COMAT Clinical – Osteopathic Principles & Practice

Content Outline and Assessment Objectives

The exam blueprint below contains Osteopathic Principles and Practice topics related to concept & philosophy, diagnosis, and treatment methods.

Selected Specific Learner-Centered Objectives for Osteopathic Principles and Practice

For Osteopathic Principles and Practice, the examinee will be required to demonstrate the ability to diagnose and manage selected patient presentations and clinical situations involving, but not limited to:

1. Osteopathic concept and philosophy: osteopathic tenets, musculoskeletal structure and function, somatic nerve structure, and lymphatic drainage
2. Osteopathic diagnosis: observation, palpation, and range-of-motion testing of the lower/upper extremities, cervical/thoracic/lumbar spine, pelvis/sacrum, head, abdomen, and ribs
3. Osteopathic treatment methods: counterstrain, muscle energy, myofascial release, high velocity low amplitude (HVLA), soft tissue, lymphatic technique, cranial osteopathic manipulative medicine, articulatory techniques, balanced ligamentous tension, ligamentous articular strain, facilitated positional release, Still technique, visceral technique, Chapman reflexes, and trigger points

Throughout these three categories, examinees will be required to demonstrate the ability to:

1. Discuss the basic principles of the osteopathic philosophy and describe the impact on the health care delivery of osteopathic physicians.
2. Discuss the scientific knowledge supporting the utilization of osteopathic principles and practices and osteopathic manipulative treatment (OMT), including the basic science of the mechanisms of OMT and somatic dysfunction, and the current evidence base for the clinical application of OMT.
3. Define the types of physical examination findings consistent with somatic dysfunction.
4. Define and describe the types of somatic dysfunction found within the ten body regions, including the head, cervical, thoracic, rib, lumbar, pelvic, sacral, abdominal, upper extremity and lower extremity body regions.
5. Describe the symptoms and physical findings consistent with viscerosomatic, somatovisceral and somatosomatic reflexes.
6. Define and describe indirect and direct types of OMT, including articulatory, balanced ligamentous tension, counterstrain, cranial osteopathic manipulative medicine, muscle energy, high velocity low amplitude (HVLA), visceral, lymphatic, exercise therapy, soft tissue and myofascial release techniques.
7. Describe the basic principles of treatment of functional technique, facilitated positional release, ligamentous articular strain and Still techniques.
8. Discuss the indications and contraindications of different types of OMT.
9. Discuss the relative value, advantages and disadvantages of different types of OMT.
10. Correctly diagnose somatic dysfunction within the ten body regions, prioritize a differential diagnosis and develop an appropriate care plan.
11. Effectively communicate with patients and their families regarding risks, benefits and alternatives associated with the use of OMT.
12. Maintain the safety and dignity of the patient while administering OMT.
13. Identify viscerosomatic relationships and the role of the musculoskeletal system in health and disease by performing a structural examination and documenting findings reflective of this relationship.
14. Show sensitivity to ethnic diversity as it may impact on the presentation of somatic and/or visceral dysfunctions.

Selected Student and Faculty Learning Resources for Osteopathic Principles and Practice

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Osteopathic Principles and Practice exam are listed below:

• American Association of Colleges of Osteopathic Medicine (AACOM) – Educational Council on Osteopathic Principles (ECOP)