Mastering OLDCARTS: The First Step to Thinking Like a Clinician

audreyriver
Jul 17
2 min read

In healthcare, asking the right questions is half the diagnosis.

When a patient says, “I’m in pain,” that’s just the beginning. Doctors, nurses, and physician assistants use a clinical interview tool called OLDCARTS to dig deeper and figure out what’s really going on.

If you're a student interested in medicine, nursing, or any healthcare field — learning OLDCARTS now will give you a head start in clinical thinking.

What Is OLDCARTS?

OLDCARTS is a simple, proven method to ask better questions about a patient’s symptoms — especially pain.

Each letter stands for a type of question that helps build a full picture of the problem:

Letter	Stands For	What You Ask
O	Onset	When did it start?
L	Location	Where is the pain? Point with one finger.
D	Duration	How long does it last? Constant or on-and-off?
C	Character	What does it feel like? Sharp, dull, burning?
A	Aggravating	What makes it worse? (e.g., movement, eating)
R	Relieving	What makes it better? (e.g., rest, medication)
T	Timing	Does it come and go? Is it worse at night?
S	Severity	How bad is it? (Usually rated 1–10)

Why OLDCARTS Matters

Every symptom tells a story. OLDCARTS helps clinicians ask the right questions to uncover that story faster.

It prevents vague answers like “It just hurts.”

It gives structure to interviews and SOAP notes.

It trains students to think critically, not just listen passively.

In other words, OLDCARTS builds the mindset of a healthcare professional.

OLDCARTS in Action – Sample Case

Chief Complaint: Stomach pain

Here’s how a student might use OLDCARTS to interview the “patient”:

O – Onset: “It started last night.”
L – Location: “Mostly on the lower right side of my belly.”
D – Duration: “It’s been constant since it started.”
C – Character: “It’s sharp and stabbing.”
A – Aggravating: “Hurts more when I walk or move.”
R – Relieving: “Lying still helps a little.”
T – Timing: “No specific time. It’s just been there.”
S – Severity: “I’d say it’s about a 7 out of 10.”

From here, a student can transfer this information into the Subjective section of a SOAP note and begin forming a hypothesis — like appendicitis or another type of abdominal issue.