FSC OSCE template

[textarea name="variable_1" default="Name:\nDOB:\nAge:\nChief Concern:\nPreferred Gender/Pronoun:\nOccupation:\nMarital Status:\nSource of History:\nReferral:\nReliability:"]
[textarea name="variable_2" default="HPI:"]
[textarea name="variable_3" default="Past Medical:"]
[textarea name="variable_4" default="Allergies:"]
[textarea name="variable_5" default="Medications/Indications/Dosages:"]
[textarea name="variable_6" default="Family History:"]
[textarea name="variable_7" default="Social History:"]

[textarea default="ROS:\nConstitutional: No fevers, weight loss, fatigue, night sweats\nHead: No headache, sinus congestion or pain\nEars: No ear pain, discharge, hearing loss, tinnitus, vertigo\nEyes No changes in vision, eye pain, diplopia, photophobia, \nNose: nasal discharge, coryza, sneezing, epistaxis \nThroat: No cough, sore throat, dysphagia, odynophagia, \nSkin: No diagnosed skin conditions, new lesions, rashes, discoloration, dryness, hair changes\nHeme: No easy bruising, easy bleeding\nCV: No chest pain, palpitations, edema, presyncope, decrease in exercise tolerance\nResp: No expectoration, dyspnea with rest or exertion, increased puffer use, orthopnea, PND, wheeze, \nGI: No abdominal pain, nausea, vomiting, diarrhea, constipation, melena, appetite changes, dyspepsia, belching\nGU: No dysuria, frequency, urgency, hematuria, nocturia, incontinence, dribbling, hesitancy, retention, flank pain\nMale: Denies discharge, lesions, testicular pain, hernias\nFemale: Denies discharge, lesions, changes in dysmenorrhea, PMS, menstrual frequency, duration, flow, or symptoms\nMSK: No new weakness, arthralgias, myalgias\nNeuro: No weakness, confusion, numbness, dizziness, imbalance\nEndocrine: No polydipsia, polyuria, heat/cold sensitivity\nPain: No new or unexplained pain\nPsychology: No new or worsening depression, anxiety, or insomnia, stress, anger \nSocial: No change in home, relationships, employment, substance use, exercise, exposure\nFunction: No change in ADLs or IADLS, memory, capacity"]


[textarea name="variable_8" cols=80 rows=2 default="Physical Exam:\nGENERAL APPEARANCE: Well developed, well nourished, alert and cooperative, and appears to be in no acute distress."]
[textarea name="variable_9" cols=80 rows=1 default="HEAD: normocephalic."]
[textarea name="variable_10" cols=80 rows=1 default="EYES: PERRL, EOMI. Fundi normal, vision is grossly intact."]
[textarea name="variable_11" cols=80 rows=1 default="EARS: External auditory canals and tympanic membranes clear, hearing grossly intact."]
[textarea name="variable_12" cols=80 rows=1 default="NOSE: No nasal discharge."]
[textarea name="variable_13" cols=80 rows=2 default="THROAT: Oral cavity and pharynx normal. No inflammation, swelling, exudate, or lesions. Teeth and gingiva in good general condition."]
[textarea name="variable_14" cols=80 rows=1 default="NECK: Neck supple, non-tender without lymphadenopathy, masses or thyromegaly."]
[textarea name="variable_15" cols=80 rows=3 default="CARDIAC: Normal S1 and S2. No S3, S4 or murmurs. Rhythm is regular. There is no peripheral edema, cyanosis or pallor. Extremities are warm and well perfused. Capillary refill is less than 2 seconds. No carotid bruits."]
[textarea name="variable_16" cols=80 rows=2 default="LUNGS: Clear to auscultation and percussion without rales, rhonchi, wheezing or diminished breath sounds."]
[textarea name="variable_17" cols=80 rows=2 default="ABDOMEN: Positive bowel sounds. Soft, nondistended, nontender. No guarding or rebound. No masses."]
[textarea name="variable_18" cols=80 rows=2 default="MUSKULOSKELETAL: Adequately aligned spine. ROM intact spine and extremities. No joint erythema or tenderness. Normal muscular development. Normal gait."]
[textarea name="variable_19" cols=80 rows=2 default="BACK: Examination of the spine reveals normal gait and posture, no spinal deformity, symmetry of spinal muscles, without tenderness, decreased range of motion or muscular spasm."]
[textarea name="variable_20" cols=80 rows=2 default="EXTREMITIES: No significant deformity or joint abnormality. No edema. Peripheral pulses intact. No varicosities."]
[textarea name="variable_21" cols=80 rows=5 default="LOWER EXTREMITY: Examination of both feet reveals all toes to be normal in size and symmetry, normal range of motion, normal sensation with distal capillary filling of less than 2 seconds without tenderness, swelling, discoloration, nodules, weakness or deformity; examination of both ankles, knees, legs, and hips reveals normal range of motion, normal sensation without tenderness, swelling, discoloration, crepitus, weakness or deformity."]
[textarea name="variable_22" cols=80 rows=2 default="NEUROLOGICAL: CN II-XII intact. Strength and sensation symmetric and intact throughout. Reflexes 2+ throughout. Cerebellar testing normal."]
[textarea name="variable_23" cols=80 rows=1 default="SKIN: Skin normal color, texture and turgor with no lesions or eruptions."]
[textarea name="variable_24" cols=80 rows=3 default="PSYCHIATRIC: The mental examination revealed the patient was oriented to person, place, and time. The patient was able to demonstrate good judgement and reason, without hallucinations, abnormal affect or abnormal behaviors during the examination. Patient is not suicidal."]
[textarea name="variable_25" default="Lab Results:"]
[textarea name="variable_26" default="Assessment:\nDiagnose 1:\nDiagnose 2:\nDiagnose 3:"]
[textarea name="variable_27" default="ICD: 10\nCPT:"]
[textarea name="variable_28" default="Therapeutic Plan:"]
[textarea name="variable_29" default="Reflection:"]
[textarea name="variable_30" default="Prescriptions: Med list only see prescription template"]
[textarea name="variable_31" default="References:"]

Minimum of 2 evidence-based references - a practice guideline and a scholarly resource. You need some in-text citations supporting your rationale of plan of care.

Are you missing any ICD-10 codes?

Did you put dates for your labs?

You need indications for medications listed?

Did you list the allergies?

Is HPI expanded on enough? Whatever you did not ask put in red text.