Maggie Smith SOAP note and illness script case guide
A video-based case assignment: complete the SOAP note on the given history, then rule in and rule out your three highest differentials with peer-reviewed evidence, each worked through a full illness script.
Editorial process
Last reviewed · August 12, 2026
How is the SOAP-and-differentials package actually graded?
The assignment runs on a strict division of labor that the rubric enforces section by section: watch the case video, fill in the documentation blanks, and keep subjective and objective information in their own compartments. The rubric's largest criterion scores exactly that separation — points come off when exam findings drift into the history or the patient's reported symptoms appear under objective data. The template hands you the scaffolding, with the HPI dimensions listed out — onset, location, duration, character, aggravating and alleviating factors, timing, severity — so the efficient move is to mine the video against that checklist and write each element in SOAP-appropriate telegraphic style. The plan section is not an afterthought either: the instructions ask what tests you will order with rationale, plus follow-up and patient education, and each ordered test needs one sentence tying it to a differential you are about to argue.
The intellectual center is the three-differential exercise, and the brief spells out its own method with the knee example: for each of your three highest-probability diagnoses, rule in by matching the patient's documented signs and symptoms to the disease's expected presentation, then rule out by naming what is missing or inconsistent — and both directions must be proven with peer-reviewed evidence, not clinical intuition. The trap is choosing three diagnoses of convenience: the rubric rewards the highest plausible differentials for the presentation you documented, argued honestly, including the one you will ultimately keep. Ruling in the eventual diagnosis and ruling out its competitors is one connected argument rather than three separate essays, so write the three differentials in parallel structure, keep the same evidence standard for each, and let the cited literature decide which one survives.
The illness script is where the assignment teaches diagnostic reasoning rather than testing recall, and the template repeats it verbatim for each differential: epidemiology, time course, clinical presentation, pathophysiology, lab, imaging. Fill every row for every differential, because a script with empty cells reads as an unfinished argument — if a differential has no imaging findings, say so and cite it, since knowing a workup is unnecessary is itself script knowledge. Note that this record carries the documentation template for the case series with a history block already given — the instructions say the history is provided — so build your note on that provided history exactly as instructed rather than inventing details the video does not supply. Cite in APA throughout; the writing criterion is small in points but it is the rubric's only pass on your sourcing.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Complete the SOAP note on the given history with subjective and objective information strictly separated, as the rubric's largest criterion scores.
- 02Mine the case video against the template's HPI checklist — onset through severity — in SOAP-appropriate style.
- 03Select the three highest-probability differentials for the documented presentation and argue rule-in and rule-out with peer-reviewed evidence.
- 04Complete a full illness script per differential: epidemiology, time course, presentation, pathophysiology, lab, imaging.
- 05Write a plan that ties every ordered test to a differential, with follow-up and education included.
Read the full question
Review every instruction before using the planning guidance that follows.
Turn the brief into deliverables
- 01A completed SOAP note built on the given history and the case video.
- 02Three highest differential diagnoses, each ruled in and ruled out with peer-reviewed evidence.
- 03A completed illness script for each of the three differentials.
- 04A plan stating ordered tests with rationale, follow-up, and patient education, in APA format.
How should the rule-in/rule-out argument be built?
The SOAP note
Complete the documentation on the given history: HPI by the template's checklist, histories and ROS in the subjective, exam and vitals in the objective, in note-appropriate style.
Three differentials, ruled in and out
Argue the three highest-probability diagnoses in parallel: symptoms matched to expected presentation to rule in, missing or inconsistent findings named to rule out, evidence cited both ways.
The illness scripts
Fill the six-row script — epidemiology, time course, presentation, pathophysiology, lab, imaging — for each differential, citing when a row is legitimately negative.
Assessment and plan
State the leading assessment and the ordered tests with rationale tied to the differentials, plus follow-up and patient education.
Where are SOAP and diagnostic-reasoning methods documented?
Recommended databases
- NCBI Bookshelf / StatPearls
- AHRQ PSNet
- MedlinePlus
Search sequence
- 1.Review the SOAP-note reference for section boundaries before documenting.
- 2.Read the diagnostic-error primer for how differential reasoning goes wrong — the failure modes the rule-out step guards against.
- 3.Pull peer-reviewed sources for each differential's expected presentation and workup.
- 4.Complete the scripts, then write the plan with test rationales tied back to the differentials.
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 documentation standard the note is graded against — what belongs in each section and the style the rubric calls note-appropriate.
- 02
Diagnostic Errors
AHRQ Patient Safety Network · 2019
The reasoning-failure evidence behind the rule-in/rule-out discipline — premature closure is exactly what arguing all three differentials honestly prevents.
- 03
Diagnostic Tests
MedlinePlus, U.S. National Library of Medicine · 2024
The plain-language frame for the plan section — what ordered tests do and how to explain them in the education element.
Review before submission
Common mistakes
- Letting objective findings leak into the subjective section — the rubric's biggest criterion scores the separation itself.
- Choosing three convenient differentials instead of the three highest-probability ones for the documented presentation.
- Ruling in with pattern-matching but ruling out with intuition — both directions require peer-reviewed evidence.
- Leaving illness-script cells empty instead of citing why a workup element is unnecessary.
- Ordering tests in the plan without tying each to a differential being argued.
- Inventing history details the video and the given note do not supply.
Submission checklist
- SOAP note complete on the given history; S and O strictly separated.
- HPI covers onset, location, duration, character, aggravating/alleviating factors, timing, severity.
- Three differentials argued rule-in and rule-out, each with peer-reviewed support.
- Illness script complete for all three — every row addressed.
- Plan includes test rationale, follow-up, and education.
- APA citations and reference page correct.
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.