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Examination: Summary and Recommendation

Little Hover Commission 2004

Regulation of Acupuncture: A Complementary Therapy Framework


In choosing between the two examinations, policy-makers should consider the soundness of the testing instruments and whether they were appropriately developed from a valid occupational analysis. The tests also must be statistically valid and securely administered.

In this case, both examinations were found by independent statistical and psychometric analysis to be sound. However, California's more extensive technical documentation of the underlying exam factors was determined to be superior.53

Further, examinations must demonstrate that they adequately test for minimum levels of competency for safe practice. In this case, both examinations could benefit from improvements, for instance, through the use of must-pass questions and modules.

Specific to acupuncture, a practical way of demonstrating physical competency must be found. Tests for practical, hands-on point location and sterile needle practice could be re-examined. As of now, due to difficulties in agreement of appropriate locations and complexity of administration, neither exam includes a hands-on component.

Over and above each of these considerations, California must reserve the ability to shape the instrument according to California's policy goals. At this time, only the California exam meets this criteria.

Recommendation 4: The California Acupuncture Board should continue to control its examination to ensure that the State's policy goals are met.

Among the policy goals that the State should ensure:

  • Demonstrate knowledge of critical components of safe practice. "Must-pass" modules should be required for areas of particular concern, including herb-drug interactions, exclusive use of single-use disposable needles, additional infection control measures, understanding of emerging infectious diseases, "red flag" conditions, first aid procedures and knowing when and how to refer to physicians.
  • Competitive examination administration. The board should continue to contract out for the secure administration of the California-designed and controlled examination.
  • Develop strategy for implementing internship. This time-tested strategy for proving the practical skills necessary to be successful in many health professions should replace the discontinued practical portion of the examination.



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