Overview of Enhanced Test Items for COMBANK 2019

At COMBANK we understand the need to have the highest quality content possible. Items that precisely match the format of the exam, plus memorable rationale that explain difficult concepts well are what differentiate a high-quality bank from one that is not-so-high quality.

One key to ensuring the best content possible is listening to your feedback. Because COMBANK is heavily used by osteopathic medical students, we get lots of feedback, and we use it to make adjustments and improve our bank. Additionally, our team of physician authors and editors have their finger on the pulse of osteopathic medical education; we are on top of the exam and how it is changing.

Here are some key initiatives that have been the focus of our content efforts over the past year, based on student feedback, faculty feedback, and our own research.

1. COMLEX stems have gotten longer over the past couple years, and we expect that trend to continue. Additionally, vital signs and lab values are now typically included as tables in the stem. We’ve adjusted our stem length and format to precisely match what you are going to see on this year’s COMLEX. This is especially important for timing reasons — in order to properly pace yourself during the exam, you should practice using questions that are the same length and complexity. If you practice with questions that are too short, you may find yourself running out of time on the actual exam.
   Concerning normal lab values, also known as reference ranges, they are now included directly in the COMLEX stem. There is no longer a lab document attached to the question that you have to open and search to find your normal values. This is good news, as it will save you time and aggravation during the exam to not have to open and sift through a labs document. We have adjusted COMBANK to match the new COMLEX format.
2. We have increased the number of difficult 2nd and 3rd order questions. A “2nd order” question is one that takes two steps to answer, and a “3rd order” question takes three steps. For example, a 2nd order question may ask. “Which of the following best describes the pathogenesis of the patient’s disease?” The first step of the question would require you to make a diagnosis, and then the second step is to answer the actual question concerning the pathophysiology. These 2nd and 3rd order questions are often how the exam authors introduce difficulty into the exam. COMLEX is not getting any easier, and we have adjusted accordingly.
3. We have introduced bolding of keywords. This is a subtle feature addition, but one we think you’ll appreciate. In answer explanations, you’ll find the correct answer option bolded, and then the primary topic of the question also bolded. This will help orient yourself in the explanation and help with quick review.
4. We have increased the number of tables, photos, and illustrations in the rationale. Many of us are visual learners, thus we have increased the amount of visual material in our rationale. This also means less wordy explanations and explanations that are more memorable.
5. We have improved explanations for the distractors. We understand the need to understand why each distractor is incorrect. What was the thought process that goes into eliminating this distractor? We have worked on improving the explanations of our distractors, making it clear why each incorrect choice is not the best choice.
6. We are very excited to announce that we have added First Aid references to our COMLEX Level 1 bank for the first time ever. References to the 2019 edition of the book are included at the end of the reference list. We include the most relevant page number first, then additional page numbers that are related to the topic follow.
7. Note: OMM is not a part of First Aid so don’t expect to see First Aid references for OMM! Also, musculoskeletal questions are not as well represented on USMLE as they are on COMLEX so expect to see a handful of MSK questions in our bank that you won’t find in a USMLE-focused bank or book.

Rest assured, we’ve got you covered at COMBANK.