- Start with a Clear Plan
- Before diving in, carefully read the case introduction and objectives. Identify the key areas to focus on, such as the patient’s chief complaint, history, and physical exam findings.
- Ask Targeted Questions
- During the history-taking phase, prioritize questions that align with the patient’s symptoms. Use the OLDCARTS framework (Onset, Location, Duration, Characteristics, Aggravating/Relieving factors, Timing, Severity) to gather detailed information.
- Perform a Focused Physical Exam
- Avoid wasting time on irrelevant systems. Focus on the systems most likely related to the chief complaint. For example, if the patient presents with chest pain, prioritize cardiovascular and respiratory exams.
- Prioritize Differential Diagnoses
- Use the information gathered to create a list of possible diagnoses. Rank them based on likelihood, considering the patient’s history, symptoms, and risk factors. Use mnemonics like VINDICATE (Vascular, Infectious, Neoplastic, Degenerative, Idiopathic, Congenital, Autoimmune, Traumatic, Endocrine) to ensure you don’t miss key possibilities.
- Order Tests Strategically
- Avoid ordering unnecessary tests. Focus on diagnostic tests that will confirm or rule out your top differentials. For example, if you suspect pneumonia, order a chest X-ray and CBC rather than a full panel of unrelated labs.
- Interpret Results Critically
- Analyze lab and imaging results in the context of the patient’s presentation. Don’t just accept the results—ask yourself how they support or refute your working diagnosis.
- Develop a Comprehensive Treatment Plan
- Your plan should address the primary diagnosis, symptom management, and patient education. Include follow-up care and referrals if necessary. For example, if treating diabetes, include lifestyle changes, medication, and regular monitoring.
- Review Feedback Thoroughly
- After completing the case, carefully review the feedback provided. Pay attention to areas where you lost points, such as missed questions, unnecessary tests, or incomplete treatment plans. Use this to refine your approach for future cases.
- Use Clinical Guidelines
- Refer to evidence-based guidelines (e.g., UpToDate, CDC, or professional organization guidelines) to ensure your diagnostic and treatment decisions align with current standards of care.
- Practice Time Management
- Allocate time for each section of the case. For example, spend 30% on history, 30% on the physical exam, and 40% on diagnostics and treatment. Avoid spending too much time on one section at the expense of others.
- Think Like a Clinician
- Always ask yourself:
- What is the most likely diagnosis?
- What is the worst-case scenario I need to rule out?
- What is the next best step for this patient?
- Stay Calm Under Pressure
- i-Human cases are designed to challenge you. If you feel stuck, take a step back, review the information you’ve gathered, and focus on the most critical aspects of the case.