Candidates’ history-taking and physical examination skills are documented by the SP portraying the patient immediately following the encounter, as are doctor-patient communication, interpersonal skills, and professionalism. Completed e-SOAP Notes and OMT skills (via a secured electronic recording process) are rated by NBOME trained and approved osteopathic physician examiners.
Pass or fail results are reported as the overall examination outcome reflecting the osteopathic medical profession standard for undergraduate students preparing for graduation and also for each of the two examination domains.
Humanistic Domain: Measures skills in doctor-patient communication, interpersonal skills, and professionalism. Assessed skills within this domain include:
- Eliciting information
- Listening skills
- Giving information
Biomedical/Biomechanical Domain: Measures skills in data-gathering, osteopathic manipulative treatment (OMT) and documentation (e-SOAP Notes).
- The data-gathering component reflects skills in history-taking and physical examination.
- The OMT portion represents performance in osteopathic assessment and manipulative treatment in select cases. The following areas are assessed globally for OMT:
- Osteopathic examination/evaluation
- Patient/physician position for treatment
- OMT modality selected
- OMT technique
- Treatment repetition/duration
- Post-treatment assessment
The completed e-SOAP Note measures communication (synthesizing information gathered in the clinical encounter), clinical problem-solving and integrated differential diagnosis and formulation of a therapeutic plan. Osteopathic principles are incorporated into each of the three areas.
In order to receive a pass outcome for the overall examination, a candidate must pass both domains.
Within the examination, since performance is assessed on several case encounters, weak performance in an encountered case can be compensated with stronger performance in another case encounter. Similarly, within domains a candidate can compensate for weaker performance on content areas of assessed clinical skills with stronger performance in other content areas (e.g. strong OMT skills can compensate for weak data gathering performance).
- All candidates who receive a fail for either domain are provided relative qualitative feedback performance for each domain, as well as for each assessed component within the Biomedical/Biomechanical domain. The purpose of this feedback is intended to assist with remediation received from the student’s osteopathic medical school or program.
- Performance feedback provided on the report represents the only feedback that can be provided to the candidate who fails a high-stakes national examination. The reason for this is due to the generality of test blueprint content across the educational spectrum not content specific to individualized training received from a medical school or program. The NBOME will not reassess encounters or components by videotape or review case-specific or general deficiencies with candidates.
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