Academic Integrity for All: Building Better Professionals: Chiropractic Educators Research Forum (CERF), June 25, 2022

The Chiropractic Educators Research Forum (CERF) holds conferences from time to time that focus on a topic relevant to education and the chiropractic profession. This conference showcases education research, innovations, and best practices and provides a forum for the presentation of scholarly work in chiropractic education theory and practice. The CERF held a virtual conference on June 25, 2022. The focus of this meeting was on research related to how chiropractic programs work to address academic integrity issues. After submission to a rigorous peer-review process, the following abstracts were accepted for presentation. As we have done with prior CERF conferences, the abstracts include the video presentations so that they may be more widely distributed.^1–3

The presentations from the conference held on June 25, 2022, are listed here in alphabetical order by first author's last name. Each abstract includes a link to the video abstract of the presentation that was delivered at the conference.

Marshall Deltoff

Objective: The purpose of this study was to analyze components of the current chiropractic oaths relevant to academic integrity and describe the variation existing among them. Methods: Data were obtained from 1988 and 2019 papers describing components of the chiropractic oaths. In adddition, chiropractic programs opening after 2019 were contacted to obtain their oaths. A total of 42 chiropractic program oaths were included in this study. Ten oath components were analyzed, including God, relief of sick/disease/suffering, keeping of a patient's confidence, refrain from wrongdoing, serve humanity, show no discrimination, regard for colleagues, respect for teachers, improving knowledge/keeping an open mind, and live up to the principles of the profession. The oaths were compared for their individual inclusion and emphasis of these components. Results: Some topics, such as “keeping a patient's confidence” (78.6%) and “refrain from wrongdoing” (64.3%) demonstrated a high rate of occurrence. Others, including “serving humanity” (28.6%) and “respect for teachers” (38.1%), were less frequent. One school's oath contained 8 topics, 11 schools had 7 topics, and 3 schools' oaths contained only 2 topics. Four programs did not administer an oath. Conclusion: This study found a wide variation in the occurrence and emphasis of academic integrity themes in the chiropractic oaths. This may demonstrate a reflection of the importance assigned to these attributes in the graduates by the various chiropractic programs. Some oaths were deficient in including important aspects of integrity, ethics, and professional behavior. (This is a conference presentation abstract and not a full work that has been published.)

Video Abstract https://youtu.be/SAbJEcMzeuw

Igor Himelfarb

Objective: The purpose of this study was to develop a statistical process for detecting unlikely similar patterns of responses between pairs of examinees. Method: The National Board of Chiropractic Examiners provided n = 1231 item responses on an 80-item exam. The methodology to detect nonindependent test takers included an adaptive item response theory–based statistic, which considered item difficulty, item discrimination, guessing, and the examinee's ability. Our logic was to minimize the variance and compute the expected number of the right and wrong answers for pairs of test takers within a test site given the ability and item difficulty levels. Results: Using test takers' responses, we created a simulated visualization of expectations and variances for the patterns of right and wrong responses. The actual response patterns were compared with simulated patterns, and where significant deviations occurred, the pair of test takers was flagged. Further investigation was conducted for flagged pairs such as investigating their previous scores, looking into seating charts, and individual response patterns. We performed calculations to determine who was likely to be the source and who is the follower. Conclusion: This statistical approach was created to identify examinees with extremely similar response patterns, which may be a result of answer copying, test coaching, or other forms of collusion. The proposed methodology accounts for possible similarities in education of the examinees. (This is a conference presentation abstract and not a full work that has been published.)

Video Abstract https://youtu.be/N-UQl_KDiaM

Stuart Kinsinger

Objective: The purpose of this study was to explore whether there was an association between learner academic dishonesty and future practitioner misconduct related to truth telling. Methods: A search of the literature and publicly available regulatory disciplinary reports was performed to identify current regulatory concerns regarding truth telling. Six regulators' websites were searched for misrepresentation during misconduct investigations. Information gathered was in the public domain and published between 2018 and 2020. Included were 2 professions in Ontario (medicine, dentistry) and 4 medical licensing boards in the northeastern United States (New York, Rhode Island, Connecticut, and Massachusetts). Misconduct descriptions were analyzed, and misrepresentation was categorized into different types. Results: The literature related to communication between physician and patient but not academic dishonesty and future practitioner misconduct. While 1 paper linked student misconduct with postgraduate misconduct, misrepresentation was not specified. The information retrieved from the 6 jurisdictions' websites revealed misrepresentation most commonly occurred in 5 ways: annual relicensure falsification, communication between professional colleagues, fraudulent billing, obstructing disciplinary investigations, and faulty record keeping. False, incomplete, and missing clinical notes and records were considered misrepresentation. Misrepresentation was usually secondary to primary allegations. No studies about educational training and student discipline information were found. Conclusion: There was no literature found on academic dishonesty and future practitioner misconduct related to truth telling. Professional misconduct from 6 regulators included 5 different types of truth telling and deceit. A link between practitioner misrepresentation and prior academic dishonesty was unable to be determined. (This is a conference presentation abstract and not a full work that has been published.)

Video Abstract https://youtu.be/3PwK-21YKwI

Marc McRae

Objective: The purpose of this study was to assess whether health professions students' scores would be different with and without supervision. Methods: In this observational retrospective analysis of test scores from a single biochemistry course, the average test score percentages were compared between 4 temporally different class cohorts, which included pre–COVID-19 pandemic in-person classroom with faculty supervision (n = 77), at-home without supervision (n = 50), at-home with computer supervision using supervision with Proctorio (n = 15), and return to in-person classroom with faculty supervision (n = 43). Results: The average test score for the prepandemic in-person classroom with faculty supervision cohort was 70.1%, the average test score was 75.6% for the at-home without any supervision cohort, while the at-home with computer supervision using Proctorio was 67.3%, and return to in-person classroom with faculty supervision test scores was 69.5%. Conclusion: This study measured a 5% to 8% increase in average scores during the at-home testing without any supervision. The actual reason for the elevated scores cannot be confirmed but may suggest the possibility of cheating due to the lack of in-person or computer supervision. (This is a conference presentation abstract and not a full work that has been published.)

Video Abstract https://youtu.be/F1sohqsc2Ag

We thank the Scientific Peer Review Committee for their excellent peer review of the abstracts submitted to the CERF Virtual Conference June 2022. We report that any reviewer who declared a conflict of interest or who was an abstract author was recused from reviewing that abstract.

• Matthew Funk, DC, University of Bridgeport, College of Health Sciences, School of Chiropractic

• Bart Green, DC, MSEd, PhD, National University of Health Sciences, USA

• Adrian Hunnisett, MPhil, PhD, McTimoney College of Chiropractic, UK

• Fatima Ismail, MTech Chiro, University of Johannesburg, South Africa

• Claire Johnson, DC, MSEd, PhD, National University of Health Sciences, USA

• John Mrozek, DC, MEd, EdD, Texas Chiropractic College

• Niu Zhang, MD, MS, Palmer College of Chiropractic, Florida