Clinical reasoning
If you want to work in healthcare, science knowledge is not the whole job. You also need clinical reasoning: asking useful questions, noticing the clue that matters, and deciding what to do next.
One of the first tools clinicians learn is the SOAP note.
What each part holds
S — Subjective. What the patient tells you. Symptoms, when the problem started, how bad it is, what makes it better or worse, and the history around it.
Example: “My stomach has been hurting for 2 days. It is worse when I walk.”
O — Objective. What you observe or measure. Temperature, heart rate, blood pressure, exam findings, labs, or scans. Anything you can see or confirm.
Example: “Temp 100.9°F. Tenderness in the lower right abdomen.”
A — Assessment. What you think is happening. A likely explanation, or a short list of possibilities — a differential. You build it from S and O, not from a hunch you skip ahead to.
Example: “Most likely appendicitis. Other possibilities: ovarian cyst, stomach virus.”
P — Plan. What you would do next. Tests, medication, procedures, follow-up, or a referral.
Example: “Order an ultrasound and a CBC. Keep the patient from eating or drinking. Start IV fluids. Ask surgery to see them.”
A sample note
This is a teaching example, not a diagnosis for anyone reading it.
Chief complaint: lower right abdominal pain
- S. Sharp pain in the lower right abdomen for 2 days. No vomiting. Worse with movement. Rates it 7 out of 10.
- O. Temp 100.9°F, heart rate 95, tenderness in the right lower quadrant.
- A. Likely appendicitis. Still need to consider ovarian torsion or a gastrointestinal infection.
- P. Order a CBC and an abdominal ultrasound. Nothing by mouth. IV fluids. Surgical consult.
The note is not paperwork for its own sake. It is the thinking, written so another person on the team can follow it.
The Explorer package is where students start using SOAP on real case material.
Academy stories explain how clinicians learn to think. They are not medical advice, and they are not a diagnosis.