iHuman Patients Guide

i-Human Patients Case Player Student Manual
Table of Contents
Student Introduction to the i-Human Patients Case Player (Pages 3–6)
a. History-taking and physical examination

1. • 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 (Pages 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 Case Player (IHP) is an online platform that helps nursing students and healthcare professionals practice patient assessment, diagnostic reasoning, and clinical decision-making. With IHP, students can interact with virtual patients, perform assessments, conduct physical exams, make medical diagnoses, and develop treatment plans, all while receiving expert feedback on their performance.

Goals for Using i-Human Patients:

• Develop clinical reasoning skills in nursing by practicing diagnostic skills with virtual patients.
• Enhance nursing assessment abilities, including history-taking and physical examinations.
• Learn the structured diagnostic-reasoning process: Writing problem statements, creating differential diagnoses, ordering tests, and interpreting results.
• Practice treatment planning to learn how to develop management strategies for various medical conditions.

History-Taking and Physical Examination

Effective nursing assessments begin with a thorough patient history. IHP provides a virtual clinical learning environment where you can practice patient assessment techniques that are focused and efficient. Through systematic history-taking and a targeted physical exam, you will gather key data to identify possible medical diagnoses.

You will:

• Ask relevant questions based on the patient’s chief complaint and medical history.
• Perform a physical exam that targets the most pertinent areas for the patient’s condition.

In virtual clinical scenarios, you will update your problem list as you proceed through the patient’s assessment, which helps develop differential diagnosis practice and diagnostic reasoning in nursing.

Problem List and Problem Statement

The problem list allows you to record key findings, such as symptoms, medical history, and physical exam results. This problem list should be concise and focused on the most important findings that will guide your clinical reasoning and diagnostic decisions.

The problem statement should summarize the patient’s presenting symptoms, key findings, and relevant medical history, providing a clear snapshot of the patient’s condition to guide your diagnostic skills in nursing.

Creating a Differential Diagnosis

After gathering data through history and exam, you will use diagnostic reasoning to create a differential diagnosis. This is a critical skill for nursing education technology, as you rank possible diagnoses based on the patient’s presentation.

The steps include:

• Categorizing possible conditions by relevant organ systems.
• Ranking hypotheses: Most likely diagnoses at the top and less likely conditions lower.
• Using diagnostic tests to confirm or rule out these hypotheses.

This process sharpens diagnostic skills in nursing and enhances your ability to make evidence-based clinical decisions.

Plan and Summary

Once you have identified the most likely diagnosis, you will create a treatment/management plan, which outlines the next steps for patient care. The summary section reinforces the key learning points of the case, reviewing clinical findings, diagnostic decisions, and treatment options.

2. Getting Started

To begin using the i-Human Patients Case Player, follow these simple steps:

Login Instructions:

1. You will receive an email with a link to set your password.
2. Go to www.i-human.com and click the LOGIN button.
3. Enter your email address and password.

Watch Training Videos:

• Watch five screencast video tutorials to familiarize yourself with navigating the IHP platform and understanding how to interact with virtual patient cases.

Find and Select Case Assignments:

• After logging in, click the Assignments tab to view your assigned cases.
• Select a case by clicking the green arrow.
• To start the case, click Start Case.

Interactive Learning for Nursing Students

Virtual Patient Simulations are a powerful way to bridge the gap between nursing theory and clinical practice. By working with interactive patient cases, you will learn how to assess, diagnose, and treat a variety of medical conditions, honing clinical reasoning in nursing.

How Virtual Patient Simulations Enhance Diagnostic Skills:
By engaging with virtual patients, students practice critical diagnostic reasoning in nursing, including:

• Developing a differential diagnosis.
• Selecting appropriate diagnostic tests.
• Making treatment decisions based on patient data.

Key Features of the i-Human Patients Case Player

• Patient History-Taking and Physical Examination: Learn to ask the right questions and conduct focused exams.
• Creating Differential Diagnoses: Develop and rank possible diagnoses.
• Diagnostic Reasoning and Treatment Planning: Strengthen decision-making by formulating treatment plans based on the diagnosis.

The Role of Technology in Nursing Education

With virtual patient simulations, the i-Human Patients Case Player offers an innovative approach to nursing skills training. By incorporating this tool into the nursing curriculum, students can practice critical skills like differential diagnosis and diagnostic reasoning in a safe, controlled environment.

i-Human Patients serves as an invaluable resource for nurse practitioner clinical training, enhancing your ability to manage complex cases and improving your evidence-based nursing practice training.

Case Study Examples

Through interactive patient cases, you will encounter real-world scenarios where i-Human Patients has improved nursing students’ ability to perform accurate diagnostic assessments and make critical decisions. Feedback from these cases highlights the importance of clinical scenario-based learning, ensuring that you are ready for real-life patient encounters.

Integrating Virtual Patient Simulations into the Nursing Curriculum

Virtual patient simulations like IHP are increasingly being integrated into nursing education programs. Instructors can customize the flow of cases and student instructions to align with specific learning objectives. This personalized learning experience ensures that students develop the skills necessary for effective nursing assessments, diagnostic skills, and clinical reasoning.

The Future of Nursing Education with Virtual Patient Cases

The future of nursing education technology is bright, with tools like the i-Human Patients Case Player playing a central role. Virtual patient cases are revolutionizing the way nursing students develop critical skills, ensuring they are well-prepared for both clinical practice and complex medical scenarios.

By engaging with these advanced simulations, nursing students gain the confidence and competence needed to excel in nursing exams, nursing assignments, and ultimately, in clinical practice.

With the i-Human Patients platform, nursing students are equipped with essential skills to provide high-quality patient care, using evidence-based practices and fostering effective clinical reasoning through interactive learning and virtual clinical scenarios.

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

The i-Human Patients (IHP) Case Player is an Internet (cloud) application which enables students to
interact with virtual patients for the purpose of learning patient-assessment and diagnostic-reasoning
skills. With IHP, you will be able to independently interview, examine, diagnose, and treat virtual
patients and receive expert feedback on your performance iHuman Patients Guide.

The program is designed to help you achieve the following goals:
 Learn how to assess a patient, to ask the right questions and perform the right physical exams
for the patient’s problem, and to identify and organize pertinent findings.
 Learn a structured diagnostic-reasoning process, write a concise problem statement, select
and rank hypotheses (differential diagnoses), and order and interpret tests.
 Develop a treatment/management plan.
 Learn basic-science concepts that underlie the clinical aspects of the case.

Within each major section of the case you will be able to compare your work with the expert’s version.

History-taking and physical examination

Most clinical interactions begin with taking the patient’s history, a process that should be systematic
and complete. IHP will help you to develop question efficiency: that is, to limit your questions to those
that are appropriate for the patient’s chief complaint, associated symptoms, and pertinent past
medical history. The patient’s history is the subjective portion of the assessment. It reflects the
patient’s self-assessment and memory of events.
The physical examination is the next component of the patient evaluation. You will select and perform
various exams, as driven by the history of the present illness and any supportive information.
Again, while it is important to be comprehensive, your goal is to perform a targeted and efficient
physical examination by selecting only those exam components relevant to, and otherwise suggested
by, the patient’s presentation iHuman Patients Guide. The physical examination is the objective portion of the assessment:
Your findings should be measurable, accurate, and reproducible.
Throughout the process of conducting the history and physical exam, you should add any/all pertinent
findings to the problem list located along the left-hand side of the screen. The problem list can be
updated at any time as you proceed through these sections.
You can achieve greater efficiency in conducting the history and physical examination by developing
the differential diagnosis as you go. The questions you pose to the patient and the exam components
that you select will, in turn, help to further characterize and refine the differential diagnosis.

Problem list

The problem list is located vertically along the left-hand side of the screen. You will add key findings to
the list as you progress through the history and physical sections of the case.
Each entry should have no more than five words. You should attempt to translate the findings into
more precise medical terminology. Here are some examples:
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Patient says                                    Translation
Came on suddenly last night………………  Acute onset
It comes and goes………………… Episodic; recurrent
The pain is 9/10……………… Severe pain
Red blood in my stool……………… Hematochezia
Shortness of breath while lying flat……………… Orthopnea

Physical examination                 Translation
Swollen legs…………… Edema
Red…………………………………… Erythematous
Sleepy and slow to respond……………… Lethargic
Slurring words……………… Dysarthric
Seeing things……………… Visual hallucinations

The problem list should include all key findings (abnormalities) throughout the entire history-gathering
process:
 Chief complaint
 History of current illness, including all associated symptoms
 Review of systems
 Past medical history
 Family history
 Social history
The iHuman Patients Guide problem list should also be inclusive of all key findings (abnormalities) throughout all aspects of
the physical examination:
 Vital signs
 Mental status
 General exam
Pertinent negatives, while clinically important, should not be listed on the problem list. They may be
entered in the Notes Section for your own review and planning purposes.
Each entry on the problem list is then ranked relative to the specific patient’s presentation:
 Most significant active problem (MSAP)
 Related
 Unrelated
 Unknown
 PMH/Resolved
Problem statement
The problem statement is a succinct paragraph that synthesizes the following:
 Patient identifiers; i.e., age, gender, race/ethnicity (if pertinent), critical PMH
Example: The patient, a 74-year-old black male with known coronary artery disease, presents
with . . .
 Presenting complaint/s
 Key findings translated into medical terminology
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The problem statement should be concise and complete, but not a simple restatement of the problem
list. Rather, key findings should be consolidated if they relate to the same problem or potential
diagnosis. For example, chest pain, shortness of breath, and smoking history might all be addressed
in the same sentence.
The number of words allowed in the problem statement will be limited. Do not construct the differential
diagnosis here, as it will be addressed in the sections that follow.
Selecting hypotheses: Creating the differential diagnosis
The next sections of the i-Human case involve the creation of a rank-ordered and prioritized
differential diagnosis. There are several steps in this process: iHuman Patients Guide
Categorization:
You will choose the organ systems relevant to the differential diagnosis for this specific case.
Hypotheses:
You will next select specific hypotheses (disease states or diagnoses) which would explain, or
account for, the patient’s presentation.

Hypothesis ranking:
After selecting your hypotheses, you will next rank them:
 Leading; i.e., the one (or two, maximum) hypotheses highest on the differential diagnosis
 Alternative; i.e., possible, but less likely hypotheses
 Additionally, each hypothesis may be marked as must-not-miss; i.e., a disease/condition,
which, if missed, could result in severe consequences, including the patient’s death.

Tests:
Next you will choose appropriate diagnostic studies to test your hypotheses. You are not expected to
be an expert in diagnostic testing; in fact, you may have had little or no formal training in this regard.
However, much of this will call upon common sense. For example, if you are concerned that the
patient may have pneumonia or lung cancer, then ordering a chest x-ray may give you vast amounts
of information. Also, it can be academically rewarding to “virtually jump in” and diagnose patients in a
structured learning environment.

Associate tests with hypotheses:
After selecting diagnostic tests, you will be asked to associate each selected test with one or more of
your hypotheses. A test may not be ordered unless it is testing a hypothesis; that is, each test that you
order must have a purpose.
You will see how data derived from diagnostic testing can support or detract from a given hypothesis
and/or differentiate between various diagnoses.
Diagnosis:
The final step in the hypothesis selection and testing section is to designate the final diagnosis, as
based upon clinical data generated throughout the case development.
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It is the synthetic interpretation of all case data (history, physical, and test results) that allows you to
diagnose your patient!
In the world of i-Human Patients, it is the clinical reasoning leading up to the point of diagnosis that is
more important than obtaining the correct diagnosis. Uncertainty is a natural part of the practice of
medicine.
Treatment / management plan
You will next write a treatment plan and, if appropriate, a long-term management plan.
Summary
The summary section contains the learning objectives for the specific case, important “take-away”
considerations and pearls — both clinical and basic-science — and 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 at the time the case is assigned, not when the case is authored.
A given case can be used to satisfy many different learning objectives. For example, one instructor
might choose to emphasize the quality of a student’s patient-assessment skills; he/she might choose
to grade the student’s ability to select only history questions and physical-exam components
appropriate for the given patient’s chief complaint.
Another instructor might choose to emphasize the quality of the student’s problem statement; while
yet instructor might emphasize the student’s performance on embedded questions and exercises.
Cases need not utilize all of the features of the i-Human program. For example, a case can consist of
just a history, physical exam and problem statement. Similarly, a case can provide a preconstructed
history and physical exam and have the student focus solely on hypothesis selection and ranking.
A case can be assigned in learning mode or test mode. In learning mode, students will receive stepby-step feedback. Such feedback compares the student’s work product with that of the expert. As
well, the student’s selections are updated and brought into line with those of the expert so as to avoid
deviation too far from the design of the case. In test mode, no feedback is provided and the student’s
choices are not corrected.
Lastly, instructors can indicate whether embedded quizzes and exercises must be completed before
proceeding to the next section; and, within a given exercise group, whether the questions must be
completed in a set sequence, or completed by the student in any order.
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Getting Started
Login instructions
1. A link will be sent to your email address. Click on the link and select a unique password.
2. Go to www.i-human.com and click on the LOGIN button.
3. Enter your email address and password. If you forgot your password, click on the Forgot your
password? link and follow the instructions.
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Watch the training videos
Watch the five screencast video tutorials to learn how to play an i-Human Patients case. Familiarizing
yourself with the complete student experience first will help you become a better case navigator!
Find and select your case assignments
To find your case assignment, click on the Assignments tab.
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To select your case assignment, click on the green arrow.
To launch your case assignment, click on Start Case. iHuman Patients Guide

iHuman Patients Guide: Student Manual

Table of Contents

1. Student Introduction to the i-Human Patients Case Player (Pages 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
ORDER HERE

2. Getting Started (Pages 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 application for learning patient-assessment and diagnostic-reasoning skills. With IHP, you can interact with virtual patients, conduct interviews, exams, diagnoses, and treatments. Expert feedback is provided on your performance.

Goals:
– Learn patient assessment and physical exams.
– Develop diagnostic-reasoning skills.
– Formulate treatment/management plans.
– Understand basic-science concepts underlying clinical cases.

Sections in the Case:
– Compare your work with expert versions.
– History-taking: Systematic and complete process.
– Physical examination: Targeted and efficient.
– Problem list: Key findings during assessment.
– Problem statement: Summarizes patient presentation.
– Creating a differential diagnosis: Rank-ordered hypotheses.
– Plan: Diagnostic tests and final diagnosis.
– Summary: Learning objectives and case summary.

2. Getting Started

Login Instructions:
1. Click link in email, set password.
2. Go to www.i-human.com, click LOGIN.
3. Enter email and password.

Watch Training Videos:
– Five screencast tutorials for case navigation.

Find and Select Case Assignments:
1. Click on Assignments tab.
2. Click green arrow to select assignment.
3. Click Start Case to begin.

For more information, refer to the i-Human Patients Guide.