ACADEMY OF CHIROPRACTIC ORTHOPEDISTS

Examination Architecture
Based upon 2015 Specialty Job Analysis

 

Chiropractic Orthopedics
Certification Examination Blueprint

Purpose of the examination

The ACO Certification examination is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified chiropractic orthopedist in the broad domain of the discipline. The examination is in two parts.

Part I is web-based critical thinking and knowledge base testing. Part I examinations occur several times each year.

Part II occurs once each year and is an Objective Structured Clinical Examination or OSCE.

Both Part I and Part II assess the candidate’s ability to make appropriate diagnostic and management decisions that have significant consequences for patients. The exams may require recognition of common as well as rare clinical problems for which patients may consult a certified chiropractic orthopedist.

Examination Content

A pre-established blueprint or table of specifications determine the examination content. The blueprint is developed by ACO and is reviewed and updated as needed for currency. Trainees, training program directors, and certified practitioners in the discipline are surveyed periodically to provide feedback and inform the blueprinting process.

The primary chiropractic orthopedic content categories of the blueprint are below, with the percentage of the exam, devoted to this content area. Below each primary category is the content subsections.

TEST ITEM DISTRIBUTION


DOMAIN I

TAKE HISTORY

24%

 
Complaints of neurological/orthopedic & systemic diseases

  • Side effects of pharmaceutical agents
  • Relationship of symptoms to various diseases
  • Relevance of family history
  • Occupational and environmental hazards
 
Interviewing techniques

  • Effects and adverse effects of various treatments
  • Relevance of patient’s age, gender & demographic data
  • Co morbid conditions with chief complaint
  • Nonorganic diseases with neuro/orthopedic manifestations
  • Professional boundaries of taking history
  • Nutritional supplements side effects
 
Obtaining medical records

  • Relevance of past medical history to current condition
  • Medical research and proper authorization

DOMAIN II

PERFORM EXAMINATION

20%

 
Well patient anthropometric standards

  • Professional boundaries of performing the examination
  • Relevance of normal and abnormal findings
  • Normal human anatomy
  • Use of proper medical equipment
 
Hereditary patterns of particular diseases

  • Systemic disease manifestations
  • Neurological, orthopedic and physical examination procedures
  • Pharmaceutical agents side effects
  • Adverse effects of various patient self-care
  • Grading and indexing systems
  • Neuromusculoskeletal system and biomechanics
 
Medical terminology/reports/abbreviations

  • Procedures employed in diagnostic imaging
  • Human physiology and anthrophysiology
  • Types of tests, findings and evaluations

DOMAIN III

DEVELOP A DIAGNOSIS

8%

 
Prognosis & clinical importance of various disorders

  • Medical terminology
  • Establish diagnosis to direct patient management
  • Ranking of disorders
  • Correlation of findings

DOMAIN IV

PREPARE & IMPLEMENT TREATMENT PLAN

22%

 
Healing times for various conditions

  • Standards of care for specific disorders
  • Outcome assessment expectations
  • Pathophysiology of various disorders
  • Natural progression and prognosis of various conditions
  • Goals of management
 
Treatment options

  • Contraindications for various treatments
  • Issues surrounding informed consent
  • Cost to benefit ratios
  • Personal and/or professional care limitations
 
Risks associated with treatment and nontreatment

  • Factors, which influence treatment
  • Issues of doctor patient confidentiality
 
Appropriate application and parameters of physiological therapeutics

  • Nutritional and appropriate use of supplements
  • Exercise for Rehabilitation
  • Supports, orthoses, and appliances
  • Adjustment of spinal and extremity articulations

DOMAIN V

ASSESSMENT & CONCLUSION OF CARE

7%

 
Expected effects of treatments

  • Expected healing times of various conditions
  • Referral protocols
  • History taking skills
 
Reexamination of findings

  • Diagnosis modification for recovery
  • Identify strategies of patient’s active phase care

DOMAIN VI

RECORD KEEPING, DOCUMENTING, REPORTING

19%

 
Clinical office forms

  • Required information
  • Issues of patient confidentiality
  • How to prepare a discharge summary
 
Medical terminology, reporting, and abbreviation

  • Legal issues of patient confidentiality
  • Statute of limitation of patient records

Examination questions in the content areas above may also address clinical topics in geriatrics, pediatrics, and pharmacology and topics in general internal medicine that are important to the practice of chiropractic orthopedics.

Examination format

  • Making a diagnosis
  • Ordering and interpreting results of tests
  • Recommending treatment or other patient care
  • Assessing risk
  • Determining prognosis
  • Applying principles from epidemiologic studies
  • Understanding the underlying pathophysiology of disease and basic science knowledge applicable to patient care

Clinical information presented may include patient photographs, radiographs, micrographs, DXA scans, electrocardiograms, angiograms, audiograms, and other media to illustrate relevant patient findings.

Please Note: The percentages for the content of a typical examination are approximate; actual exam content may vary.