Interviewing well and writing a history well are two different skills, and the second one is what NR-557 grades. A fourteen-year-old sitting in a family practice room with her mother beside her will give you thirty minutes of usable material, and the stage this week tests is whether you can convert that half hour into a structured written history in which every element has a home: present concern, past medical, medications and allergies, family, personal and social, and a review of systems that reports rather than examines. The written history is the spine of the whole document, and a thin one cannot be rescued by a strong examination section. Your section may print this as NR 557 or NR557; it is the same course. The catalog prints the informatics description under this title, which duplicates NR-558 and looks like a listing error, so read the title and confirm the focus in Canvas. Chamberlain publishes no syllabi outside Canvas. The placement here is our teaching judgment from the course's catalog arc; your section's rubric decides what your week actually asks.
What NR-557 Week 2 asks for
A written health history is not a transcript of a conversation. Conversations wander, patients circle back, and mothers answer questions you asked the adolescent. The document has to arrive in the reader's hands already sorted, which means the writing work is mostly reorganization: taking material that came out in a jumbled order and placing it under the heading where a clinician would look for it. That reorganization is precisely what the completeness and organization rows on a documentation guide are pricing.
Take the fourteen-year-old with three months of afternoon headaches. In the room, her mother mentions that the child's father gets migraines, that the family moved districts in January, that she has been skipping lunch, and that a bottle of ibuprofen lives in the school bag. On paper those four facts go to four different addresses: family history, personal and social history, personal and social history again under nutrition and daily pattern, and medications, with the ibuprofen carrying dose, frequency and who is supervising it. A student who writes them in the order they were said produces a narrative. A student who files them produces a health history.
The second demand of this stage is scope discipline. A history has a defined perimeter, and graduate assessment writing rewards a writer who fills it fully and stops. Past medical history means conditions, hospitalizations, surgeries, injuries and, for a young patient, birth and developmental milestones where relevant. It does not mean an essay on childhood in general. The review of systems is a set of reported symptoms elicited by direct question, not a place to put anything you examined. Every time content migrates across those perimeter lines, a section that should have been complete becomes both padded and incomplete at once.
An eight-week session moves fast, and by the second stage most sections have moved from orientation into graded work. Expect a written history built from a supplied or constructed case, possibly paired with a discussion post about interviewing technique. If your section runs the discussion, remember that posts do not reopen after submission in Canvas, so the post is final copy. Whatever the shape, the skill installed here carries every remaining week: the focused write-up in the second half of the session is a compressed version of the same architecture.
The NR-557 Week 2 method, step by step
Six moves for turning an interview into a filed written history.
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Build the empty headings before you type any content
Lay down every section your scoring guide names, in the order it names them, with nothing underneath. Then fill them. Writing into a prepared skeleton makes an empty section visible immediately, and an empty required section costs more than a thin one because it reads as omitted rather than as sparse.
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Sort every fact to exactly one address
Take your notes line by line and assign each item to one heading only. Duplicated content across sections is a common quiet penalty, since a grader reading a family history that repeats the present concern sees a writer who has not decided what each section is for. If a fact seems to belong in two places, it belongs in the one where a reader would go looking for it.
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Write medications with dose, route, frequency and who gives them
An entry that says ibuprofen is not a medication history. An entry that says ibuprofen 200 mg by mouth, roughly three afternoons a week for the past two months, self-administered at school, is. In family practice and pediatrics you also record who supervises the dose, because the supervision arrangement is often the clinically interesting part.
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Take the family history to a defined depth and say what that depth was
Two generations is a standard perimeter: parents, siblings, and grandparents where known. Record the condition and the relative, note the age at onset if it was given, and state plainly when a branch is unknown. Unknown paternal history is information. A blank space is not.
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Interview the adolescent separately and document that you did
Where the case involves a young person, a written history that never distinguishes what the parent said from what the patient said has lost information a grader is looking for. Note who was present for which portion, and attribute accordingly. That single structural note is worth more on a scoring guide than an extra paragraph of content.
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Run the review of systems as reported symptoms only
Head to toe, by system, recording what was denied as well as what was endorsed, and never containing a finding you produced with your hands. If a system is not relevant to the case and your guide permits selection, say which systems you covered rather than implying you covered all of them.
Budget the history: sections and word targets
The frame our tutors use for a written health history of roughly 1,000 to 1,300 words. This is our own outline rather than anything the university publishes, and your week's scoring guide outranks it wherever they disagree. If your guide weights a row heavily, move words toward it before anything else.
| Section | What belongs in it | Word target |
|---|---|---|
| Source and reliability | Who gave which portion of the history, who was present, and a stated judgment about how complete the account is. | 50 to 80 |
| History of the present concern | The full course of the problem in the historian's terms, from first appearance to today, with what has been tried. | 280 to 340 |
| Past medical and developmental | Conditions, hospitalizations, surgeries, injuries, and where age makes it relevant, birth history and milestones. | 150 to 190 |
| Medications and allergies | Every agent with dose, route, frequency, supervision, plus reactions described rather than labelled as allergy. | 110 to 150 |
| Family history | Two generations to a stated depth, conditions with the relative attached, and explicit gaps where a branch is unknown. | 110 to 140 |
| Personal and social history | Household, school or work, sleep, nutrition, activity, safety and supports, written as facts rather than impressions. | 200 to 250 |
| Review of systems | Reported symptoms by system, endorsed and denied, with a sentence saying which systems were covered. | 150 to 200 |
Evidence craft for the written history
Give the present concern a timeline with fixed points. Three months of headaches is a duration. Headaches beginning in early April, three or four afternoons a week, worse since the school term restarted in August, none reported on weekends, is a timeline, and a timeline is what allows a reader to see a pattern you did not have to announce. Anchor to reported events rather than to vague intervals.
Convert every allergy into a described reaction. Allergic to amoxicillin tells a reader nothing about severity or mechanism. A flat red rash on the trunk on the third day, no swelling, no breathing difficulty, reported by the mother, is a documented reaction. Scoring guides in assessment courses treat undescribed allergies as incomplete entries, and the fix is one clause.
Support general statements with a named assessment text or professional guidance. A graduate history that asserts what a comprehensive interview should include, or how a symptom is normally characterized, is making a claim that belongs to published literature. Name the source and its year inside the sentence, and keep your own clinical experience as illustration rather than as authority.
Write social history as observable facts, not as character judgment. Lives with mother and two younger siblings, shares a bedroom, walks fifteen minutes to school, eats breakfast on four school days out of five by her own account, is documentation. A supportive home environment is an opinion, unscoreable and quietly biased, and graders in this course mark the difference.
Say what the history could not establish. Adolescents decline questions, parents step out, and adopted patients often have no family history to give. Record the limit in one sentence and the reader knows your perimeter was deliberate. Leave it silent and the same page reads as a history you never finished.
Five mistakes that cost points in this week's territory
- Chronological retelling instead of filing. A history written in the order the conversation happened forces the grader to sort your material for you, and organization rows price exactly that labour.
- Examination findings inside the review of systems. The review is reported symptoms. A palpated node or an auscultated murmur belongs in the objective section and nowhere near it.
- Medications without dose or supervision. A drug name alone is an incomplete entry, and in pediatric and family cases the supervision detail is frequently the point.
- Adolescent and parent merged into one voice. If the document cannot tell a reader who said what, half the interviewing skill being assessed has disappeared from the page.
- Padding a thin section with adjectives. Pleasant, cooperative and well-appearing fill space in a history without adding a single scoreable fact.
Before you submit
- Every section named by the scoring guide exists and holds content
- No fact appears under two headings
- The present concern carries a timeline with fixed reference points
- Every medication has dose, route, frequency and who administers it
- Allergies are described as reactions rather than labelled
- The review of systems contains no finding you produced yourself
- Gaps in the history are stated rather than left blank
Writing the history for NR-557?
Send the case and the scoring guide out of Canvas. A premium original draft comes back in 24 to 48 hours with every fact filed to one section and the reported voice attributed, and revisions run until the grade lands.