lOMoAR cPSD| 63316909
NR509 Faculty Tip Sheet: Week 3
Instructions: This tip sheet accompanies the notes for this case located in iHuman and is
intended to guide faculty in scoring the grading rubric and coaching students. For
grading purposes and to review detailed case information and individual student results,
refer to the Performance Overview Report (POR) and corresponding tabs in iHuman.
Brief Case Summary:
• Understand the pathophysiology and epidemiology of group A streptococcal
pharyngitis
• Identify classic history findings and risk factors associated with the development
of group A streptococcal pharyngitis
• Recognize physical exam findings consistent with group A streptococcal
pharyngitis
• Appropriately manage a patient with group A streptococcal pharyngitis
• Recall potential sequelae of untreated group A streptococcal pharyngitis
Key Findings Students Must Identify in the Case:
Coaching Students About the Key Findings:
, lOMoAR cPSD| 63316909
• Remember that key findings should include everything that is out of the ordinary
about this client, even when it does not appear to be a “problem”.
• For this client, the presenting complaint is a sudden onset of severe pharyngitis
for 2 days.
• Students must learn to identify the Most Significant Active Problem (MSAP).
Encourage students to understand why the MSAP is significant and its
relationship to the other findings.
• Explore the context of the case and recent exposure to a roommate with a sore
throat within the past week. Assist the student in making connections between
the history and presenting illness.
Grading Tips Using the Rubric: In this area, be prepared to explain to students
why the following information is important and why points may be deducted.
Students often omit important subjective/objective data.
Focused health history (graded by iHuman): Review the POR from iHuman to provide
insight and guidance
Focused physical exam (graded by iHuman): Review the POR from iHuman to provide
insight and guidance
EHR documentation subjective data:
History:
• Sudden onset of severe pharyngitis x 2 days (severity: 11 on a 10-point scale)
Fever of 101.5°F yesterday
• Symptom characteristics include: o Pain with swallowing o Absence of cough
o Mild headache
o Swollen and tender glands on both sides of the neck
• Recent exposure: Roommate with sore throat within the past week
• History of infectious mononucleosis at age 15
• Denies conjunctivitis, coryza, cough, stiff neck, chest pain, shortness of breath,
abdominal pain, diarrhea, dysuria, or rash.
Coaching Students About History Taking and Subjective Data
• The Review of Systems (ROS) is subjective data collected during the patient
interview, not objective data that is collected during the physical examination.
Organize and separate information by the appropriate body system.
• The ROS helps rule in or out potential differential diagnoses. Therefore, all
relevant body systems must be assessed. It is more accurate to document
“denies” rather than “negative” for each symptom. This conveys the patient’s
NR509 Faculty Tip Sheet: Week 3
Instructions: This tip sheet accompanies the notes for this case located in iHuman and is
intended to guide faculty in scoring the grading rubric and coaching students. For
grading purposes and to review detailed case information and individual student results,
refer to the Performance Overview Report (POR) and corresponding tabs in iHuman.
Brief Case Summary:
• Understand the pathophysiology and epidemiology of group A streptococcal
pharyngitis
• Identify classic history findings and risk factors associated with the development
of group A streptococcal pharyngitis
• Recognize physical exam findings consistent with group A streptococcal
pharyngitis
• Appropriately manage a patient with group A streptococcal pharyngitis
• Recall potential sequelae of untreated group A streptococcal pharyngitis
Key Findings Students Must Identify in the Case:
Coaching Students About the Key Findings:
, lOMoAR cPSD| 63316909
• Remember that key findings should include everything that is out of the ordinary
about this client, even when it does not appear to be a “problem”.
• For this client, the presenting complaint is a sudden onset of severe pharyngitis
for 2 days.
• Students must learn to identify the Most Significant Active Problem (MSAP).
Encourage students to understand why the MSAP is significant and its
relationship to the other findings.
• Explore the context of the case and recent exposure to a roommate with a sore
throat within the past week. Assist the student in making connections between
the history and presenting illness.
Grading Tips Using the Rubric: In this area, be prepared to explain to students
why the following information is important and why points may be deducted.
Students often omit important subjective/objective data.
Focused health history (graded by iHuman): Review the POR from iHuman to provide
insight and guidance
Focused physical exam (graded by iHuman): Review the POR from iHuman to provide
insight and guidance
EHR documentation subjective data:
History:
• Sudden onset of severe pharyngitis x 2 days (severity: 11 on a 10-point scale)
Fever of 101.5°F yesterday
• Symptom characteristics include: o Pain with swallowing o Absence of cough
o Mild headache
o Swollen and tender glands on both sides of the neck
• Recent exposure: Roommate with sore throat within the past week
• History of infectious mononucleosis at age 15
• Denies conjunctivitis, coryza, cough, stiff neck, chest pain, shortness of breath,
abdominal pain, diarrhea, dysuria, or rash.
Coaching Students About History Taking and Subjective Data
• The Review of Systems (ROS) is subjective data collected during the patient
interview, not objective data that is collected during the physical examination.
Organize and separate information by the appropriate body system.
• The ROS helps rule in or out potential differential diagnoses. Therefore, all
relevant body systems must be assessed. It is more accurate to document
“denies” rather than “negative” for each symptom. This conveys the patient’s
