Criteria Ratings Pts

Opening Statement 5 pts 3 pts 1 pts

Begins with the chief concern (usually in patient’s/caregiver’s Full Marks Partial Marks Partial Marks
words) and includes relevant patient information including age, Concise and comprehensive, Accurate with most of the pertinent Inaccurate, incomplete,
presence/absence of conditions directly relevant to the includes all relevant information included and most of the and/or includes excessive
assessment, and reason for presentation. information irrelevant data omitted. irrelevant data

5 pts

History of Present Illness/Interval History 5 pts 3 pts 1 pts

Identifies all patient/caregiver concerns. Includes interval Full Marks
illnesses and information from follow-up appointments with Description of all parent/caregiver
subspecialists if applicable. concerns is hypothesis (assessment)
driven, concise, comprehensive,
organized. Also includes summary of
interval ED visits/hospitalizations;
follow up appointments with
subspecialists; management of
chronic conditions.
Partial Marks
Description of parent/caregiver
concerns is accurate, mostly
organized and well-characterized
(quality, severity, etc.). Most of
the irrelevant data omitted.
Limited information regarding
interval illnesses, prior
encounters with health care
system, or status of chronic
conditions.
Partial Marks
Inaccurate, incomplete,
and/or includes excessive
irrelevant data. Does not
include description of
parent/caregiver concerns,
information regarding interval
encounters with health care
system, or status of chronic
5 pts
conditions.

Additional History 7 pts 3.5 pts 1 pts

Nutrition/Elimination; Sleep; Developmental Screen/Education; Full Marks Partial Marks Partial Marks
Social History (including SSHADDESSS for adolescents); Patient specific. Accurate, age-appropriate but incomplete information. Inaccurate, incomplete,
Screeners for Lead, TB, Smoke Exposure (when appropriate); Complete. PMH, FH, SH, and ROS included but limited information and/or poorly described
Past Medical History; Family History; Review of Systems; is available.
Allergies; Medications

7 pts

Social Determinant of Health and Psychosocial Stressors 5 pts 3 pts 1 pts 5 pts
Assess economic security (ability to pay for food, housing, Full Marks Partial Marks Partial Marks
transportation, utilities, medications etc.), social context, Patient specific. Patient specific. Inaccurate, incomplete, and/or poorly
neighborhood and physical environment, health literacy. Assess Complete. Complete. described.
for patient and/or caregiver distress and mental health
challenges, experiences with discrimination, and distrust in
health care system. May use Structural Vulnerability
Assessment Tool as a guide to help facilitate questions. May
also refer to completed screeners.
 Criteria Ratings Pts

Vital Signs and Growth Parameters 3 pts 2 pts 1 pts

Full Marks Partial Marks Partial Marks
All age-appropriate growth Accurate with complete vital signs Inaccurate or
parameters/percentiles. Patient specific. and some age-appropriate growth incomplete
(eg. preterm/syndrome specific growth parameters/percentiles information 3 pts
chart). provided.

Physical Exam 5 pts 3 pts 1 pts

Full Marks Partial Marks Partial
Hypothesis (assessment) driven. When appropriate, includes subtle Accurate, Marks
positive and negative findings, and additional maneuvers/observations complete, age- Inaccurate
that distinguish among diagnoses under consideration. (e.g, detailed appropriate and/or
lower extremity exam if concern for intoeing; acanthosis nigricans if physical exam. incomplete
concern for elevated BMI; observed behaviors including speech,
5 pts
interactions with examiner, etc.)

Assessment 5 pts 3 pts 1 pts

“Big picture” synthesis of collected information, providing Full Marks Partial Marks Partial Marks
assessment of overall growth and development. For concerns Accurate, age-appropriate Incomplete or inaccurate Absent assessment of overall
raised in either history or exam, assessment includes assessment of overall growth assessment of overall growth and growth and development. Misses
formulation of a prioritized differential and identification of the and development. For development. Identifies some many critical findings, fails to
most likely diagnosis. Author (1) Identifies critical defining problems identified on either defining history AND physical include relevant physical
history AND physical exam findings; (2) Synthesizes findings history or exam, synthesizes exam/diagnostic study findings but exam/diagnostic study findings,
into medical terms and concepts (e.g. not yet combining two an accurate and concise does not fully synthesize findings and/or restates findings without
words into short phrase and limited vocabulary of about 5 summary statement into medical terms or concepts. synthesis
words, concerning for expressive speech delay); (3) Highlights
impact of patient's SDOH on health and access to care

5 pts
 Criteria Ratings Pts

Problem List/Plan 5 pts 3 pts 1 pts

Diagnostic, therapeutic, referrals, connection to resources, Full Marks Partial Marks Partial Marks
patient/caregiver education (anticipatory guidance), and follow- Accurately, concisely, and thoroughly Addresses most aspects of the Poorly described,
up addresses all identified problems. identified problems while describing unsupported, and/or
Considers patient/caregiver decision making rationale. does not match the
preferences, literature/practice Sometimes includes patient/caregiver problem list or
guidelines, SDOH, and/or education and discharge/follow-up assessment. Does not
contingency plans when appropriate. plans when appropriate. consider SDOH. 5 pts

Discussion 10 pts 5 pts 3 pts

Health outcomes and lifestyle practices are shaped by larger Full Marks Partial Marks Partial Marks
socioeconomic, political and cultural forces. Identify a clinical Presents an accurate and Literature review begins to answer stated Question to be answered
question related to SDOH and patient health and health comes complete literature review question but remains incomplete. Literature remains unclear.
and conduct a literature review. Connect it back to the patient. using primary sources that cited may be more general references Literature review is
Discuss how social conditions and practical limitations may answers the stated question. rather than primary sources. Begins to absent, unsupported,
undermine the capacities of patients and their families to Connects current patient connect current patient's relevant history, and/or poorly described.
access health care, adhere to treatment, and modify lifestyles relevant history to findings physical exam, and diagnostic elements to
successfully. Consider what steps may be taken at the provider, from the literature literature review.
community, and health systems levels to address concerns
regarding SDOH and psychosocial stressors impacting your
patient’s health and how these actions or resources may be
effectively used to optimize health care

10 pts

Total Points: 50