Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE)

COMSAE BULLETIN OF INFORMATION

• Introduction
• Content
• Format
• Timing Modes and Access Period
• Reporting
• Sample Test and Sample Report
• Security, Conditions, and Disclaimer
• Initial Purchasing and Re-Entering the Test
• Minimum Technical Requirements

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This document was last updated March 20, 2008.

Introduction

There has been strong interest in measurement tools for osteopathic medical students at various educational stages to self-assess their understanding of osteopathic medicine. The National Board of Osteopathic Medical Examiners (NBOME) developed the Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) series to serve this need for self-assessment for osteopathic medical students.

COMSAE consists of three examinations. COMSAE Phase 1 emphasizes scientific understanding of osteopathic medicine. It is most appropriate for second-year osteopathic students. COMSAE Phase 2 emphasizes the concepts and principles necessary for making appropriate medical diagnoses. It is most appropriate for fourth-year osteopathic students. COMSAE Phase 3 emphasizes the concepts and principles necessary for making appropriate patient management decisions. It is most appropriate for osteopathic interns or residents.

The NBOME will launch COMSAE by stages. Phase 1 will be launched in March or early April of 2008. Phase 2 will be launched in May or June of 2008. Phase 3 will be launched in September or October of 2008. At the time each Phase is launched, it will have only one form. By the end of 2008, Phase 1 will have two forms. By late 2009, all Phases will have at least two forms.

The content of COMSAE is similar to that of the Comprehensive Osteopathic Medical Licensing Examinations (COMLEX). The test questions have the same format and style as that of COMLEX. In fact, many questions in COMSAE are retired COMLEX questionsCOMSAE results are reported in a format similar to that of COMLEX results. Because of these features, osteopathic students may find COMSAE examinations to be useful for becomingfamiliar with COMLEX content and format before actually taking COMLEX examinations.

COMSAE is Internet-delivered, making it convenient for busy osteopathic medical students and residents. Any osteopathic student or resident with an established Internet account with the NBOME can take the examinations at any time from any place using a computer with Internet access. Examinees do not need to complete an entire test in a single sitting. Within a defined time period an examinee can start a test session, stop the session, and come back later to continue taking the test. COMSAE has two timing modes: matching-timed and self-timed. An examinee can choose a timing mode based on his/her purpose and individual situation. The feedback of COMSAE is immediate. As soon as the examination is finished, an examinee will be able to print test results instantly from the computer.

COMSAE development is independent from specific osteopathic medical schools and osteopathic medical specialty colleges. Therefore, it is possible that COMSAE does not reflect what a specific osteopathic school or specialty emphasizes, and the results may not be consistent with the results of other assessments of osteopathic medicine.

Furthermore, although COMSAE closely resembles COMLEX, it is not intended to be a mini-COMLEX. The results of COMSAE should not be considered as a close predictor of future results on COMLEX.

Content

COMSAE Phase 1

The content of Phase 1 is defined by the same nine categories as the COMLEX Dimension 1 topics.  Detailed content categories can be found in the Bulletin of Information for COMLEX at www.nbome.org.  Most questions have clinical presentations.  Similar to COMLEX Level 1, the emphasis of Phase 1 is scientific understanding of the mechanisms of these clinical situations.

COMSAE Phase 2

The content of Phase 2 is defined by the same nine categories as the COMLEX Dimension 1 topics.  Detailed content categories can be found in the Bulletin of Information for COMLEX at www.nbome.org.  Similar to COMLEX Level 2, the emphasis of Phase 2 is making appropriate diagnoses for various clinical problems.  Management and prevention of these problems are also important considerations in Phase 2.

COMSAE Phase 3

The content of Phase 3 is defined by the same nine categories as the COMLEX Dimension 1 topics.  Detailed content categories can be found in the Bulletin of Information for COMLEX at www.nbome.org.  Similar to COMLEX Level 3, the emphasis of Phase 3 is making appropriate management decisions.  Diagnosis and prevention of these problems are also important considerations in Phase 3.

Format

Each Phase of COMSAE has 200 items, divided into four sections. All items are multiple-choice items that are grouped by item type within each section. Stand-alone items appear first, followed by items clustered in cases. Matching items, when present, are in the last section. Some items may have medical images as attachments. Sections are not based on content; all items are randomly assigned to sections.

Timing Modes and Access Period

Timing Modes

All Phases of COMSAE have two timing modes: Timed and Self-Paced. Examinees must choose one of the modes before launching a test. Once examinees select one of the two timing modes, it cannot be changed.

The Timed mode does not have time limit for each section.  It allows a maximum of 240 minutes to complete the entire examination within the Access Period.  The time allocation in the timing mode is similar to the suggested timing for COMLEX.  The Self-Paced mode allows examinees up to 90 days to complete the entire test with no time limit for each section.  If an examinee wants to take COMSAE in conditions as close to the conditions of COMLEX as possible, the Self-Paced mode should be avoided.

Access Period

After an examinee purchases any Phase of COMSAE, a maximum of 90 days is allowed to complete the test.  Within the 90 days, the test can be started at any time.  Once started, the test can be discontinued at any point.  If the examinee does not finish the test in one sitting, he/she can come back to continue the test any time within the three-month period.  When examinee comes back to the test, the test will start at the place it was last stopped.  Ninety (90) days from the date of the first purchase of a particular Phase, if the test has not been completed, the examinee will not be allowed to resume the test.  COMSAE will not generate a score report or any feedback for an incomplete test.

Reporting

The COMSAE report consists of a three-digit numerical score for the total test and a graphic presentation of performance by content area. The total score for each Phase is scaled to have a mean of 500 and a standard deviation of 80 for Phase 1, 85 for Phase 2, and 120 for Phase 3. COMSAE does not involve a numerical minimum passing score. Instead, based on standard scores, it provides the following four suggested performance levels:

STANDARD SCORE	PERFORMANCE LEVEL
Lower than 350	Poor Performance
351 – 450	Borderline Performance
451 – 550	Acceptable Performance
Higher than 550	Good Performance

One advantage of COMSAE is that it provides a graphic performance profile for three groups of content areas: nine COMLEX Dimension 1 topics, six COMLEX Dimension 2 topics, and six to seven medical disciplines. Performances level for each topic in these content areas is reported according to the mechanism described in the above table.

The NBOME strongly encourages examinees to take full advantage of the detailed COMSAE reports. An examinee should spend time studying his/her performance profile to diagnose his/her strengths and weaknesses.

When using the performance profile to assess strengths and weaknesses, examinees should be aware that the accuracy of performance categories on specific content areas is limited since the number of items in some content areas is relatively small. Therefore, it is possible that apparent patterns of subtest scores do not precisely match with the numerical score for the total test.

Sample Test and Sample Results

A sample COMSAE examination will be available in April at http://www.nbome.org/comsae/samples.html. The sample test contains a small number of items and provides a tool that looks and feels like an actual COMSAE examination. A sample COMSAE report will also be provided at http://www.nbome.org/comsae/samples.html.

Security, Conditions, and Disclaimer

COMSAE is a testing system only available for osteopathic medical students. An examinee must accept the confidentiality requirements and other conditions and disclaimers before purchasing the test. Once an examinee agrees the terms and completes the purchasing process, the exam fees will not be refundable. The NBOME strongly suggest examinees go to http://www.nbome.org/comsae/disclaimer.html to read the details of the Security, Conditions, and Disclaimers before purchasing the tests.

Initial Purchasing and Re-Entering the Test

Initial Purchasing

LOGIN – In order to maintain the security and confidentiality of our COMSAE environment, only individuals with an active NBOME ID may access the COMSAE exam. You will be presented with a standard login screen and be asked to enter your NBOME ID and password. If you do not know your password, or are not sure if you have an account, links will be available to request assistance.

PURCHASE – Upon logging in and prior to purchasing an exam you will be required to agree to terms of security, conditions, and disclaimers related to COMSAE. Please read this document carefully before agreeing. After you have agreed to the terms of security, conditions, and disclaimers for COMSAE, payment for exams will be accepted via most major credit cards. Your credit transaction will be approved immediately, and you will then be given access to the COMSAE servers Your payment is not refundable after it is accepted.

SERVER ACCESS – Immediately following credit card approval, you will receive on-screen a one-time use purchase code. You will be required to input this code into the COMSAE test servers. A link to the test servers will also be available on-screen after purchase, along with more detailed instructions how to use it. If a valid email address is on file, you will also receive an email with this information.

Accessing Purchased Exams

LOGIN – The first time you purchase an exam, you will be asked to enter your email and choose a password that is specifically for use with the COMSAE servers. This password is separate and distinct from your NBOME ID password, and should not be confused with it. When you return to the site to continue your exam or after purchasing new exams, you will want to use the email and password you supplied here to proceed. You may want to bookmark this first page in order to expedite access later.

PURCHASE CODE – The first time you attempt to access a purchased exam, you will need to enter the purchase code provided to you as detailed above. This seven digit code is only required the very first time you access it, and can be discarded after you gain access to the exam environment.

TEST – All testing options and scores are accessible via the COMSAE servers and your account entered there. You will be able to view your performance, pause, restart exams in process, and review, and print past COMSAE results and scores. Help and support links and telephone numbers specifically for the COMSAE will be available here.

Minimum Technical Requirements

Requirement	Windows	Macintosh
Supported Browser	Microsoft Internet Explorer 5.5 or higher	Apple Safari 1.2 or higher
Operating System	Windows Vista, XP or Windows 2000	Mac OS X 10.4 or Mac OS X 10.3
Processor	233 MHZ or higher: Intel Pentium/Celeron family, or AMD K6/Athlon/Duron family, or compatible processor recommended.	Power PC G3, G4, or G5 processor
RAM	128 MB or higher	256 MB or higher
Display	17" display at 1024x768 with 16-bit color or higher	17" display at 1024x768 with 16-bit color or higher
Internet Connection	Broadband connection or higher	Broadband connection or higher