Recommended standards for
online CE delivery.
A proposed reference framework for online chiropractic continuing education course delivery. Recommendations are distinct from existing Board requirements.
This TRACE-adapted reference framework is derived from Dr. Guy Annunziata’s earlier Gold Standard for Online CE Delivery and its Board-review overview. It concerns how individual online courses function, not clinical content review, provider accreditation or chiropractors' annual renewal-hour quotas. No recommendation on this page is automatically a legal requirement in every state. State Boards decide which safeguards to adopt, modify, replace or reject.
Three principles
Verification over assumption. Participation and completion should be demonstrated. Enforcement over suggestion. Platform safeguards should actually function rather than exist only in written policies. Auditability over opacity. Records should permit independent reconstruction of what occurred during a course.
1. Video participation
Verify learner engagement rather than counting passive playback. Suggested safeguards include randomized prompts or equivalent checks, a defined response window, enforced video progression, controls against credit for skipped or unattended playback, interruption of credit accrual when participation is not established, and auditable records of prompts and responses.
Original Gold Standard illustration: prompts every 8–15 minutes, a 30-second response window, and termination of an unresponsive session. These numerical values were proposed benchmarks, not universal Board mandates. The later Board-reference framework allows Boards to set frequency, timing and suitable alternatives.
2. Reading participation
Provide enough reading material and defensible engagement checks for the credit claimed. Options include reasonable word-count estimates, documented reading-speed assumptions, time-on-task or equivalent participation controls, enforced progression, and access/completion logs. The original proposed benchmark used approximately 180 words per minute; a Board may choose another evidence-based method.
3. Credit-hour and instructional-time integrity
Only qualifying instructional activity should count toward credit. Verify the runtime of video lessons, the instructional scope of reading courses, and combined time calculations for mixed formats. Do not permit premature certificate issuance, accelerated progress or inactive time to substitute for required course participation.
The proposed reference commonly uses 50 minutes of defensible instruction per CE hour, unless the applicable jurisdiction defines an alternative. The controlling requirement remains each Board’s actual rule.
4. Examination and assessment integrity
Assess comprehension rather than permitting trial-and-error passing. Suggested protections include course-relevant questions, a defensible passing score, exam access only after required learning activity, full rather than partial retakes, protection against disclosure of correct answers on failed attempts, question/answer randomization, and records of attempt duration, score and retakes.
The original proposal suggested 10 questions per CE hour and a 70% passing threshold, unless a Board sets other values. Expanded recommendations also discuss sufficiently large question banks, application-based questions, reasonable safeguards against copying or bulk extraction, and reducing AI-assisted answer harvesting. No online exam can be guaranteed AI-proof.
5. Learner identity verification
Provide reasonable assurance that credit is awarded to the person who completed the course. Suggested safeguards include unique accounts, strong authentication, two-factor authentication, appropriate license-number or government-ID checks when required, concurrent-login controls, secure reauthentication, and an auditable link between activity and the certificate holder. Boards determine proportional verification requirements and privacy protections.
6. Instructor communication
Identify the instructor or an appropriately qualified course-content contact. Provide a clear way to ask educational questions, reasonable response expectations, backup support, and documentation where needed. The original strict Gold Standard proposed a response within 48 hours; later guidance leaves the method and timing to the Board.
7. Audit trails, certificates and course-specific checks
Retain adequate records of enrollment, identity, login, content access, time, participation checks, exams, interruptions, remediation and certificate issuance, with privacy and retention limits defined by the Board. Certificates should issue only when the applicable completion conditions are actually met.
When independent verification is required, testing should examine each individual course from the learner's perspective. Testing a provider’s overall platform or checking one sample course does not necessarily establish that every course functions correctly. Material changes should trigger appropriate reevaluation.
Board flexibility and other oversight options
Boards may strengthen their own audits, require clearer technical controls and reporting, enforce existing rules, adopt or adjust benchmark safeguards, and use outside review. TRACE prefers course-specific independent third-party functional verification, but does not claim these are the only useful approaches. Existing PACE and Board approval are supplemented, not replaced.
The source documents used the name CDE and described a potential CDE verification role. TRACE is a separate independent research, education and policy initiative. It does not verify courses, accredit providers, qualify vendors or endorse an exclusive organization. These are recommendations for Board consideration, not an official approval standard or a guarantee of compliance.