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Related Experiment Video

Updated: May 30, 2026

Evaluating Tests of Cognition using a Computerized Touch-Sensitive Tablet, Eye Tracking, and Functional Magnetic Resonance Imaging

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Competency-based classification of COMLEX-USA cognitive examination test items.

Erik Langenau¹, Gina Pugliano, William Roberts

¹National Board of Osteopathic Medical Examiners, National Center for Clinical Skills Testing, NBOME, Conshohocken, PA 19428-2004, USA. elangenau@nbome.org

The Journal of the American Osteopathic Association

|July 21, 2011

Summary

This summary is machine-generated.

The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) assesses osteopathic competencies. While patient care and medical knowledge are most frequent, other competencies increase across the exam series.

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Area of Science:

Osteopathic medical education assessment
Competency-based medical education

Background:

The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) assesses osteopathic medical knowledge through progressive cognitive examinations.
The Fundamental Osteopathic Medical Competencies (FOMC) document outlines essential competencies for osteopathic practice.

Purpose of the Study:

To evaluate how well current COMLEX-USA cognitive examination items assess the competencies outlined in the FOMC document.
To measure the distribution and extent of competency assessment within the COMLEX-USA series.

Main Methods:

Eight medical education panelists reviewed 1046 multiple-choice items from COMLEX-USA Level 1, Level 2-CE, and Level 3 (2008-2009).
Panelists individually classified each item according to the 6 fundamental osteopathic medical competencies.

Main Results:

Most items assessed patient care (40%) and medical knowledge (51%), identified as easiest to assess.
Medical knowledge item frequency decreased across the COMLEX-USA series (69% to 40%).
Items assessing interpersonal/communication skills, systems-based practice, practice-based learning, and professionalism increased progressively.

Conclusions:

Current COMLEX-USA examinations assess all 6 fundamental osteopathic medical competencies to varying degrees.
Findings suggest areas for enhancing existing assessments and developing new tools for competency evaluation.