Phase of Encounter (01_Codes)

Physical Exam (02_PE)

descriptive information mentioned (03_PE_descriptive)

weight, BCS

CRT, MM

TPR

attitude

systems examined (03_PE_systems)

General Appearance

Integumentary

Ophthalmic

Otic

Musculoskeletal

Cardiovascular

Respiratory

Reproductive

Mammary

Urinary

Nervous

Alimentary

Lymphatic

Planning (02_Planning)

Initial Plan (03_Tx_Plan_Proposed)

considers patient status

considers client perspective

matches data obtained

follows logically from presumptive diagnosis

Diagnostic Tests Requested (03_Case_Name)

Jade (05_Jade_diagnostics2) Note: 06_requested is where Dx tests are selected

CBC

chem

UA (05_Jade_UA)

free catch

cysto

urine culture

PCV/TS

Snap 4DX

renal values post IV fluids

abdominal radiographs

thoracic radiographs

abdominal ultrasound

cortisol

ACTH stim

fecal

GI panel

SDMA

T4

VBG

Lepto

histoplasmosis

pythium serology

Max (05_Max_diagnostics2)

CBC

chem

UA (05_Max_UA)

free catch

cysto

ultrasound-cysto

urine culture

abdominal radiographs

urethra stone check

abdominal ultrasound

LDDS

ACTH stim

Lepto

fecal

Tiger (05_Tiger_diagnostics2)

CBC

chem

UA (05_Tiger_UA)

free catch

cysto

urine cultrue

UPC

FeLV/FIV

GI panel

blood pressure

T4

abdominal radiographs

thoracic radiographs

abdominal ultrasound

LN FNA

PARR

fecal

Giardia wet mount

tritichomonas

Diagnostic Review (02_DxReview)

additional tests requested (05_Case_Name2)

desired client communication

case summary (code for communication - 02_ReflectiveListening)

Demonstrations of Reasoning (01_Codes)

Subsequent Hypothesis (02_Hypothesis) in comments list hypothesis

Hypotheses during encounter

level of specificity (03_HypothesisLevel)

disease process

specific disease (AKA differential)

confidence (03_HypothesisConfidence)

high (8-10)

medium (4-7)

low (1-3)

action (re-prioritize) (03_HypothesisPrioritize)

increase confidence

decrease confidence

final dx (03_Final_Dx)

correct (list in comments)

incorrect (list choice in comments)

Use of Data (02_UseOfData)

data noted by participants as "missed" (e.g. I wish I'd asked about...)

data acquired (03_DataObtained)

acknowledged verbally

took into consideration

missed opportunity

Type of Prior Knowledge (02_KnowledgeTypes)

basic sciences (03_KnowledgeRight)

stated correctly

stated incorrectly

applied correctly

applied incorrectly

clinical sciences (03_KnowledgeRight)

stated correctly

stated incorrectly

applied correctly

applied incorrectly

CR process (03_KnowledgeRight)

stated correctly

stated incorrectly

applied correctly

applied incorrectly

communication process (03_KnowledgeRight)

stated correctly

stated incorrectly

applied correctly

applied incorrectly

referral to literature (03_KnowledgeRight)

stated correctly

stated incorrectly

applied correctly

applied incorrectly

Communication and CR (01_Codes)

Reflective listening (02_ReflectiveListening)

paraphrasing (lay terms)

confirmation/clarification of client statements (add comment)

empathy

Question (03_Question)

open

closed

diagnostic tests reviewed (04_Case_Name2)

Max

Jade

Tiger

list of Dx tests (07_Max_diagnostics2)

list of Dx tests (07_Jade_diagnostics2)

list of Dx tests (07_Tiger_diagnostics2)

Max

Tiger

Jade

list of Dx tests (06_Jade_diagnostics2) - 06_Jade_UA

rationale to interviewer (06d_rationale_to_interviewer)

list of Dx tests (06_Max_diagnostics2)

(06d_rationale_to_interviewer)

list of Dx tests (06_Tiger_diagnostics2)

lymph node cytology

sign-posting (previewing, transitioning, structuring)

:

not determined (list choices under consideration)

fecal smear

full tick panel

lymph node aspirate

USG

History (02_History)

elicited information (02a_elicited info)

verbal prompt - type of question (03_Question)

open

content of Q (03_Content)

biomedical (04_BiomedicalContent)

systems review

client perspective

background (04_BackgroundInformation)

diet

prior med/surgical

medications

lifestyle, environment

use/purpose

spontaneously volunteered

content of statement (03_Content)

client perspective

background info (04_BackgroundInformation)

biomedical (04_BiomedicalContent)

systems review

analysis of clinical signs

sequence of events

prior med/surgical

medications

lifestyle, environment

use/purpose

diet

presenting complaint

sequence of events

presenting complaint

closed

content of Q (03_content)

background information (04_BackgroundInformation)

medications

lifestyle, environment

prior med/surgical

use/purpose

diet

analysis of clinical signs

client perspective

Initial Assessment (02_Assessment)

case summary (EOC, w/comment)

initial hypotheses (02a_Initial_Hypothesis) - Enter hypothesis in comments!!!! ... analysis continues under CR

level of concern (03_Concern_Level)

additional history (02_History)

rationale

yes

no

empathy statements

Hx and PE Problems (02_Problems)

refinement of problems (03_ProblemRefinement)

problem discarded

problem refined/restated (reducing # of problems, making more specific)

grouping of diagnostic information (from all over)

use of semantic qualifiers (acute/chronic)

integration and synthesis (02_Integration)

problem list

if yes, launch questionnaire

problem abandoned

needed (I didn't know)

applies ALL information relevant to patient

relates problems on problem list to each other

yes

no - what missed

incorrect- used wrong

Initial Hypothesis (before entering room)

system

reasonable

level of specificity

confidence

no

yes

system

disease process

specific disease

medium (4-7)

low (1-3)

hypothesis reasonable (during process) (03_HypothesisReasonable)

yes

no

high (8-10)

systematic approach (03_Systematic_Approach)

specific to patient

cookbook

none

Pre-Introduction (02_Pre-Introduction)

pre-conceived ideas based on signalment and presenting complaint (e.g. pattern recognition, illness scripts)

semantic qualifiers - note terms used

level of concern (03_Concern_Level)

moderate (4-7)

low (1-3)

high (8-10)

Home Care Plans - enter the proposed interventions

Empirical Treatment - enter the proposed treatment(s)

Introduction (comments only)

requested (06_requested)

rationale to client? (06c_rationale_to_client)

test received (06b_received)

Approach to Interpretation (04_Systematic_Approach)

results percieved

Systematic Approach (04_Systematic_Approach)

no (relevant results not percieved)

yes (02_Knowledge_types)

rationale to interviewer (06d_rationale_to_interviewer)

Systematic Approach (04_Systematic_Approach)

requested (07_requested)

rationale to interviewer (07d_rationale_to_interviewer)

received (07b_received)

Systematic Approach (04_Systematic Approach)

requested (07_requested)

rationale to interviewer (07d_rationale_to_interviewer)

received (07b_received)

Systematic Approach

requested (07_requested)

rationale to interviewer (07d_rationale_to_interviewer)

received (07b_received)

Systematic Approach

non-verbal encourager (03_content)

client perspective

background info (04_BackgroundInformation)

biomedical (04_BiomedicalContent)

analysis of clinical signs

systems review

sequence of events

presenting complaint

lifestyle, environment

use/purpose

diet

medications

prior med/surgical

rationale to client (06d_rationale_to_client) (yes/no)

rationale to client (06d_rationale_to_client) (yes/no)

inappropriate use of medical terminology

summarize

all

one

all

one

one

one

one

one

some

one

all

some

problem identification (03_ProblemIdentification) - enter problem in comments

one

extra/inaccurate info (list what they made up)

yes

no

one

all

some

some

one

one

one

one

one

02_metacognition

some

draws on prior experience

error avoidance

uses minimal mental resources (unconsciously competent)

reports overwhelmed/high cognitive load

thinks about how to manage encounter

ID's areas for growth

one

some

multiple passes - full classification for each Q

one

one

one

one

some

some

some

some

some

some

some

need to do some type of checklist for each test:
was it requested?
rationale to client? (yes/no does not determine next step)
test received? - it would be nice to carry this info to review branch.

some

some

one

one

this is the same list of tests for each case, shown above. For each test ordered (e.g. CBC), we need to note the following:

  • was a rationale provided to the interviewer
  • the approach used to interpreting the test (systematic, generic, etc)
  • for each grouping of results (major, fair, minor), need to check off things that were perceived
  • for each item that was perceived, need to note if the interpretation was correct AND the type of knowledge used

one

see list of interpretation items, above

some

some

some

some

biomedical (04_BiomedicalContent)

some

sequence of events

presenting complaint

systems review

analysis of clinical signs

some

some

some

some

some

some

some

moderate (4-7)

low (1-3)

high (8-10)

one

does not match data obtained

does not follow logically

this is the only way I could figure out to bring up different lists of diagnostic tests for different patients

one

click to edit

one

relates problems to final diagnosis

builds rapport (fir logic, consider under comm)

restated presenting complaint