sitting the practical examination are assigned a specific examination
period based upon the order in which they applied to take the examination and
upon the retake status of the candidate. The candidate is informed as to
the time of his/her particular time segment and told where to report to await
the examination. The practical examination is divided into AM and PM segments
with the candidates waiting their turns in a quiet room called a holding tank. They
may have personal materials but no electronic equipment with them in the holding
tank and must leave all materials there when the escort arrives to take them
to the practical examination room.
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 candidate is allowed eight (8) minutes to take a complete case history,
thirty (30) minutes to perform a physical/neurological head to toe examination,
ten (10) minutes to perform five (5) provocative neurological and/or orthopedic
tests, and
thirty (30) minutes to view and answer questions on fifteen (15) video simulation
clips. The candidate is scored on the completeness of the history, accuracy
and completeness of the physical examination, accuracy and completeness of the
special tests performance and accuracy and completeness of answering questions
regarding the video clips. The history includes but is not limited to:
- Present health care status and complaint
- Past history
- Family history-first & second degree relatives
- Social history
- 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-tibial (popliteal fossa) junction eliciting
a reflex arc”.
It is advised that candidates conduct a comprehensive head-to-toes physical
examination including but not limited to:
- Vital signs
- Sensory evaluation
- Motor evaluation
- Cranial nerve evaluation
- Palpatory or provocative (orthopedic/chiropractic type) testing
- Cardiovascular and visceral evaluation
- Other neurological evaluation (balance testing, optokinetic etc.)
All physical examinations are performed on the patient to demonstrate the psychomotor skills involved.
At the conclusion of the physical examination, the candidate will be asked
to perform five (5) special tests. These include optokinetics, vestibular,
orthopedic and other routine tests normally used by the chiropractic neurologist. The
candidate needs to know the proper procedure, the rationale for doing the
test, and the implications of the findings.
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 )
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.