Applying structural equation modeling to Canadian Chiropractic Examining Board measures

The purpose of this research project was to determine if structural equation modeling (SEM) can be successfully applied to the Canadian Chiropractic Examining Board (CCEB) measures to explore the inferential nature of the "causal" relationship between academic ability and success on the CCEB examinations; specifically the ability to make correct clinical decisions. As this was a time-series study (pre-chiropractic grade-point-average to licensure examination data), a latent variable path analysis was the SEM method of choice. The Comparative Fit Index for the model to data fit was 0.98. Inferences include: 1) the need to recruit students with strong academic abilities, 2) the need to hold back students who have not achieved a high level of understanding of the first two-years of work at chiropractic college, and 3) that the CCEB extended-matching, long-format questions are a better estimate of clinical reasoning ability than 5-option short-format questions or the OSCE.