Online vs in-person delivery of preclinical coursework: A retrospective cohort study evaluating National Board of Chiropractic Examiners performance

Objective: 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. Methods: 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. Results: 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. Conclusion: 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.