Information for Authors of Case Study Challenges

Information for Authors of Case Study Challenges

This section features case presentations reflecting either unusual presentations of common conditions or more uncommon conditions that might be seen in primary care. The anonymity of patients presented should be maintained

The cases are designed to challenge the NP to formulate the correct diagnosis just as they would with a real patient -- using the information in the history and physical leading to a differential diagnosis and then posing questions to guide them through appropriate diagnostic testings, treatment and diagnostic reasoning process. The case information and questions will appear in one section of the journal with the answers, summary and references in another section to continue the format of a clinical challenge. See the suggested template for case study preparation.

Patient anonymity should be maintained. In accordance with the International Committee of Medical Journal Editors recommendations (http://www.icjme.org) no patient names, initials, or hospital numbers should be included in manuscripts. Although author affiliations may reflect where the patient was cared for, specific institutions should not be identified in the text. The identity of the patient must be disguised to protect their anonymity.

This activity will run periodically in The Journal for Nurse Practitioners on a space available basis.

The case study should have 5 specific components and be written in a narrative style:

Part 1

(1)  Brief introduction to the case

(2)  Case Presentation

(3)  Case Study Questions

Part 2

(4)  Case Study Questions repeated with Answers

(5)  Conclusion

(6)  References

Template:

Title: Should not give away the diagnosis, focus on symptoms or signs that were challenging

Brief introduction: including a summary of the patient(s) that will be presented.

Case Presentation including any of the following that are pertinent to the case:

·  Chief complaint

·  History of Present Illness (includes status of immunizations, travel, exposure)

·  Past Medical History (includes hospitalization, surgeries, trauma)

·  Medications (response, adverse effects, allergies)

·  Family History

·  Personal/Social/Developmental History

·  Review of Symptoms

·  Pertinent Physical Examination Findings

·  Diagnostic Studies (include any laboratory or radiologic evaluation, which are of importance for diagnosis). Including this information here is optional as the author may wish to have the learner consider what diagnostic testing is most important.

Case Study Questions:

Three to five case study questions should appear at the end of the presentation. These should help the reader construct a differential diagnosis or identify additional history or physical that might be needed and the diagnostic testing plan to confirm a diagnosis. The diagnosis is still not known at this point.

Additional questions might focus on treatment, interventions and followup if the differential can be narrowed to a specific diagnosis.

Examples of questions are:

·  What differential diagnoses should be considered for this individual?

·  What diagnostic evaluation are you considering?

·  Based on available information, what is the mostly likely diagnosis and why?

·  What is your proposed management for the patient?

·  What is the best available evidence that supports this management strategy?

·  What important patient and family education is required?

·  What is the recommended followup for this individual?

Case Study Answers:

In the second half of the case study challenge please state the questions again and provide detailed and referenced answers for each question posed. Authors are encouraged to use practice guidelines when available. If there is a practice guideline available, critically appraise the guideline and briefly discuss whether the guideline was appropriate for use in the case. If a practice guideline is not available, please provide the best available-evidence for the case management.

Conclusion: A concluding paragraph should summarize the patient condition and outcome.

References:

Identify 6-10 of the best references on this topic.

References should be no older than 5 years.

For questions or clarification please contact Associate Editor Julee Waldrop at