Scoring Principles

Candidates’ history-taking and physical examination skills are documented by the Standardized (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:

Biomedical/Biomechanical Domain: Measures skills in data-gathering, osteopathic manipulative treatment (OMT) and documentation (e-SOAP Notes).

  1. The data-gathering component reflects skills in history-taking and physical examination.
  2. 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).

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