Here is how a COM score is calculated.
In order to pass CSA, you must pass pre-defined performance standards set by medical experts in two separate components. The first component, called the Integrated Clinical Encounter (ICE), is a combination of the Data Gathering (DG) and Patient Note (PN) scores. The second component, Communication Skills (COM), is derived from the SP evaluations of interpersonal skills and spoken English language proficiency. You will have eleven patient encounters, ten of which will be used to derive your scores.
Scoring Components
Data Gathering (DG)
Using the history taking and physical examination checklists, the SP documents your ability in each station to gather data relevant to the clinical encounter. Your DG score for a particular encounter is the percentage of checklist items that you were given credit for in the history taking and physical examination. The SP does not evaluate your medical performance, but simply documents whether or not you successfully obtained relevant information or correctly performed the case-specific physical examination maneuvers. Your final DG score is the average of your DG scores over ten CSA encounters in the assessment form.
Patient Note (PN)
Following the encounter with the SP, you will be required to complete a patient note. Physicians are trained to rate these notes based on predefined criteria that include:
organization;
quality of information;
interpretation of data;
egregious/dangerous actions;
legibility.
Your final PN score is the average score you earned across the ten scored exercises.
Integrated Clinical Encounter (ICE) Score
The DG and PN scores are combined to form an ICE score. Your final DG and PN scores reflect your average performance across ten scored encounters. Therefore, you may compensate for poor performance in one encounter with excellent performance in another.
Communication Skills (COM)
Following each encounter the SP will also evaluate your COM skills along five dimensions:
interviewing;
counseling and delivering information;
rapport;
personal manner;
spoken English proficiency.
For each of these dimensions, the SP assigns a score. SPs make these evaluations according to a scoring system that is fair, consistent and objective. Your COM score for the encounter is the sum of the five COM dimension scores.
Over the ten scored encounters, the average of these COM scores makes up your final Communication score. Your score must meet or exceed a performance standard predefined by physician experts.
NB: UsmleSource has a unique form that allows you to calculate your COM score based on your patient interaction. This form is not available anywhere and is closest to the actual one used by Usmle
