What were the presenting symptoms? From this how did you rule in/ rule out the differential diagnosis?
APACS Case Assignment “TOP TIPS”
1) Ensure that you pick a case where you have:
- Taken a conventional history
- Undertaken the clinical Examination
- Derived the diagnosis and formulated the clinical management plan.
This will enable you to provide a level 7 critical synopsis of how you derived the diagnosis. At the beginning of the assignment give a brief summary of the case to set the scene.
2) Place the confidentiality front sheet at the beginning of the assignment to ensure all names and places have been anonymised. Place your patient history and examination write up in the appendix where you can refer to it. You need to demonstrate the ability to undertake safe and systematic history taking. Please refer to the Module Handbook for layout, font and presentation. You must ensure accurate referencing the current standard used here at SHU is APA. It is imperative that good academic conduct is maintained at all times.
3) It is assumed that as an experienced practitioner you will be aware of effective communication techniques therefore this should not be the focus of this particular assignment.
4) Diagnostic reasoning plays an important role when deriving a differential diagnosis. You may wish to include a concise analysis regarding the importance of consultation, this may include diagnostic error. One of the most frequently used is the Hypothetico-deductive model. This is not the main focus of the assignment but can be acknowledged.
5) The main body of the assignment should focus upon what signs and symptoms the patient had taken from the history and the clinical examination. What were the presenting symptoms? From this how did you rule in/ rule out the differential diagnosis? What were the red flags? You must combine this with a L7 synopsis of evidence to demonstrate your ability to base your findings upon a contemporary evidence base.
6) You need to underpin your critical synopsis with high level evidence, usually within the last 5 years unless it is a key text. As this is level 7 you need to be critical of the evidence you are using Trisha Greenhalgh (2014) “How to read a paper” is a useful text see the RLO. Try to use the literature as the starting point for your analytical discussion rather than merely illustrative of what you are trying to say.
7)Use evidence such as, primary research papers, Cochrane reviews, meta analyses, peer reviewed journals, NICE and other guidelines if they exist for your topic. It is anticipated that you will be drawing from predominantly medical journals relating to the particular condition you are considering.
8) Wherever possible you need to relate your clinical examination findings to sensitivity and specificity of the clinical sign or symptom. How did this impact upon your decision making? What were the pertinent positives? And pertinent negatives? This allows clear demonstration of the objectivity within your decision making.
9) You must ensure that you link your diagnosis and the clinical management plan together. Please ensure that this is not a descriptive account of what you initiated. You must demonstrate clear L7 writing (comparing and contrasting authors and commenting on the validity of research) you may include safety netting as well as a well-developed conclusion.
10) Please contact your academic advisor/marker to check the appropriateness of your case and send in a draft of 500 words only for comment and feedback. This is advisable as it is important that you are writing at L7 and to ensure you are meeting the assignment brief.
