Table 1.

Blueprint for PCSE

Chief complaints and concerns	Dysuria	Elevated blood pressure	Shortness of breath	Elevated temperature	Abdominal pain	Fatigue	Health maintenance	Diabetes
Communication skills challenges options	Embarrassing topic for teenagers	Parent and child in interview and physical exam	Worried patient	History from non-parent caregiver	Hard of hearing, blind, or demented	Reticent historian with hidden agenda	Complex and changing recommendations	Need for shared decision-making and non-judgmental stance
Data gathering: history components	Sexual history	Lifestyle, family history	Pulmonary, cardiac, hematologic compliance	Immunization history	Use of interpreter or family member	Depression or abuse or alcohol Multiple labs and tests on chart	Risk factors, patient goals, beliefs	Barriers to compliance
Data gathering: physical examination components	Pulse Pediatric Abdominal Exam (GU exam)	Vitals, including blood pressure, in both arms Lungs Heart Abdomen Extremities	Vitals Lungs Heart Vascular	Vitals Ears Lymph nodes Lungs Abdomen (meningeal signs)	Vitals Abdominal (rectal)	Vitals Lymph nodes Thyroid Lungs Heart Abdomen (breast/pelvic/ rectal)	Vitals Thyroid Lungs Heart Abdomen Vascular	Vitals Funduscopic Carotids Lungs Heart Abdomen Feet
Differential diagnosis of major active problem/s	By case scenario	By case scenario	By case scenario	By case scenario	By case scenario	By case scenario	By case scenario	By case scenario
Management plan	Antibiotic choice	Non-pharmacologic approaches	Medication changes necessary	In patient or outpatient work up	In patient or outpatient Imaging Antibiotics	Appropriate testing	Latest screening recommended	Lifestyle and pharmacologic approaches
Necessary science application options	Pathology Anatomy EBM Microbiology Pharmacology Ethics	Physiology Nutrition Genetics Public health	Anatomy Physiology Pharmacology	Micro Pharmacology Impact on family Safety	Anatomy Immuno Micro Pharm Path Nutrition	Patient impact Family impact Public health Ethics Psychopharm Behavior	Epidemiology Biostatistics Principles of screening	Biochemistry Nutrition Neurobiology of compliance/satisfaction
Controversies, Concerns, and complexities options	Stress Specter of abuse Confidentiality	Defining hypertension Addressing hypertension in a developmental context Treatment choices	Patient beliefs vs. biomedical etiology	Immunization evidence Parent and dependent interests	Antibiotics or not? Dietary recommendations	Chronic undifferentiated complaint Meds vs. talk therapy	Changing recommendation and challenging patient education	Control parameters Autonomy