To evaluate the association between basic science curriculum delivery method with other academic and demographic factors on National Board of Chiropractic Examiners (NBCE) part I pass rates.


This was a retrospective cohort study of students from 3 campuses of 1 chiropractic institution who matriculated in 2018 or 2020. COVID-19 regulations required online delivery of a basic science curriculum for students in the 2020 cohorts, whereas students in the 2018 cohorts experienced a traditional classroom delivery. A general linear model estimated odds ratios for passing NBCE part I, comparing individual online cohorts with the combined classroom cohort while adjusting for academic and demographic variables.


A total of 968 students were included, 55% from the classroom cohort. The spring 2020 cohort had the fewest students with bachelors’ degrees (59%) and more students with high in-program grade point averages (GPA; 61%) along with the lowest estimated odds ratio [0.80 (95% CI: 0.73–0.87)] for passing vs the classroom cohort. The fall 2020 cohort had significantly higher odds [1.06 (95% CI: 1.00–1.03)] of passing vs the classroom cohort. Additional predictors included main campus matriculation, white ethnicity, bachelors’ degree, no alternative admission status, and in-program GPA. Students with high in-program GPA (vs low) had a 36% increased odds of passing.


Compared to the classroom cohort, the spring 2020 cohort had the lowest odds while the fall 2020 cohort had the highest odds of passing part I. In-program GPA had the highest association with passing. These results provide information on how curriculum delivery impacts board exam performance.

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Author notes

Dustin Derby is the senior director of Institutional Research and Effectiveness at Palmer College of Chiropractic (1000 Brady St, Davenport IA 52803; [email protected]).

Robert Percuoco is vice chancellor of Institutional Research and Effectiveness at Palmer College of Chiropractic (1000 Brady Street, Davenport, IA, 52803, USA; [email protected]).

Author Contributions Concept development: BA, DD. Design: BA, DD. Supervision: BA, DD, RP. Literature search: BA. Data collection/processing: BA, DD. Analysis/interpretation: BA. Writing: BA, DD, RP. Critical review: BA, DD, RP.