Building a health history discussion: case guide
Each case in this discussion bundles two very different patients, and the 500-word post must answer three questions for both — which makes contrast the winning strategy: barriers, exam techniques and SOAP documentation that visibly change between an elderly urban man with disabilities and a pregnant inner-city teenager.
Editorial process
Last reviewed · August 11, 2026
Why does each case contain two deliberately unalike patients?
The detail that reshapes the whole post is easy to skim past: your assigned case contains two scenarios, and the brief says to answer the questions 'to both scenarios within your case'. The six patients pair into three cases — each pairing deliberately unalike in age, culture, setting and vulnerability — so the assignment is really a structured comparison: how do communication barriers, examination approach and documentation change when the patient changes? A post that answers the three questions once, generically, has quietly done half the assignment; a post that answers them twice identically has missed why the pairs were built. Budget the 500 words accordingly: a short frame, then two parallel passes whose differences do the arguing. The contrast is the content; the frame just names it. Two headings, one per patient, make the structure visible to a grader in seconds.
Each question rewards patient-specific reasoning. Communication barriers should come from the described lives, not a textbook list: sensory and cognitive considerations plus possible medical mistrust for the 76-year-old Black man with disabilities; parental presence, developmental stage and confidentiality for the adolescent; language access and health literacy where the vignette implies them; safety, stigma and correct pronoun use for the transgender man in a homeless shelter; trust and fear of judgement for the pregnant sixteen-year-old. Examination techniques likewise: the standard sequence — inspection, palpation, percussion, auscultation — adapted to age (developmental approach for the pre-schooler), condition (obstetric considerations), and circumstance (privacy and trauma-informed care). The SOAP question is definitional but not free: describe each component and what belongs in it, and the strongest posts connect it back to the cases — what would be Subjective versus Objective for this patient's visit.
The mechanics are stated and points-mapped: at least 500 words, current APA, at least two academic sources, worth eight points; then replies to one post from each of the other two cases, constructive, literature-supported where possible, worth a point each. The reply structure is unusual — one reply per other case, not two anywhere — and following it exactly is the cheapest two points in the course. Extending or nuancing a peer's barrier analysis with a cited source meets the stated standard for replies. Draft the replies after reading, not before — the extend-or-refute standard requires knowing what the peer actually claimed. A reply that cites the same two sources as your initial post is technically compliant but visibly lazy; one new source per reply reads far better. Post early enough that the good peer posts are still unclaimed.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Answer all three questions for both scenarios in the assigned case, as the brief instructs.
- 02Derive communication barriers from each patient's described age, culture, setting and vulnerability rather than a generic list.
- 03Adapt physical examination procedures and techniques to each patient — developmental, cultural, obstetric or circumstantial.
- 04Explain the SOAP components accurately and illustrate them against the case patients.
- 05Execute the one-reply-per-other-case response structure with literature support.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes. Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages. Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor. The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument
Turn the brief into deliverables
- 01An initial post of at least 500 words answering, for both scenarios in your assigned case: the barriers to interpersonal communication, the procedures and examination techniques for the physical exam, and a description of the S.O.A.P. approach and its components.
- 02Current APA formatting with support from at least two academic sources, per the stated 8-point standard.
- 03Two reply posts — one to each of the other two cases — that extend, refute/correct, or add nuance, constructive and literature-supported, worth one point each.
How should the 500 words split across both scenarios?
Frame the pairing
Open by naming your case's two patients and the axis on which they differ — the sentence that signals you noticed the comparative design.
Barriers, patient by patient
For each scenario, derive the interpersonal communication barriers from the described life: developmental stage, culture and language, disability, housing and safety, identity and trust.
The exam, adapted twice
Set out the procedures and examination techniques for each patient: the standard sequence adapted for age, condition and circumstance, with the accommodations each vignette makes necessary.
SOAP, defined and applied
Describe Subjective, Objective, Assessment and Planning as a documentation approach, then ground each component with an example of what it would contain for one of your patients.
The two replies
Draft one reply per other case, choosing the extend/refute/nuance mode the peer's post actually invites, with a supporting citation.
Which SOAP and communication sources meet the two-source rule?
Recommended databases
- Course text and Learning Resources
- NCBI Bookshelf (StatPearls)
- PubMed Central
Search sequence
- 1.Read the StatPearls SOAP notes chapter for component definitions precise enough to describe and apply — it is also a citable academic source.
- 2.Read a therapeutic-communication barriers study so the barrier analysis has a literature anchor beyond intuition.
- 3.Check the course text's examination-techniques chapters for the age- and condition-specific adaptations your two patients need.
- 4.Confirm two academic sources are cited in the initial post; the SOAP chapter and a communication study cover the minimum.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
SOAP Notes
StatPearls, NCBI Bookshelf · 2023
The authoritative component-by-component description of SOAP documentation for question three — and one of the two academic sources the post requires.
- 02
A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients
BMC Nursing (via PMC) · 2019
Evidence for the barrier analysis — patient-related, nurse-related and environmental barriers from actual clinical settings, citable behind the case-specific claims.
- 03
Communication Barriers Perceived by Nurses and Patients
Global Journal of Health Science (via PMC) · 2016
A second communication-barriers study offering the dual perspective (nurse and patient) — useful for reply posts that add nuance to classmates' barrier lists.
Review before submission
Common mistakes
- Answering the three questions once instead of for both scenarios in the case — the two-patient structure is the assignment's core and the brief states it explicitly.
- Listing textbook communication barriers unmoored from the patients described; every vignette detail (age, setting, identity, condition) is there to generate a specific barrier.
- Describing one standard physical exam when the pairs are built to force adaptation — a pre-schooler and a pregnant teenager are not examined the same way.
- Defining SOAP in the abstract without touching the cases, which answers the question at the lowest band it permits.
- Replying twice to the same case when the brief requires one reply to each of the other two.
- Posting 'great analysis' replies when the stated standard is extend, refute/correct, or add nuance, with literature where possible.
Submission checklist
- Both scenarios of the assigned case addressed under all three questions.
- Each barrier and technique traceable to a stated feature of the patient.
- SOAP components each described, with at least one case-anchored example.
- 500+ words, current APA, two or more academic sources.
- One reply per other case, each substantive and cited where possible.
Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.
Written by
Aaron Bishop
MA, Education
assignment interpretation and research-methods coaching across disciplines
Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.
Reviewed by
Dr. Nathan Cole
PhD, Rhetoric & Composition
Argumentation and thesis development
Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.