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

2. Getting started 7–9
a. Login instructions
b. Watching videos
c. How to find an assigned case

1. Student Introduction to the i-Human Patients Case Player

The i-Human Patients (IHP) Case Player is an Internet (cloud) application that allows students to engage with virtual patients to learn patient-assessment and diagnostic-reasoning skills. Through IHP, you gain the ability to independently conduct interviews, examinations, diagnoses, and treatments on virtual patients while receiving expert feedback on your performance.

Diana Wiseman iHuman Case Summary

The program aims to help you achieve the following objectives:
– Acquire the skills to assess a patient, ask relevant questions, and perform appropriate physical examinations based on the patient’s issue while identifying and organizing pertinent findings.
– Develop a structured diagnostic-reasoning process, formulate a concise problem statement, select and prioritize hypotheses (differential diagnoses), and request and interpret tests.
– Establish a treatment/management plan.
– Understand fundamental scientific concepts that underlie the clinical aspects of the case.

In each major section of the case, you can compare your work with the expert’s version.

History-taking and physical examination

Many clinical interactions begin with gathering the patient’s history, a systematic and comprehensive process. IHP assists you in developing question efficiency, ensuring you ask only the relevant questions related to the patient’s chief complaint, associated symptoms, and pertinent medical history. The patient’s history constitutes the subjective part of the assessment, reflecting the patient’s self-assessment and memory of events.

Following history-taking, the physical examination is the next step in evaluating the patient. You will select and perform various exams based on the history of the current illness and any supporting information. While comprehensiveness is essential, the goal is to conduct a focused and efficient physical examination by selecting components relevant to the patient’s presentation. The physical examination constitutes the objective part of the assessment, requiring accurate and reproducible findings.

Throughout the history and physical examination, add pertinent findings to the problem list on the left-hand side of the screen. You can update the problem list as you progress.

Efficiency in conducting the history and physical examination can be enhanced by developing the differential diagnosis concurrently. The questions you ask the patient and the exams you select will help further refine the differential diagnosis.

Problem list

The problem list, located vertically on the left-hand side of the screen, is where you add key findings as you advance through the history and physical examination sections. Each entry should be concise, containing no more than five words. Translate findings into precise medical terminology.

Examples:
– Patient says: Came on suddenly last night -> Translation: Acute onset
– Physical examination: Swollen legs -> Translation: Edema

The problem list should encompass all key findings, both from the history-gathering and physical examination, including chief complaint, history of the current illness, review of systems, past medical history, family history, social history, vital signs, and general exam. Pertinent negatives should not be included but can be noted in the Notes Section for your reference.

Each entry on the problem list is ranked based on the patient’s presentation: Most significant active problem (MSAP), related, unrelated, unknown, or PMH/Resolved.

Problem statement

The problem statement is a concise paragraph that synthesizes patient identifiers, presenting complaints, and key findings translated into medical terminology. It should be complete but not a mere restatement of the problem list. Instead, it consolidates related findings into a coherent statement.

Selecting hypotheses: Creating the differential diagnosis

The next sections of the i-Human case involve creating a rank-ordered and prioritized differential diagnosis. This process includes:
– Categorizing relevant organ systems
– Selecting specific hypotheses (disease states or diagnoses) to explain the patient’s presentation
– Ranking hypotheses as leading, alternative, or must-not-miss
– Choosing appropriate diagnostic studies to test hypotheses and associating tests with hypotheses
– Designating the final diagnosis based on clinical data generated throughout the case development

The clinical reasoning leading to the diagnosis is more crucial than the correct diagnosis itself in the i-Human Patients environment.

Treatment / management plan

Following the diagnosis, you will develop a treatment plan and, if necessary, a long-term management plan.

Summary

The summary section contains the case’s learning objectives, important considerations and pearls (both clinical and basic-science), 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 when the case is assigned, and a single case can serve various learning objectives. Instructors can emphasize different aspects, such as patient-assessment skills, problem statement quality, or performance on embedded questions and exercises. Cases can vary in complexity, focusing on history, physical exams, problem statements, or hypothesis selection and ranking.

Getting Started

Login instructions

1. A link will be sent to your email address for password setup.
2. Visit www.i-human.com and click on the LOGIN button.
3. Enter your email address and password. If you forget your password, follow the provided instructions.

Watch the training videos

View the five screencast video tutorials to familiarize yourself with playing an i-Human Patients case. Understanding the complete student experience will improve your case navigation skills.

Find and select your case assignments

To locate your case assignment, click on the Assignments tab.
To choose your case assignment, click on the green arrow.
To launch your case assignment, click on Start Case.