The final case analysis allows the student

The final case analysis allows the student to demonstrate a thorough but directed clinical history, with initial hypothesis generation and subsequent testing through specific questioning, selection of a primary diagnosis and differential diagnoses in order of likelihood, physical examination directed at gathering further data necessary to confirm or refute the hypotheses, thoughtful and critical selection of investigations to gather additional data such as appropriate diagnostic studies and implementation of a targeted and rationalized management plan that considers the holistic patient and includes appropriate medication selection. Case John Smith is a 50 year old Native American Male who presents with chest discomfort described as burning under the sternum. He has a history of Hypertension, Hyperlipidemia, Hypothyroidism, Diabetes Mellitus Type II and a sore on the right lower extremity draining purulent exudate He was last seen in the clinic one year ago. He has no current medications available. He states he ran out a few months ago. Rubric: Competency 10 points 8 points 6 points 0 points Thorough directed clinical history Includes the ROS, PMH, PSH, and Social history in discussion of clinical history Discusses clinical history but misses one important consideration (ROS, PMH, PSH, and Social history) Discusses clinical history but misses two important consideration (ROS, PMH, PSH, and Social history) Content not presented, No submission Evidence-supported primary hypothesis for a differential diagnosis Develops an evidence-supported primary hypothesis for a differential diagnosis Omits the primary diagnosis or the scientific base Omits the identification of the most likely diagnosis instead generates a list of potential diagnoses Content not presented, No submission Alternate hypotheses (differential diagnoses) and supports with evidence Develops a list of five alternate hypotheses (differential diagnoses) and supports with evidence Develops a list of four alternate hypotheses (differential diagnoses) and supports with evidence Develops a list of 3 or less alternate hypotheses (differential diagnoses) and supports with evidence Content not presented, No submission Physical assessment signs that support each differential diagnosis presented Describes physical assessment signs that support each differential diagnosis presented Describes physical assessment signs that support most (4) differential diagnosis presented Describes physical assessment signs that support some Less than 4 differential diagnosis presented Content not presented, No submission Prescribes diagnostic studies to evaluate hypotheses. Includes the specificity and sensitivity of each study Prescribes diagnostic studies to evaluate all hypotheses. Includes the specificity and sensitivity of each study Prescribes diagnostic studies to evaluate most (4) hypotheses. Includes the specificity and sensitivity of each study Prescribes diagnostic studies to evaluate all hypotheses. Does not include specificity and sensitivity for tests Content not presented, No submission Patient and family inclusion to assist in diagnostic error avoidance Thoroughly discusses patient and family inclusion to assist in diagnostic error avoidance Discusses patient inclusion without any family or community discussion or strategy presentation Discusses generalized importance of Patient and family inclusion but provides no planned strategy Content not presented, No submission Health IT resources to improve diagnostic accuracy Describes Health IT resources to improve diagnostic accuracy Describes Health IT resources but does not relate to specific case or diagnostic accuracy Speaks in general about Health IT without discussion of its impact on diagnostic accuracy Content not presented, No submission Evidence-based evaluation of implementation of Health IT resources Provides evidence-based support of implementation of Health IT resources to improve diagnostic accuracy Describes evidence-based implications but does not relate to specific case AND diagnostic accuracy Describes evidence-based implications but does not relate to specific case OR diagnostic accuracy Content not presented, No submission Pharmacologic interventions appropriate to each differential diagnosis Chooses pharmacologic interventions appropriate to each differential diagnosis Chooses pharmacologic interventions appropriate to most (4) differential diagnoses Chooses pharmacologic interventions appropriate to some (less than 4) differential diagnoses Content not presented, No submission 5 4 3 0 Demonstrates graduate level writing skills without grammatical errors No grammatical errors One to two grammatical errors Three to four grammatical errors Content not presented, No submission Demonstrates compliance with APA No APA errors One to two APA errors Three to four APA errors Content not presented, No submission

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