Your PCS Simulator comes with a variety of bundled patient scenarios designed to provide your learners with consistent and realistic training experiences. These cases cover a wide range of common clinical situations, but we recognize it’s impossible to anticipate every scenario or use case you might need.
That’s where the Patient Concept (PC) comes in. The PC is a powerful tool that allows you to customize existing cases or build entirely new ones from scratch. With just a few quick edits, you can adapt an existing patient to fit your teaching needs. And when you need a scenario that isn’t already available, you can create your own case by writing a PC from scratch.
This guide will walk you through the process, showing you how to structure and write PCs so you can design patient scenarios that are realistic, flexible, and will respond how you would expect.
Note: This is not a user interface (UI) guide. It does not cover which buttons to press or how to navigate the platform—those basics are assumed as prior knowledge. Instead, this guide focuses on the writing techniques that bring your patient scenarios to life.
For a general overview of how to access and edit patients in PCS, please see this guide.
General Guidelines
The Patient Concept (PC) is organized into 14 (+1) sections, each of which represents a key element of a healthcare interview. Each section should contain the relevant information you want your patient to know and respond with during the interview.
When writing these sections, always use the language you want your patient to speak. Avoid medical jargon unless you specifically want your patient to sound clinical. For example:
If you write “The patient has hypertension and hypercholesterolemia,” the patient will use those words.
If you write “The patient's blood pressure and cholesterol are high,” the patient will speak in lay terms.
It is important to group the patient’s information under the correct sections so the AI can build a structured and realistic overview of the patient profile. If there is no relevant or important information for a section, you may leave it blank. In that case, the AI will improvise. Remember that improvisations can and will be different from simulation to simulation.
You are describing the patient, not prompting the AI. Do not write instructions like “role-play” or “answer as the patient.” The AI is already trained to act like the patient.
Keep in mind:
Use quotes and first person if you want the patient to say something word-for-word.
Example: “I’m not sure what’s going on, but this pain in my stomach is killing me.”
The patient "knows" every single piece of information you put in the PC. For example:
“He takes Simvastatin 20 mg/day. He doesn’t know the name of his medication, but he says it’s a yellow pill.” → In this case, the patient will know the name of the medication, because you included it in the PC.
Each section has an information
icon on the right-hand side that explains what kind of information belongs there. Use that guidance to write answers for each section.
The patient knows about their health and medical condition only what you include in the PC. This is how the AI is trained.
Do not expect the patient to “follow logic” or make inferences as a human would—or even as a general LLM (like ChatGPT) might. For example:
If you list Simvastatin and also mention high cholesterol separately, the patient will not automatically say, “I take Simvastatin because I have high cholesterol.”
The AI does know what Simvastatin is for, but unless you explicitly state in the PC that the medication is for the patient’s high cholesterol, they will not make that connection in their answers.
If information is missing from the PC, the AI will generate it. This can include social and personal information such as marriage, children, education, employment, hobbies, or travel. Be aware that:
These AI-generated details are usually realistic and believable.
They can vary from simulation to simulation if you leave them up to the AI.
If you want the patient to always give the same response, you must write it into the PC.
Avoid instructions like “the patient shall always answer X” or “the patient shall never answer Y.” Instead, refine the PC itself. Focus on writing clear, factual information, then test it by interviewing the patient in the conversation tester. Adjust and iterate until you get the responses you want.
Medical symptoms are denied by default unless you specify them as positives.
Speech style does not work out-of-the-box. The LLM has a general sense of tone, but results can be inconsistent. If you need a specific speech style, contact help@pcs.ai
Typical PCS patients are trained to be open, clear, and cooperative. This ensures learners don’t miss critical history. This works well for most use cases (chest pain, diabetes, medication adherence). However, you cannot prompt patients to randomly disclose information or to deliberately withhold it. If you need that behavior—for example, LGBTQ identity and practices, or patients who resist sharing—please contact PCS support.
Tips you can use:
Borrow speech styles from bundled patients (pediatrics, aggressive, non-cooperative mental health).
Write a strong opening line to set tone.
Include keywords the patient should use.
The 15 Sections of a Patient Concept
The Patient Concept is broken up into 14+1 sections. The numbered sections below include detailed explanations and examples of how to fill them out. Remember: everything you put into the PC is what the patient will know and consistently share in their interviews. Anything you leave blank is open for the AI to improvise.
1. Opening & Reason for Visit
Provide a brief statement that sets the context and complaint. This is the “initial statement” the patient makes when asked what’s going on. Keep it brief but specific enough to establish the complaint.
Example:
“I’m pretty freaked out, I’ve been throwing up for 2 days.”
“I came in because I can’t stop vomiting and I’m worried something serious is wrong.”
2. Main Concern: Attributes
What are the attributes of the main concern?
Describe the primary concern in detail, including onset, severity, and what makes it better or worse. This is where you include everything you want the patient to say about their main problem.
Try to answer the questions below but don't just list medical terms and attributes, unless you want your patient to sound like that.
How is the patient managing the main symptom?
What provokes the symptom?
What does the patient do for relief? List palliative or alleviating factors, and provoking, triggering or aggravating factors.
Include medication and non-pharmacological therapies and whether or not they’re helping.
Example:
Patient is throwing up for two days, can’t keep anything down, now it’s only that yellowish sour stuff. His throat hurts from the vomiting. He throws up 4-5 times a day, and he’s always nauseous. Tried Pepto-Bismol, didn’t really stop the vomiting.
3. Associated Symptoms
What other symptoms is the patient having?
List other symptoms occurring before, during, or after the main complaint. Include both positives (symptoms the patient does have) and negatives (symptoms the patient denies). The patient may or may not know these symptoms are related. Order them chronologically when possible.
Example:
He had diarrhea on the first day, but that’s gone now. He doesn’t think he has fever but didn’t check.
Note: By default, Review of Systems (ROS) symptoms are denied unless specified.
4. Allergies
What allergies does the patient have?
List all allergies with onset and reaction. If there are no allergies, you must still specify this.
Example:
Allergic to Penicillin. Causes rash and swelling, first occurred in childhood.
No known food or environmental allergies.
No insect or material allergies.
5. Medication List
What medications (prescriptions, otc) or vitamins, supplements is the patient currently taking?
Include all medications (prescription, OTC, vitamins, supplements). Write them as the patient would describe.
Example:
Simvastatin, 20 mg, once a day, for high cholesterol.
He didn’t take yesterday and today, didn’t think he could keep it down.
He takes Pepto-Bismol for 2 days for his vomiting, he feels it doesn’t help.
6. Diagnosed or Chronic Illnesses
Does the patient have any ongoing, diagnosed, major or serious, chronic illnesses or diseases (including Physical & Mental Health)?
List all ongoing conditions with dates, treatments, and management.
Example:
Diagnosed with high cholesterol in 2018. Denies diabetes, hypertension, asthma, or chronic lung disease.
If none: “The patient has no chronic illnesses.”
7. Medical History
Include hospitalizations, surgeries, OB/GYN, and preventative care in chronological order. Also include pertinent or age related screenings, and preventative actions. Include relevant vaccinations and immunizations for the patient’s age and/or main complaint.
Example:
Two hospitalizations for childbirth (2013 and 2016)
A septoplasty outpatient procedure (2011)
GYN screening every two years (last screen 2024, results normal)
Immunizations up to date, gets flu shots yearly
8. Family Medical History
Does the patient’s family have any diagnosed, serious or chronic illnesses or diseases?
Include major family conditions.
Example:
Father, James, died of heart attack at age 58. Mother, Lily, alive, 62, history of type 2 diabetes. Brother, Ron, healthy, age 35.
Or: No major medical history in the family.
9. Relationship Status & Sexual Health
What is the patient’s marital status?
Include relevant patient relationship status, and include protection and contraceptive methods. Include specific practices if relevant. Include past history of STIs (negative or positive). Only document relationship safety if the patient is at risk for intimate partner violence. The patient will not have an STI and/or risk history, unless specified otherwise.
Example:
Married, lives with spouse. Sexually active with one partner, uses condoms occasionally. No history of STIs.
10. Personal & Social History
What is the patient’s Home Environment like?
Describe home environment, supports, occupation, education, hobbies, travel.
Example:
Lives with spouse and two children (ages 12 and 9).Works as a middle school teacher. Bachelor’s degree in Education. Enjoys gardening, reading novels, and playing tennis. Recently traveled to Mexico for vacation (one week ago).
11. Substance Use & History
Does the patient use Alcohol, Tobacco, and/or Recreational Drugs?
Always state whether patient uses substances. Include quantities.
Example:
Drinks socially, 2–3 glasses of wine per week. Never smoked tobacco. Denies recreational drug use.
12. Lifestyle: Diet, Exercise, Stress, Sleep, ADLs
What is the patient’s diet like? Does the patient exercise?
Include only relevant lifestyle habits, pertinent positives or negatives that are impacting the patient’s health. If there are no anomalous lifestyle habits, this field can be left blank.
Example:
Usually sleeps 7 hours a night, but currently only 4–5 due to illness. No problems with ADLs (activities of daily living).
13. Emotional State & Personality
Add patient’s perspective, fears, or worries.
Example:
“I’m really scared this might be something serious.”
He expresses fear of having a heart attack because of his father's death of heart attack.
14. Conversational Attitude & Speech Style
This should be a short description of the patient’s speech style, or tone of the patient’s responses.
You will likely have to experiment, and your case might need custom training of the AI. For assistance, reach out to help@pcs.ai.
15. Special Patient Info
Case-specific details relevant to the patient’s history, such as confirmed diagnosis, provider orders or post-visit instructions.
Patients don’t know their current diagnosis and do not know about their treatments. This information may be useful if you are simulating a hand-off for nursing, for example, after talking to the doctor.
Example:
The doctor told the patient she had an allergic reaction to shell fish. He gave her an epinephrine shot and that she may need another one. She has an IV and oxygen mask. She was told she may need a nebulizer treatment soon.
DO’s and DON’Ts
✅ DO:
Follow the 15-section structure.
Write everything the patient must know and consistently share.
Test your PC using the conversation tester, refine as needed.
Give response options your patient would say.
❌ DON’T:
Prompt the AI directly (e.g., “Act like a 40 year old male patient with chronic pain”).
Instruct patients to behave a certain way (e.g., “the patient shall never answer X”).
Assume the AI will infer facts not in the PC.
Getting Help
If you’re stuck or your patient isn’t responding as intended:
📧 Email help@pcs.ai