May 30, | nursing, med, NURS, Paper
iHuman Patients Guide
iHuman Patients Guide
i-Human Patients Case Player Student Manual
Table of Contents
1. Student introduction to the i-Human Patients Case Player 3–6
a. History-taking and physical examination
b. Problem list
c. Problem statement
d. Creating a differential diagnosis
e. Plan
f. Summary
g. References
h. Customized case flow and instructions
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2. Getting started 7–9
a. Login instructions
b. Watching videos
c. How to find an assigned case
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i-Human Patients, Inc. Page 3
1. Student Introduction to the i-Human Patients Case Player
The i-Human Patients (IHP) Case Player is an Internet (cloud) application which enables students to
interact with virtual patients for the purpose of learning patient-assessment and diagnostic-reasoning
skills. With IHP, you will be able to independently interview, examine, diagnose, and treat virtual
patients and receive expert feedback on your performance iHuman Patients Guide.
The program is designed to help you achieve the following goals:
Learn how to assess a patient, to ask the right questions and perform the right physical exams
for the patient’s problem, and to identify and organize pertinent findings.
Learn a structured diagnostic-reasoning process, write a concise problem statement, select
and rank hypotheses (differential diagnoses), and order and interpret tests.
Develop a treatment/management plan.
Learn basic-science concepts that underlie the clinical aspects of the case.
Within each major section of the case you will be able to compare your work with the expert’s version.
History-taking and physical examination
Most clinical interactions begin with taking the patient’s history, a process that should be systematic
and complete. IHP will help you to develop question efficiency: that is, to limit your questions to those
that are appropriate for the patient’s chief complaint, associated symptoms, and pertinent past
medical history. The patient’s history is the subjective portion of the assessment. It reflects the
patient’s self-assessment and memory of events.
The physical examination is the next component of the patient evaluation. You will select and perform
various exams, as driven by the history of the present illness and any supportive information.
Again, while it is important to be comprehensive, your goal is to perform a targeted and efficient
physical examination by selecting only those exam components relevant to, and otherwise suggested
by, the patient’s presentation iHuman Patients Guide. The physical examination is the objective portion of the assessment:
Your findings should be measurable, accurate, and reproducible.
Throughout the process of conducting the history and physical exam, you should add any/all pertinent
findings to the problem list located along the left-hand side of the screen. The problem list can be
updated at any time as you proceed through these sections.
You can achieve greater efficiency in conducting the history and physical examination by developing
the differential diagnosis as you go. The questions you pose to the patient and the exam components
that you select will, in turn, help to further characterize and refine the differential diagnosis.
Problem list
The problem list is located vertically along the left-hand side of the screen. You will add key findings to
the list as you progress through the history and physical sections of the case.
Each entry should have no more than five words. You should attempt to translate the findings into
more precise medical terminology. Here are some examples:
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Patient says Translation
Came on suddenly last night……………… Acute onset
It comes and goes………………… Episodic; recurrent
The pain is 9/10……………… Severe pain
Red blood in my stool……………… Hematochezia
Shortness of breath while lying flat……………… Orthopnea
Physical examination Translation
Swollen legs…………… Edema
Red…………………………………… Erythematous
Sleepy and slow to respond……………… Lethargic
Slurring words……………… Dysarthric
Seeing things……………… Visual hallucinations
The problem list should include all key findings (abnormalities) throughout the entire history-gathering
process:
Chief complaint
History of current illness, including all associated symptoms
Review of systems
Past medical history
Family history
Social history
The iHuman Patients Guide problem list should also be inclusive of all key findings (abnormalities) throughout all aspects of
the physical examination:
Vital signs
Mental status
General exam
Pertinent negatives, while clinically important, should not be listed on the problem list. They may be
entered in the Notes Section for your own review and planning purposes.
Each entry on the problem list is then ranked relative to the specific patient’s presentation:
Most significant active problem (MSAP)
Related
Unrelated
Unknown
PMH/Resolved
Problem statement
The problem statement is a succinct paragraph that synthesizes the following:
Patient identifiers; i.e., age, gender, race/ethnicity (if pertinent), critical PMH
Example: The patient, a 74-year-old black male with known coronary artery disease, presents
with . . .
Presenting complaint/s
Key findings translated into medical terminology
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The problem statement should be concise and complete, but not a simple restatement of the problem
list. Rather, key findings should be consolidated if they relate to the same problem or potential
diagnosis. For example, chest pain, shortness of breath, and smoking history might all be addressed
in the same sentence.
The number of words allowed in the problem statement will be limited. Do not construct the differential
diagnosis here, as it will be addressed in the sections that follow.
Selecting hypotheses: Creating the differential diagnosis
The next sections of the i-Human case involve the creation of a rank-ordered and prioritized
differential diagnosis. There are several steps in this process: iHuman Patients Guide
Categorization:
You will choose the organ systems relevant to the differential diagnosis for this specific case.
Hypotheses:
You will next select specific hypotheses (disease states or diagnoses) which would explain, or
account for, the patient’s presentation.
Hypothesis ranking:
After selecting your hypotheses, you will next rank them:
Leading; i.e., the one (or two, maximum) hypotheses highest on the differential diagnosis
Alternative; i.e., possible, but less likely hypotheses
Additionally, each hypothesis may be marked as must-not-miss; i.e., a disease/condition,
which, if missed, could result in severe consequences, including the patient’s death.
Tests:
Next you will choose appropriate diagnostic studies to test your hypotheses. You are not expected to
be an expert in diagnostic testing; in fact, you may have had little or no formal training in this regard.
However, much of this will call upon common sense. For example, if you are concerned that the
patient may have pneumonia or lung cancer, then ordering a chest x-ray may give you vast amounts
of information. Also, it can be academically rewarding to “virtually jump in” and diagnose patients in a
structured learning environment.
Associate tests with hypotheses:
After selecting diagnostic tests, you will be asked to associate each selected test with one or more of
your hypotheses. A test may not be ordered unless it is testing a hypothesis; that is, each test that you
order must have a purpose.
You will see how data derived from diagnostic testing can support or detract from a given hypothesis
and/or differentiate between various diagnoses.
Diagnosis:
The final step in the hypothesis selection and testing section is to designate the final diagnosis, as
based upon clinical data generated throughout the case development.
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It is the synthetic interpretation of all case data (history, physical, and test results) that allows you to
diagnose your patient!
In the world of i-Human Patients, it is the clinical reasoning leading up to the point of diagnosis that is
more important than obtaining the correct diagnosis. Uncertainty is a natural part of the practice of
medicine.
Treatment / management plan
You will next write a treatment plan and, if appropriate, a long-term management plan.
Summary
The summary section contains the learning objectives for the specific case, important “take-away”
considerations and pearls — both clinical and basic-science — and a brief case summary and patient
disposition.
References
The references section cites resources used by the case author, as well as useful media resources for
the student.
Customized case flow and student instructions
Student instructions are set at the time the case is assigned, not when the case is authored.
A given case can be used to satisfy many different learning objectives. For example, one instructor
might choose to emphasize the quality of a student’s patient-assessment skills; he/she might choose
to grade the student’s ability to select only history questions and physical-exam components
appropriate for the given patient’s chief complaint.
Another instructor might choose to emphasize the quality of the student’s problem statement; while
yet instructor might emphasize the student’s performance on embedded questions and exercises.
Cases need not utilize all of the features of the i-Human program. For example, a case can consist of
just a history, physical exam and problem statement. Similarly, a case can provide a preconstructed
history and physical exam and have the student focus solely on hypothesis selection and ranking.
A case can be assigned in learning mode or test mode. In learning mode, students will receive step by-step feedback. Such feedback compares the student’s work product with that of the expert. As
well, the student’s selections are updated and brought into line with those of the expert so as to avoid
deviation too far from the design of the case. In test mode, no feedback is provided and the student’s
choices are not corrected.
Lastly, instructors can indicate whether embedded quizzes and exercises must be completed before
proceeding to the next section; and, within a given exercise group, whether the questions must be
completed in a set sequence, or completed by the student in any order.
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i-Human Patients, Inc. Page 7
Getting Started
Login instructions
1. A link will be sent to your email address. Click on the link and select a unique password.
2. Go to www.i-human.com and click on the LOGIN button.
3. Enter your email address and password. If you forgot your password, click on the Forgot your
password? link and follow the instructions.
i-Human Patients® – Student Manual iHuman Patients Guide
iHuman Patients Guide
i-Human Patients, Inc. Page 8
Watch the training videos
Watch the five screencast video tutorials to learn how to play an i-Human Patients case. Familiarizing
yourself with the complete student experience first will help you become a better case navigator!
Find and select your case assignments
To find your case assignment, click on the Assignments tab.
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i-Human Patients, Inc. Page 9
To select your case assignment, click on the green arrow.
To launch your case assignment, click on Start Case. iHuman Patients Guide
May 30, | nursing, med, NURS, Paper
Rachel Adler conversation concept lab shadow health
Rachel Adler conversation concept lab shadow health
Experience Overview
Student Performance Index Score: 19.0 of 19.0 (100.0%)
Time
21 minutes spent interacting with patient
21 minutes total spent in assignment
Examination
33 questions asked
1 empathetic statement made
The Educational Statement tab was not used
No tools or tests were conducted
Documentation
No documentation was written
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Transcript
Started: Jul 17, 2022 | Total Time: 21 min
All Lines (34)Interview Questions (33)Statements (1)Exam Actions (0)
Hello Rachel. I’m xx and I’m here to interview and examine you today (No matching questions found.)
Question
07/17/22 1:13 AM MDT
Hello Rachel. I’m Monique and I’m here to interview and examine you today (No matching questions found.)
Question
07/17/22 1:14 AM MDT
What brings you in today
Question
07/17/22 1:15 AM MDT
I’m here for my physical.
What medical conditions do you have
Question
07/17/22 1:15 AM MDT
I’ve never had any health problems. I almost never get like, a cold, and I’ve never been in the hospital. I’ve never even broken a bone.
What medications do you take
Question
07/17/22 1:15 AM MDT
I don’t take any medications. I mean, unless you count ibuprofen every so often.
Why do you take ibuprofen
Question
07/17/22 1:16 AM MDT
For cramps — when I get my period.
What dose of ibuprofen do you take
Question
07/17/22 1:16 AM MDT
Um, I don’t know how many milligrams… It’s not extra-strength or anything. I think it’s just kind of regular Advil.
How often do you take the Advil
Question
07/17/22 1:16 AM MDT
I only take Advil once a month.
When did you last take Advil
Question
07/17/22 1:17 AM MDT
Two weeks ago. That’s the last time I got my period.
Do you take any other over-the-counter medication
Question
07/17/22 1:17 AM MDT
The only thing I ever take is Advil.
Do you take any vitamins or herbal supplements
Question
07/17/22 1:17 AM MDT
I don’t take any vitamins, supplements, anything like that.
What allergies do you have
Question
07/17/22 1:19 AM MDT
I’m just allergic to peanuts. That’s about it.
How old were you when you had your first reaction to peanut
Question
07/17/22 1:19 AM MDT
I first found out I couldn’t eat peanuts when I was 4.
What are your symptoms to your peanut allergy
Question
07/17/22 1:19 AM MDT
Well, when I’ve eaten peanuts the inside of my mouth and inside my throat gets pretty itchy. It’s weird. But I don’t think I’ve ever had hives or anything like that.
How severe is your peanut allergy
Question
07/17/22 1:20 AM MDT
Not really. Just the itching in my mouth and stuff when I’ve eaten peanuts, or food made with peanut oil or whatever.
Have you ever been hospitalized for a reaction to peanuts
Question
07/17/22 1:20 AM MDT
Nah, it’s never been that bad.
How do you avoid eating peanut
Question
07/17/22 1:20 AM MDT
Well… I ask what’s in things, especially if something’s fried, because it could be fried in peanut oil. And I read ingredients before I buy something if I’m not sure.
How do you treat your reaction to peanuts
Question
07/17/22 1:21 AM MDT
The last time I had a reaction, the doctor told me it was pretty mild and to just take some Benadryl. Other than that, I just avoid them.
Do you have any other food allergies
Question
07/17/22 1:21 AM MDT
Nope, no other food allergies.
Do you have any allergies to latex
Question
07/17/22 1:21 AM MDT
Latex allergy? No, I’ve never had that.
Do you have any medication allergies
Question
07/17/22 1:21 AM MDT
No, I’m not allergic to any medications that I know of.
Do you have any environmental allergies
Question
07/17/22 1:22 AM MDT
No, I don’t have trouble with pollen or anything else like that. My dad always gets hay fever, so I know it’s a total drag. In the spring, he blows his nose about a million times a day.
What tobacco products have you used
Question
07/17/22 1:23 AM MDT
Just cigarettes, honestly.
Do you smoke cigars
Question
07/17/22 1:23 AM MDT
No, last I checked I wasn’t an old dude.
Have you tried chewing tobacco
Question
07/17/22 1:24 AM MDT
Ew! Like chewing tobacco. No.
Have you tried e-cigarettes
Question
07/17/22 1:24 AM MDT
Yeah . . . Well, I have.
How many times have you smoked
Question
07/17/22 1:24 AM MDT
I’ve had, like, three cigarettes ever. It wasn’t a big deal.
How do you feel about smoking
Question
07/17/22 1:24 AM MDT
I guess I feel kinda embarrassed that I smoked, because I know all the bad stuff it does. Cancer, emphysema, all of that. It wasn’t even enjoyable really.
Can you tell me about the impacts of smoking on your health
Question
07/17/22 1:25 AM MDT
I know people die from smoking all the time, like millions of people. It causes lung cancer, emphysema… A whole bunch of other stuff. I mean, by this point everyone must know that.
Do your friends encourage you to smoke
Question
07/17/22 1:25 AM MDT
When I smoked, I wasn’t trying to impress anyone. I mean, maybe I did want to fit in, but mostly I was just curious. My friends didn’t, like, make me do it–I definitely don’t want you to think that.
What will you say if your friends ask you to smoke again
Question
07/17/22 1:26 AM MDT
I’ll tell them no thanks, and that it’s not for me. I’m sure they’ll be cool with that.
Have you ever use any recreational drug
Question
07/17/22 1:26 AM MDT
No. I’ve never done any drugs, ever.
Have you ever drink alcohol
Question
07/17/22 1:26 AM MDT
Nah, I’m not really interested in that.
I commend you for not doing drugs or drinking alcohol
Empathize
07/17/22 1:27 AM MDT
Thank you.
Subjective Data Collection: 19 of 19 (100.0%)
Hover To Reveal…
Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.
Found:
Indicates an item that you found.
Available:
Indicates an item that is available to be found.
Category
Scored Items
Experts selected these topics as essential components of a strong, thorough interview with this patient.
Patient Data
Not Scored
A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.
Introduction and Medical History
Finding:
Established reason for visit
Finding:
Reports needing an annual physical
(Found)
Pro Tip: Asking the patient’s reason for their visit is a practical way to establish a chief complaint.
Example Question:
What brings you in today?
Finding:
Asked about past medical history
Finding:
Denies medical conditions
(Found)
Pro Tip: A broad question about the patient’s past medical history may prompt a more comprehensive answer.
Example Question:
What medical conditions do you have?
Medications
Finding:
Asked about general medication use
Finding:
Reports taking occasional ibuprofen
(Found)
Pro Tip: Asking a patient what medications they take may prompt a broader response that does not capture a complete picture of their medication use.
Example Question:
What medications do you take?
Finding:
Denies taking prescription medication
(Available)
Pro Tip: Asking the patient what medications are prescribed to him or her may prompt the patient to report medications taken daily or on an as-needed basis.
Example Question:
Do you take any prescription medications?
Finding:
Only OTC medication is ibuprofen (no others reported)
(Found)
Pro Tip: Asking specifically about a patient’s use of the over-the-counter medications may prompt a more definitive response and yield greater insight into their medication use.
Example Question:
Do you take any other over the counter medications?
Finding:
Followed up about reason for ibuprofen use
Finding:
Takes ibuprofen to relieve menstrual cramps
(Found)
Pro Tip: When a patient reports taking any type of medication, it is important to gather information about the reasons it is used.
Example Question:
For what reason do you take ibuprofen?
Finding:
Followed up on frequency and dosage of ibuprofen use
Finding:
Takes ibuprofen monthly
(Found)
Pro Tip: When a patient reports taking any type of medication, it is important to gather information about the frequency of its use. A broader question may prompt a broader response from the patient.
Example Question:
How often do you take ibuprofen?
Finding:
Takes 2 at a time
(Available)
Pro Tip: When a patient reports taking any type of medication, it is important to gather information about the quantity of its use.
Example Question:
How many ibuprofen do you take at a time?
Finding:
Typically takes 2 doses on first day of period
(Available)
Pro Tip: When a patient reports taking any type of medication, it is important to gather information about the frequency of its use.
Example Question:
How many days do you take ibuprofen?
Finding:
Unsure of the dosage, but reports they are “regular strength”
(Found)
Pro Tip: When a patient reports taking any type of medication, it is important to gather information about the quantity of its use.
Example Question:
What dosage of ibuprofen do you take?
Finding:
Last dose was 2 weeks ago
(Found)
Pro Tip: When a patient reports taking any type of medication, it is important to gather information about the frequency of its use. Asking specifically about the last time the patient took the medication may prompt a response that speaks to the medications day to day use.
Example Question:
When did you last take Advil?
Finding:
Asked about supplements
Finding:
Denies vitamins
(Found)
Pro Tip: Asking a patient a specific question about their use of vitamins will prompt a definitive answer and provide insight into their supplement use.
Example Question:
Do you take any vitamins?
Finding:
Denies herbal supplements
(Found)
Pro Tip: Asking a patient a specific question about their use of herbal supplements will prompt a definitive answer and provide insight into their supplement use Rachel Adler conversation concept lab shadow health.
Example Question:
Do you take any herbal supplements?
Allergies
Finding:
Asked about general allergies
Finding:
Reports allergy to peanuts
(Found)
Pro Tip: Beginning an interview with a broad question is a good entry into the topic.
Example Question:
What allergies do you have? Rachel Adler conversation concept lab shadow health
Finding:
Followed up on peanut allergy symptoms
Finding:
Discovered at age 4
(Found)
Pro Tip: When a patient reports an allergy, it is important to establish its onset.
Example Question:
How old were you when had your first reaction to peanuts?
Finding:
Symptoms are itchy mouth and throat
(Found)
Pro Tip: When a patient reports an allergy, it’s necessary to determine the type and extent of his or her allergic reaction. For example, if a patient reports a bee-sting allergy, the provider must determine whether the patient has experienced localized allergic reactions or anaphylaxis.
Example Question:
What are the symptoms of your peanut allergy?
Finding:
Followed up on peanut allergy severity
Finding:
Describes allergy as not severe
(Found)
Pro Tip: When a patient reports an allergy, it is important ascertain the severity of their reaction to the allergen. A broad question about this topic, while a good starting point, may prompt a broad response that lacks the specifics of the reaction type.
Example Question:
How severe do you think your peanut allergy is?
Finding:
Denies breathing problems after exposure
(Available)
Pro Tip: Asking a patient about specific life-threatening reactions to their allergy, such as breathing problems, will prompt a response that characterizes the severity of the allergy.
Example Question:
Do you experience breathing problems when you eat peanuts?
Finding:
Denies hospitalization for reaction to peanuts
(Found)
Pro Tip: Asking a patient about past, allergy-related hospitalizations will prompt a response that characterizes the severity of the allergy.
Example Question:
Have you ever been hospitalized for a reaction to peanuts? Rachel Adler conversation concept lab shadow health
Finding:
Followed up on peanut allergy treatment
Finding:
Treated with Benadryl
(Found)
Pro Tip: When a patient reports an allergy, it is important to ask about the patient’s ability and willingness to treat allergic reactions. The patient’s response may provide insight into their health literacy and impact the allergy has had on their daily life.
Example Question:
How do you treat your peanut allergy?
Finding:
Reports avoiding peanuts and peanut oil
(Found)
Pro Tip: When a patient reports an allergy, it is important to ask about the patient’s ability and willingness to avoid the allergen. The patient’s response may provide insight into their health literacy and impact the allergy has had on their daily life.
Example Question:
How do you avoid eating peanuts?
Finding:
Denies use of epi-pen
(Available)
Pro Tip: When a patient reports an allergy, it is important to ask about access to specific resources that may treat an allergic reaction in the event of an emergency.
Example Question:
Do you have an epi pen?
Finding:
Asked about medication allergies
Finding:
Denies known medication allergies
(Found)
Pro Tip: While general questions about allergies may elicit important information, the patient may not spontaneously report all allergies. For example, medication allergies may be overlooked by the patient because he or she considers adverse reactions to medications separate from more common allergies, such as hay fever or allergic reactions to animal dander. In addition, if the patient experienced an allergic reaction to medication long ago, he or she may not immediately recall it. Therefore, it is important to ask specifically about medication allergies.
Example Question:
Are you allergic to any medications?
Finding:
Asked about other allergies
Finding:
Denies latex allergy
(Found)
Pro Tip: While general questions about allergies may elicit important information, the patient may not spontaneously report all allergies. For example, a latex allergy may be overlooked by a patient who rarely comes into contact with latex, or who has only experienced a mild allergic reaction. Therefore, it is important to ask specifically about latex allergy.
Example Question:
Are you allergic to latex?
Finding:
Denies food allergies or sensitivities (other than peanuts)
(Found)
Pro Tip: While general questions about allergies may elicit important information, the patient may not spontaneously report all allergies. For example, a food allergy may be overlooked by a patient who hasn’t experienced an allergy to things they eat, or to a patient who has already reported known food allergies. To form a more complete picture, it is important to ask specifically about food allergies.
Example Question:
Do you have any food allergies?
Finding:
Denies known environmental allergies
(Found)
Pro Tip: While general questions about allergies may elicit important information, the patient may not spontaneously report all allergies. For example, seasonal allergies may be overlooked by the patient because he or she considers them to be very common or harmless. In addition, if the patient is not currently experiencing an allergic reaction, this information may slip his or her mind. Therefore, it is important to ask specifically about environmental allergies.
Example Question:
Do you have any environmental allergies?
Substance Use
Finding:
Asked about tobacco and nicotine use
Finding:
Reports “some” tobacco use
(Found)
Pro Tip: Tobacco use in all its forms carries risk of adverse health consequences, so it is critical to ask your patient about tobacco use during a health history interview.
Example Question:
What tobacco products have you used?
Finding:
Followed up on type of tobacco or nicotine
Finding:
Reports smoking cigarettes
(Found)
Pro Tip: Smoking is a significant risk factor for many diseases and conditions including lung cancer, emphysema, and heart disease. Therefore, it is essential to ask patients about smoking and other tobacco use during a health history interview.
Example Question:
What do you smoke?
Finding:
Denies other forms of smoking tobacco such as cigars and pipes
(Found)
Pro Tip: Smoking is a significant risk factor for many diseases and conditions including lung cancer, emphysema, and heart disease. Furthermore, different forms of smoked tobacco may carry specific health risks; it is important to ask about other types of smoking tobacco to form a full picture of the patient’s smoking patterns.
Example Question:
Do you smoke cigars?
Finding:
Denies using chew or smokeless forms of tobacco
(Found)
Pro Tip: Smokeless tobacco also carries the risk of adverse health consequences for users, therefore it is important to ask a patient specifically about these products.
Example Question:
Have you ever tried chewing tobacco?
Finding:
Denies vaping or e-cigarettes
(Available)
Pro Tip: While less is known about the specific health consequences of e-cigarettes and personal vaporizers for tobacco use, it is important to to ask a patient about these products to form a more complete picture of their tobacco use patterns.
Example Question:
Have you ever tried an electronic cigarette?
Finding:
Followed up on patterns of tobacco use
Finding:
Reports smoking “really not very many” cigarettes
(Available)
Pro Tip: When a patient reports smoking, it is important to determine the quantity of the patient’s tobacco use in order to assess the patient’s risk level for associated health problems, and also to gauge the degree of the patient’s dependence Rachel Adler conversation concept lab shadow health.
Example Question:
How much do you smoke?
Finding:
Has smoked 3 times (one cigarette each time)
(Found)
Pro Tip: When a patient reports smoking, it is important to determine the frequency and duration of the patient’s tobacco use in order to assess the patient’s risk level for associated health problems, and also to gauge the degree of the patient’s dependence.
Example Question:
How many times have you smoked?
Finding:
Explored patient’s perception of tobacco use
Finding:
Reports understanding of health impacts of smoking
(Found)
Pro Tip: When a patient reports smoking, assessing their knowledge about tobacco use can enable providers to engage in relevant conversation with the patient, and to offer helpful education.
Example Question:
Can you tell me what you know about the health impacts of smoking?
Finding:
Reports negative experiences with smoking
(Found)
Pro Tip: In an adolescent patient, evaluating his or her attitude towards smoking can enable the provider to offer relevant support and education. For example, if the patient communicates that he or she views smoking as a means of relaxing, a provider can offer education and strategies for achieving relaxation in healthy ways.
Example Question:
How do you feel about smoking?
Finding:
Explored reasons that patient experimented with smoking
Finding:
Describes peer pressure related to smoking
(Found)
Pro Tip: When an adolescent patient reports smoking, evaluating the circumstances and social pressure involved may help the provider understand the patient’s motive for smoking. Addressing these motives directly, and exploring their origins, can be essential components of patient education regarding smoking.
Example Question:
Do your friends encourage you to smoke?
Finding:
Reports that she will avoid smoking in the future
(Found)
Pro Tip: When an adolescent patient reports smoking, evaluating the circumstances and social pressure involved may help the provider understand the patient’s motive for smoking. Addressing these motives directly, and exploring their origins, can be essential components of patient education regarding smoking.
Example Question:
What will you say if your friends asked you to smoke again?
Finding:
Asked about alcohol use
Finding:
Denies alcohol use
(Found)
Pro Tip: Asking direct opening questions about alcohol consumption is more likely to prompt a definitive response from a patient.
Example Question:
Have you ever tried alcohol?
Finding:
Denies being around friends who consume alcohol
(Available)
Pro Tip: When asking an adolescent patient about alcohol consumption, it is important to evaluate the circumstances and social pressure involved. Addressing these motives directly, and exploring their origins, can be essential components of patient education regarding drinking.
Example Question:
Do your friends ever drink alcohol?
Finding:
Reports alcohol consumed by parents at home
(Available)
Pro Tip: When asking an adolescent patient about alcohol consumption, it is important to evaluate the circumstances and social pressure involved. Since parents serve as direct models of adult alcohol consumption, asking about drinking patterns in the home may prove insightful.
Example Question:
Does anyone at home drink alcohol?
Finding:
Reports that parents drink “a glass of wine at dinner”
(Available)
Pro Tip: When asking an adolescent patient about alcohol consumption, it is important to evaluate the circumstances and social pressure involved. Since parents serve as direct models of adult alcohol consumption, asking about drinking patterns in the home may prove insightful. A broad question about the quantity of alcohol use in the home is a good starting point.
Example Question:
How much alcohol do your parents drink at home?
Finding:
Asked about drug use
Finding:
Denies previous drug use
(Found)
Pro Tip: Asking direct opening questions about drug use is more likely to prompt a definitive response from a patient.
Example Question:
Have you ever experimented with drugs?
Finding:
Denies being around friends who use drugs Rachel Adler conversation concept lab shadow health
