Outcome of I-Human case study of Alvin Stafford
Question description
Do you have previous outcomes of the case study done on Alvin Stafford in i-human.
Alvin Stafford V4 PC (Basic DDx) 63 years 5′ 11″142 pounds Alvin Stafford Chief complaint: Worsening shortness of breath Start Your session will be saved automatically as you proceed through the case.
Instructions:
Below is the breakdown of the grading rubric for this Basic DDX case: Note you will be allowed to push the Interview Progress Button and receive feedback on your history questions up to 10 times.
a) % required history questions you asked (30% of grade)
b) % required physical exam performed (30% of grade)
c) differential diagnoses list (10%)
d) differential diagnoses ranking (10%)
e) differential diagnoses ranking MNM (5%)
f) tests ordered (5%)g) science exercises (10%)
NOTE: Your score is based on a 10-point scale.
Example: If your score is 90%; then it equals 9/10.****
Outcome of I-Human case study of Alvin Stafford HELPFUL HINTS ****
The Avatars and cases in the IHP case library are based on “real patients” and as such may at times provide minor incongruent information.
As an example, an Avatar may claim to have a “rash” but the skin lesions are not, by medical definition, a rash. Avatars may refuse to answer questions, just like real patients. Phrasing of questions IS important. Asking a “similar” question that is less specific may not be scored correct if it does not provide the clarity of information needed to narrow the differential.
Our recommendation is to pretend this is a real clinical patient encounter and select a time so you can enjoy the process and not feel pressured for time. Remember, you are not scored on whether you get the correct diagnosis, but rather have you mastered the process. Mastery of the process will help you avoid making diagnostic errors throughout your clinical career.
Detailed Instructions Below:
|1. Take the patient’s history.
Start by determining why the patient is here to see you. During the interview process, try to determine the severity of illness and whether hospitalization is a possibility, if so, a more complete history is frequently warranted.
TIPS: Always check to see if you have a prior record; use the file folder system (if available) to assist in finding the questions you want to ask; don’t forget to look under body systems for ROS questions; always ask the questions you missed when compared to the expert as the additional information will assist you develop a more complete differential diagnosis list. Document the chief complaint Document any abnormal history or complaints on your problem list The Interview Progress Button can be used up to 10 times to give you feedback on how close you are to asking all the authors “required questions”.
2. Proceed to perform a PHYSICAL EXAM. Assess vital signs and perform the examination appropriate for the type of case identified by the above history. Remember the comprehensive cases require a comprehensive physical. Document abnormal findings in your problem list.
3. Document abnormal history and physical findings on your problem list.
4. Write a concise problem statement.
Start with a demographic description of your patient and the chief complaint and most significant active problem (MSAP). Try to keep your problem statement below 100 words. Although this will not count towards your final case score, it will allow you to practice learning to communicate patient information in a complete and concise fashion.
5. Complete your differential diagnosis list.
You may start your differential diagnosis during the history taking section, but after completing the problem statement, reflect and finalize your differential diagnosis list. Remember, this part of the case will be scored on how comprehensive this list is. You will not lose points for having too many, points are lost only if you have too few. The average list contains between 4-8 diagnoses depending to the symptoms.
6. Rank your differential diagnosis list Select your leading diagnosis (most likely just one) and then rank the others on the list as alternative diagnoses.
Review each diagnosis and determine whether its acuity is such that it should be marked as Mnm (must not miss). These diagnoses are loosely defined as diagnoses that if missed can result in patient morbidity or mortality in the short term.
7.Order each test and link it to a diagnosis. Some tests are ordered to “rule in” a diagnosis while others are ordered to “rule out” a diagnosis. Remember, some diagnoses do not have any definitive test.
8. Review the test results.
9. Select your final diagnosis.
10. Write a SOAP note in the space provided for a treatment plan.
DO NOT try to scam the system by just clicking on everything.
The software tracks not only what is done, but also keeps track of the order of completion. Clicking on the first opening question and then just going down the list of questions in the history is viewed as “scamming” the system and can result in a score of ZERO—same principle applies to each section.
The time for completion of the case, as well as time spent in each section of the case is also recorded. This data has been shown to correlate with case performance. Very short times have lower scores as do very long times.
The former is most likely due to lack of effort while the latter may be because the user is receiving multiple interruptions. The low score then most likely reflects “lack of continuity” of thought. Try to set aside enough time to complete the case in its entirety in a single sitting.
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