• Green BN
• Johnson CD
• Brown R
• Korporaal C
• Lawson D
• Russell E
• Fujikawa R

• Affiliation / Durban University of Technology. Faculty of Health Sciences. Department of Chiropractic
• Affiliation / National University of Health Sciences
• Affiliation / Parker University
• Affiliation / Real Centro Universitario Escorial Maria Cristina. Chiropractic Program
• Affiliation / World Federation of Chiropractic (WFC)
• Affiliation(G) / Canada / Ontario / Toronto
• Affiliation(G) / South Africa / Durban
• Affiliation(G) / Spain / Madrid
• Affiliation(G) / United States / Illinois / Lombard
• Affiliation(G) / United States / Texas / Dallas
• Certification
• Education, Chiropractic
• Educational Measurement
• Licensure, Chiropractic
• Open Access Document
• Surveys and Questionnaires

Objective: Many countries require examinations as a gateway to chiropractic licensure; however, the relevance of these exams to the profession has not been explored. The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs.

Methods: We designed an electronic survey that included open-ended questions related to CQEs. In August 2019, the survey was distributed to 234 international stakeholders representing academic institutions, qualifying boards, students, practitioners, association officers, and others. Written comments were extracted, and concepts were categorized and collapsed into 4 categories (benefits, myths, concerns, solutions). Qualitative analysis was used to identify themes.

Results: The response rate was 56.4% representing 43 countries and yielding 775 comments. Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies.

Conclusion: International stakeholders identified concepts about CQEs that may facilitate or hinder collaboration and efforts toward portability. Stakeholder beliefs were aligned with those expected of learned professions. This qualitative analysis identified 9 major themes that may be used when making future decisions about CQEs.

Author keywords: Chiropractic, Licensure, Certification/Standards, Internationality, Educational Measurement/standards

Author affiliations: BNG, CJ: National University of Health Sciences, Lombard, Illinois, United States; RB: World Federation of Chiropractic, Toronto, Ontario, Canada; CK: Chiropractic Department, Durban University of Technology, Durban, South Africa; ER:Student Engagement and Special Projects, Parker University, Dallas, Texas, United States; RF: Chiropractic program, Real Centro Universitario Escorial Maria Cristina, Madrid, Spain

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