Scenarios

1. 1

   Focused history: severe abdominal pain in a young adult

   Take a rapid abdominal-pain history, check urgent symptoms and alternative causes, acknowledge distress, and arrange immediate supervised assessment.

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2. 2

   Focused history: recurrent abdominal pain

   Characterize recurring pain and meal relationships, explore risks and alternative causes, check warning symptoms, and explain supervised assessment.

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3. 3

   Focused history: burning upper-abdominal pain

   Characterize upper-abdominal pain, ask about meals, reflux, and over-the-counter medicines, and screen for warning symptoms while explaining supervised next steps.

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4. 4

   Focused history: persistent diarrhea and cramping

   Characterize bowel symptoms, compare possible causes, screen for bleeding and other warning signs, and address the patient’s concerns about ongoing symptoms.

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5. 5

   Focused history: new rectal bleeding

   Clarify the amount and timing of bleeding, screen for urgent symptoms, review bowel changes and risks, and address fear while explaining assessment.

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6. 6

   Focused history: burning chest discomfort in clinic

   Characterize chest burning and its triggers, assess serious alternative causes and risk factors, and explain prompt evaluation while acknowledging time concerns.

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7. 7

   Focused history: diarrhea after travel

   Clarify diarrhea and travel timing, assess hydration and warning symptoms, review specific exposures and health risks, and explain safe follow-up.

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8. 8

   Consult: gastroenterology for upper gastrointestinal bleeding

   Summarize bleeding and treatment response, explain remaining risk, request an endoscopy plan, and confirm interim care, responsibilities and escalation.

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9. 9

   Consent: paracentesis for comfort

   Explain abdominal fluid drainage, explore the patient’s comfort goals and treatment fatigue, discuss tradeoffs, and confirm understanding and a voluntary decision.

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10. 10

    Handoff: overnight care after gastrointestinal bleeding

    Summarize current bleeding risk, assign overnight tasks, explain monitoring and emergency responses, and confirm the receiving clinician’s understanding and responsibility.

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