Langenau Erik E, Dowling Dennis J, Dyer Caitlin, Roberts William L
National Board of Osteopathic Medical Examiners, 101 W Elm St, Suite 150, Conshohocken, PA 19428-2004, USA.
J Am Osteopath Assoc. 2012 Aug;112(8):509-13.
As one of the key measures of clinical skills assessment, the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) is used to rate candidates' performance of osteopathic manipulative treatment (OMT).
To evaluate the frequency of specific OMT modalities used by COMLEX-USA Level 2-PE candidates and to report frequent use on the basis of clinical presentation.
With enhanced scoring procedures in place, OMT physician-examiners identified and documented specific OMT techniques that were performed by candidates at the 28 colleges of osteopathic medicine and branch campuses that had eligible students at that time. A frequency analysis for OMT techniques, according to clinical content axis, was applied to all candidates (N=4757) for the 2010-2011 testing cycle.
Students used a wide range of specific OMT techniques. Candidates performed 24,202 instances of specific OMT techniques, including 10,471 myofascial/soft tissue (43.3%), 3942 muscle energy (16.3%), 1676 sinus drainage (6.9%), 1476 inhibition (6.1%), 1221 fascial release (5.0%), 1171 rib raising (4.8%), 918 lymphatic (3.8%), and 866 counterstrain (3.6%). A few students (<0.01%) used high-velocity, low-amplitude (HVLA), a technique that is prohibited from use on the COMLEX-USA Level 2-PE because of the potential hazard of repeatedly treating a standardized patient with thrust technique to the same segment in a given day. Additional techniques included functional, facilitated positional release, balanced ligamentous tension, and visceral. Use of techniques also varied according to the clinical presentation of the standardized patient (ie, cardiovascular, respiratory, neuromusculoskeletal, gastrointestinal, or other) and chronicity (ie, acute or chronic).
Findings contributed to a better understanding of the types of OMT techniques being used by candidates taking COMLEX-USA Level 2-PE. Frequency of use of specific OMT modalities varied according to clinical case presentation.
作为临床技能评估的关键措施之一，美国综合整骨医学执照考试2级——实践评估（COMLEX - USA 2级 - PE）用于对考生的整骨手法治疗（OMT）表现进行评分。
评估COMLEX - USA 2级 - PE考生使用特定OMT方式的频率，并根据临床表现报告其常用方式。
在采用强化评分程序的情况下，OMT考官识别并记录了当时有符合条件学生的28所整骨医学院及其分校的考生所执行的特定OMT技术。针对2010 - 2011考试周期的所有考生（N = 4757），根据临床内容轴对OMT技术进行了频率分析。
学生们使用了广泛的特定OMT技术。考生共进行了24202次特定OMT技术操作，其中包括10471次肌筋膜/软组织操作（43.3%）、3942次肌肉能量技术操作（16.3%）、1676次鼻窦引流技术操作（6.9%）、1476次抑制技术操作（6.1%）、1221次筋膜松解技术操作（5.0%）、1171次肋骨提升技术操作（4.8%）、918次淋巴引流技术操作（3.8%）和866次对抗牵引技术操作（3.6%）。少数学生（<0.01%）使用了高速低幅（HVLA）技术，由于在给定日期对标准化患者同一节段反复进行推力技术治疗存在潜在风险，该技术在COMLEX - USA 2级 - PE中被禁止使用。其他技术包括功能技术、易化体位释放技术、平衡韧带张力技术和内脏技术。技术的使用也因标准化患者的临床表现（即心血管、呼吸、神经肌肉骨骼、胃肠道或其他）和病程（即急性或慢性）而异。
研究结果有助于更好地了解参加COMLEX - USA第2级 - PE考试的考生所使用的OMT技术类型。特定OMT方式的使用频率因临床病例表现而异。
