Printer Friendly Email a Friend PDF RSS Feed

Dynamic Chiropractic – June 17, 2011, Vol. 29, Issue 13

National Board Revises Ethics & Boundaries Exam Format

By Editorial Staff

The National Board of Chiropractic Examiners has revised its Ethics and Boundaries (E&B) post-licensure examination, with the major change being a shift from multiple-choice to computer-based essay format.

The exam features five essay scenarios designed to assess examinees' understanding of the boundary or ethical issue. According to the board, each essay scenario is graded on a 16-point scale (possible four points each for introductory opinion statements, examples and explanations, consequences and solutions). A score of less than 12 on three or more of the five scenarios requires the examinee to retake the entire examination, with new scenarios randomly selected from topics designated by the state board; while examinees scoring below 12 on two or less scenarios can retake failed portions only, again with random essay scenarios as selected by the state board.

The E&B exam is one of two post-licensure examinations currently offered by the National Board (the Special Purposes Examination for Chiropractic, which "assesses the clinical competency of licensed or previously licensed practitioners in areas reflecting clinical conditions generally encountered in chiropractic practice" and is administered only at the request of a state or foreign licensing board, is the other). The E&B exam "requires that examinees demonstrate an acceptable level of understanding and judgments pertaining to appropriate relationships and interactions required in unsupervised chiropractic practice." State boards can customize the exam topics to fit the circumstances of the individual being examined.

The E&B exam's essay scenarios cover four distinct areas: 1) boundary violations (doctor with patient and doctor with staff); 2) fraud billing and coding, and kickback / steering schemes; 3) doctor's duties and office protocols, including standards of care and patient records / documentation; and 4) unprofessional conduct: alcohol and/or substance abuse and negligent / inappropriate behavior. The exam is administered six times per year.

For additional information regarding the NBCE Ethics and Boundaries Exam, visit and click on "Post-Licensure Examination." An interactive sample essay scenario is also available online at

To report inappropriate ads, click here.