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Why Am I Always So Tired?

A Provider-Patient Simulation


Kari Brossard Stoos
Department of Health Promotion and Physical Education
Ithaca College
Chelsea Doig

Ithaca College
Melissa K. Gilroy
Physician Assistant Program
DeSales University
Maura F. Benner

Ithaca College
Michael H. Caruso

Ithaca College


This case study consists of a role-play activity designed to simulate interactions between a patient and a health care provider. The patient, played by the instructor, describes symptoms associated with systemic lupus erythematosus and lupus nephritis (SLE and LN) as clinical complaints. The students act in the role of health care providers and are tasked with asking appropriate questions as part of a clinical evaluation. After the initial patient visit, students analyze the presented subjective data, observations, and laboratory results to formulate a diagnosis. At the culmination of the activity, students create their own scenarios taking turns to act as patients and providers with their peers. This case study simulates a real life clinical scenario exposing students to practice each level of Miller’s triangle of clinical competence in a safe classroom setting. This case can be utilized in any course addressing pathophysiology, health, and clinical work-up skill development. Due to the open-ended nature of the activity, an answer key is not available.


  • Perform a complete history for a new patient encounter.
  • Collect observational data on physical appearance, hygiene, and behavior of the patient.
  • Practice interrelational skills during provider-patient interactions.
  • Recall mechanism and symptomatology of systemic lupus erythematosus and lupus nephritis.
  • Evaluate initial information of history, subjective patient symptomatology and physical observations formulating differential diagnoses.
  • Choose the appropriate laboratory tests that will assist in diagnosis.
  • Interpret laboratory results.
  • Integrate and synthesize the above information to generate a hypothetical working diagnosis for the presented case simulation.
  • Create a new patient simulation.


Lupus; nephritis; autoimmune; diagnosis; systemic lupus erythematosus; SLE; LN; clinic; simulation; SOAP

Topical Areas


Educational Level

Undergraduate upper division, Clinical education



Type / Methods




Subject Headings

Nursing  |   Medicine (General)  |  

Date Posted


Teaching Notes

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