NBCE Part IV study plan

Build a written intake checklist that sequences history-of-present-illness questions before past-medical, family, and social history items

Write out 15 red-flag findings (e.g., progressive neurological deficit, unexplained weight loss, night pain, bowel/bladder change) and the immediate action each one triggers

Rehearse and record a 10-minute patient interview, then score your own recording against a 12-point rubric covering open-ended questioning, empathy statements, and summation

List the standard components of a regional physical exam (inspection, palpation, range of motion, orthopedic provocation, vascular) for cervical, thoracic, lumbar, and extremity regions

Practice 20 minutes of vital-sign and anthropometric measurement technique, narrating each step aloud as you would to a patient

Demonstrate and self-check 12 orthopedic special tests, stating the structure tested, the positive finding, and the common false-positive source for each

Map the dermatome, myotome, and deep tendon reflex level for C5 through S1 onto a blank body diagram from memory

Perform and describe a full cranial nerve screen (I-XII) with the specific instruction given to the patient at each step

Differentiate upper versus lower motor neuron findings by writing a comparison table with at least six distinguishing signs

Sequence a neurological screening exam for a new patient in under 8 minutes and time yourself twice

Classify 20 named chiropractic adjustive techniques by their contact point, line of drive, and intended tissue, written from memory

Explain the biomechanical rationale for a prone thoracic move and a supine cervical move, including patient positioning and set-up steps

List absolute and relative contraindications to high-velocity low-amplitude adjustment and match each to a clinical scenario

Write a three-sentence informed-consent script that names the technique, expected sensation, and material risks

Describe the appropriate use of non-manual and low-force approaches for a patient who cannot receive HVLA, with two concrete examples

Systematize a reading order for a plain film series (alignment, bone, cartilage/joint space, soft tissue) and apply it to five practice descriptions

Identify and describe the standard radiographic lines and measurements used in cervical and lumbar spine evaluation

State the accepted patient positioning, central ray, and film criteria for cervical, thoracic, lumbar, and extremity views

Distinguish when advanced imaging is indicated from when plain film or conservative care suffices, using at least six clinical triggers

Explain radiation-protection principles (ALARA, collimation, shielding) in terms a patient would understand

Draft a complete SOAP note from a practice case that links each subjective finding to a documented objective finding and a stated diagnosis

Construct a differential list of at least five conditions for three practice presentations, ranked with the reasoning for each rank

Write three referral letters (one to a specialist, one for imaging, one for co-management) that state the question being asked

Script a difficult conversation delivering a diagnosis with a poor prognosis, using plain language and a teach-back check

Outline the documentation and reporting obligations that apply when a patient discloses a reportable condition

Run three full patient encounters end to end (history through neuro screen) and log decision points where findings changed your working diagnosis

Retest the 12 orthopedic special tests from week 2 and note which you performed incorrectly or hesitantly

Re-time the neurological screen and compare against week 2, targeting a consistent sub-8-minute routine

Rebuild the intake sheet to add any screening question you missed during the three encounters

Re-drill the technique matrix from week 3, correcting any contact or line-of-drive entries you could not recall unaided

Re-read the five practice films from week 4 and rewrite each impression without looking at your first attempt

Isolate your two weakest subareas across all six domains and build a targeted 90-minute drill for each

Convert every missed fact from weeks 1-6 into a single spaced-repetition deck

Sit two full-length timed practice exams under test-day conditions and record the score for each domain separately

Review every missed item and write the underlying rule, not just the correct answer

Rehearse the timed patient-interview and physical-exam station five times, with self-scoring after each run

Finalize a one-page test-day checklist covering timing, station order, and reset routine between stations