Comsae Answer Key

[Riley Dyen]

Itwould be interesting to know whether time spent focusing on specific content in weaker disciplines leads to higher scores. However, this will require much more detailed information on student study habits, including their real (or perceived) discipline-based strengths and weaknesses. Student surveys, combined with a data sharing agreement between the NBOME and the COMs, would be needed to answer this question.

It is reasonable to postulate that preparation for a second medical licensing exam (e.g., USMLE Step 1) will improve performance on COMLEX-USA Level 1. While these two examinations have unique elements and designs, they do measure some overlapping constructs. This is one variable which addresses the relationship between total study time and examination performance. Perhaps students who dedicated double the time to prepare for COMLEX-USA Level 1 would do just as well as those who split their time studying for USMLE Step 1 and COMLEX-USA Level 1. Once again, more detailed information of study habits is needed to answer the question and further research is warranted.

Neither COMSAE nor COMLEX-USA Level 1 were designed to help faculty evaluate and improve instructional and assessment activities at their schools. While some information based on aggregate student performance could be helpful for this purpose, the primary purpose of these assessments is to provide students with a reasonably precise ability estimate, one that can be used for assessing readiness and preparing for licensure examinations (e.g., COMSAE) or for making reliable and defensible competency decisions in the pathway for licensure (e.g., COMLEX-USA Level 1). As a service to the COMs, the NBOME does provide aggregate performance data on an annual basis based on exam blueprint dimensions. While it may be possible to provide more detailed feedback, it is likely to be of questionable reliability, thus negating its value for identifying areas for curricular program improvement.

The answers to the questions posed by Sefcik and Petsche will require continued collaboration between the NBOME, the COMS, and various other organizations involved in the education, licensure, and certification of osteopathic students, graduates, and practicing physicians. The NBOME appreciates the contributions of all our colleagues who work to help to continuously improve the value of our assessments and provide information to learners and other stakeholders that is meaningful. Ultimately, our patients will benefit.

Author contributions: All authors provided substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; all authors drafted the article or revised it critically for important intellectual content; all authors gave final approval of the version of the article to be published; and all authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Competing interests: Drs. Sandella, Craig, Tsai, Fleury, and Clem are employees of the National Board of Osteopathic Medical Examiners and therefore have a financial stake in the success of the Comprehensive Medical Self-Assessment Examination.

COMLEX: Whew, it was a beast. I walked out of the test angry. I thought man, that was an OB/GYN shelf exam. After talking with a few people, I realized that I probably got alot of questions right and I was just focusing on the negative. Anyways some topics that I had on my test is below.

Microbiology: My test was very simple. Probably only had about 20 pure microbiology questions. Only remember 2 things on viruses. I would still study your brains out for microbiology as some people got hit HARD with micro.

Neurology: Super simple on my test. Cranial Nerve lesions. Some peoples tests were very heavy in neuro so be careful. I personally love neurology and was very upset to see only about 20 questions on it.

The correct answer is D. Myasthenia gravis (MG) is an autoimmune disease in which antibodies are directed against specific human body proteins It is characterized by fluctuating weakness of commonly used voluntary muscles, leading to the development of skeletal muscle weakness, ptosls, and difficulty in swallowing Physical activity exacerbates muscle weakness The primary pathologic effect of MG is a dramatic decrease in nicotinic acetyicholine receptors on the motor endplate where nerves form neuromuscular junctions with skeletal muscees It has recently been discovered that a second category of MG is due to autoantiboclies against MusK (muscle-specific kinase). which is a tyrosine kinase receptor required for the formation of the neuromuscular junction Antibodies against MuSK inhibit the signaling of MuSK normally induced by its nerve-derived ligand. agrin. The result isa decrease in patency ot the neuromuscular junction, and the consequent symptoms of MG. MG is improved with drugs that inhibit acetyicholinesterase and is worsened by medications that have anti-nicotinic side effects Gentamicin is an aminoglycoside antibiotic Aminoglycosides may have curare-like side effects, and therefore could potentially worsen the symptoms of MG.

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