Relationships between the Comprehensive Osteopathic Medical Achievement Test (COMAT) subject examinations and the COMLEX-USA Level 2-Cognitive Evaluation.

CONTEXT: The relationship between the Comprehensive Osteopathic Medical Achievement Test (COMAT) series of subject examinations and the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Cognitive Evaluation (COMLEX-USA Level 2-CE) has not been thoroughly examined. OBJECTIVE: To investigate the factors associated with performance on COMAT subject examinations and how COMAT scores correlate with COMLEX-USA Level 2-CE scores. METHODS: We examined scores of participants from 2 COMAT examination cycles in 2011 and 2012. According to surveys, most schools used COMAT scores in clerkship and clinical rotation evaluation, which were classified as being used for "high-stakes" purposes. We matched first-attempt COMAT scores with first-attempt COMLEX-USA Level 2-CE scores, and we conducted correlation analyses between the scores from the 7 COMAT subject examinations, as well as between COMAT and COMLEX-USA Level 2-CE scores. Multiple linear regression analyses were performed to investigate how much variance in COMLEX-USA Level 2-CE scores was explained by COMAT scores. RESULTS: In 2011 and 2012, respectively, 3751 and 3786 COMAT candidates had COMLEX-USA Level 2-CE scores (53.0% and 93.9%, respectively, had ⩾1 high-stakes COMAT score). Intercorrelations between COMAT scores were low to moderate (r=0.27-0.53), as hypothesized. Correlations between COMAT and Level 2-CE scores were moderate to high, with the highest correlations for internal medicine COMAT scores (r=0.63-0.65). All regressions showed internal medicine scores as the strongest predictor of Level 2-CE performance. Groups with high-stakes scores had larger adjusted coefficients of determination than those with low-stakes scores (eg, R(2)=0.63 vs 0.52, respectively, in 2011). For 2012 candidates with high-stakes scores, all predictors were statistically significant. CONCLUSION: The COMAT subject examination scores were moderately intercorrelated, as hypothesized, with higher correlations between COMAT and COMLEX-USA Level 2-CE scores. The COMAT performance was predictive of COMLEX-USA Level 2-CE performance.

Relationship between COMLEX-USA scores and performance on the American Osteopathic Board of Emergency Medicine Part I certifying examination.

CONTEXT: Few studies have investigated how well scores from the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) series predict resident outcomes, such as performance on board certification examinations. OBJECTIVES: To determine how well COMLEX-USA predicts performance on the American Osteopathic Board of Emergency Medicine (AOBEM) Part I certification examination. METHODS: The target study population was first-time examinees who took AOBEM Part I in 2011 and 2012 with matched performances on COMLEX-USA Level 1, Level 2-Cognitive Evaluation (CE), and Level 3. Pearson correlations were computed between AOBEM Part I first-attempt scores and COMLEX-USA performances to measure the association between these examinations. Stepwise linear regression analysis was conducted to predict AOBEM Part I scores by the 3 COMLEX-USA scores. An independent t test was conducted to compare mean COMLEX-USA performances between candidates who passed and who failed AOBEM Part I, and a stepwise logistic regression analysis was used to predict the log-odds of passing AOBEM Part I on the basis of COMLEX-USA scores. RESULTS: Scores from AOBEM Part I had the highest correlation with COMLEX-USA Level 3 scores (.57) and slightly lower correlation with COMLEX-USA Level 2-CE scores (.53). The lowest correlation was between AOBEM Part I and COMLEX-USA Level 1 scores (.47). According to the stepwise regression model, COMLEX-USA Level 1 and Level 2-CE scores, which residency programs often use as selection criteria, together explained 30% of variance in AOBEM Part I scores. Adding Level 3 scores explained 37% of variance. The independent t test indicated that the 397 examinees passing AOBEM Part I performed significantly better than the 54 examinees failing AOBEM Part I in all 3 COMLEX-USA levels (P<.001 for all 3 levels). The logistic regression model showed that COMLEX-USA Level 1 and Level 3 scores predicted the log-odds of passing AOBEM Part I (P=.03 and P<.001, respectively). CONCLUSION: The present study empirically supported the predictive and discriminant validities of the COMLEX-USA series in relation to the AOBEM Part I certification examination. Although residency programs may use COMLEX-USA Level 1 and Level 2-CE scores as partial criteria in selecting residents, Level 3 scores, though typically not available at the time of application, are actually the most statistically related to performances on AOBEM Part I.

AOA's position against use of placebos for pain management in end-of-life care.

A number of organizations have advised against the use of placebo substitution, including the American Pain Society, Agency for Healthcare Policy and Research, World Health Organization, Healthcare Facilities Accreditation Program, Joint Commission on Accreditation of Healthcare Organizations, Education for Physicians on End-of-Life Care Project (cosponsored by the American Medical Association and The Robert Wood Johnson Foundation), American Nursing Association, and the American Society of Pain Management Nurses. This white paper describes the literature and rationale in support of the American Osteopathic Association's (AOA's) position on the controversial subject of the use of placebos for pain management in terminally ill patients.

Selection criteria for applicants in primary care osteopathic graduate medical education.

Program directors of American Osteopathic Association (AOA)-approved primary care graduate training programs were surveyed concerning the relative importance of 12 academic and 10 nonacademic performance-based variables related to trainee selection. Programs holding both AOA and Accreditation Council for Graduate Medical Education approval were also compared to programs holding only AOA approval. Results were compared to a previous osteopathic survey and to similar surveys among allopathic programs. Nonacademic variables remain among those most highly valued by directors, though a possible trend toward the academic variables was perceived. Implications for colleges of osteopathic medicine, program directors, and students are discussed.