How to Use OMM to Prep for COMLEX Level 2 PE

Unlike the COMLEX Level 1 & 2 exams, your Level 2 Performance Evaluation (PE) is a real-life simulation of what it is like to treat an actual patient. The PE evaluates two main domains: the Humanistic domain and the Biomedical/Biomechanical domain.

The Biomedical/Biomechanical domain is broken into three disciplines:

• Osteopathic Manipulative Medicine (OMM)
• Data gathering (history taking and physical exam)
• Documentation of patient encounter with a SOAP note

When concentrating on the OMM portion of the PE, it’s important to keep in mind the following five tips in mind.

5 THINGS TO KEEP IN MIND PREPARING FOR OMM ON PE

1. OMM SHOULD NOT BE PERFORMED ON ALL CASES

Using OMM on all cases in the Encounter would indicate to the evaluator that you are not sure when to use osteopathic manipulation.

Approximately 25 percent of your cases will require you to use OMM. You should expect any case involving a musculoskeletal complaint will involve OMM.

On the flip side, don’t be too hesitant in using OMM techniques. A common mistake is avoiding manipulation in the fear of causing further pain to the patient. For example, if a patient presents with a sprained ankle, it would be wrong to say that you could not manipulate before you have an x-ray for fear of causing more pain.

There are many OMM treatments you are able to administer to facilitate healing and reduce pain. If you fail to recognize this during your PE exam, you would receive a 0 out of 30 for that case.

Your performance on the OMM portions of the examination will be judged on 15 criteria, each ranging from a possible zero to two points. Zero points are given if no OMM is done at all, one point if OMM is done, but with hesitation, and two points if the treatment is done with proficiency.

2. HISTORY IS IMPORTANT

Always make sure to ask your patient if they’ve had this condition in the past. If they reply that they have had the same condition, ask them how it was treated. If it sounds like an OMM treatment was applied in the past, you should do the same, especially if it worked. Many times this is a dead-giveaway to use OMM treatment.

3. ALWAYS ASK FOR PERMISSION

If you feel osteopathic manipulation is an appropriate treatment, always explain carefully to the patient how you intend to treat them and ask them for permission to do so. This could save you time on your exam in that if manipulation is not expected, the patient may decline. Again, this is another indication that will help you avoid incorrectly using OMM during the encounter.

4. IMPORTANCE OF POSITIONING

Positioning in the administration of OMM is key, as is being deliberate. You will be critiqued on multiple positioning factors such as if you helped the patient change into the correct position, whether you put the patient in the correct position for the treatment that you selected and whether you are in the correct position to administer the treatment.

5. BE CONFIDENT AND DELIBERATE

It’s important you administer the treatment in a deliberate manner and with confidence. Be deliberate in the amount of pressure and repetitions you apply. Be confident and make sure not to stumble when you are administering the treatment. Failure to appear confident and deliberate in your training will result in a lower score.

To see examples of standardized patient encounters with OMM properly administered, and to learn more about how and when to use OMM during your Level 2 PE cases, check out COMBANK’s Level 2 PE Video Series.

COMBANK’s Level 2 PE Videos include 47 chapters to help you prepare for COMLEX Level 2 PE, led by Mark Kauffman, DO.