When you copy a bundled patient, your copied custom patient will come with the basic structure of the Objectives and Credits, but you might need to define what the exact requirements are.
The layout of the Objectives tab is the following:
To customize a credit, click the pencil icon next to a credit to open the editing window.
The AI-based Assessment
There are two methods to define a credit's requirements: Classic criteria or AI-based Assessment.
The AI-based Assessment is only available for simulations utilizing the Generative AI upgrade, but it allows you to create accurate quantitative assessments focued on communication.
Understanding the editing interface
Each AI-based assessment credit has three important sections. Understanding the purpose of each section helps you create accurate scoring criteria and provide clear guidance to learners:
1. Credit Name
Example: Onset
The Credit Name is the title or label for the credit. It is visible to learners by default.
The name helps identify what the credit is about, but it does not determine what the AI scores.
Examples:
Onset
Chief Complaint
Medication Use
Family Medical History
The Credit Name can be broad. The Credit Description defines what earns the point.
2. Credit Description
Example: Give 1 pt. credit if session transcript covers: "Pain onset"
This is where you tell the AI what information should award credit.
The AI uses the words, phrases, and concepts in this field to determine whether the learner gathered the required information from the patient.
Broad credits are more lenient and award credit for a wider range of information.
Example: Pain onset
Any discussion about when the pain began could receive credit.
Specific credits are stricter and require more precise information.
Example: Pain started two days ago.
Credit is awarded only if that specific information appears in the transcript.
Whether broad or specific, the description should always be clear and unambiguous.
3. In-Session Credit Guidance for Learners
Example: "Discussed onset."
This section is shown to learners on the simulation review screen.
Use it to provide hints, reminders, or coaching about what they should do.
This guidance does not affect AI scoring.
Writing Effective Credit Descriptions
Overview
The AI quantitative assessment is trained and weighted to award points for identifying important patient information, including:
Information gathering
Understanding the patient's condition
The AI uses the words, phrases, and sentences in the Credit Description field to identify whether the learner has gathered the required information from the patient.
The goal is to define what information should award credit.
How the AI Scores Credits
The AI reviews the entire session transcript.
A credit can be fulfilled:
Anywhere in the interview
Through different questions
Through patient statements (explicitly elicited or volunteered)
It is not necessarily tied to one specific question or one specific response.
What Makes a Good Credit Description?
A good credit description is:
✅ Specific
✅ Patient-focused
✅ Easy for a human to interpret
✅ Clear about what earns the point
✅ Free from unnecessary ambiguity
The AI will accurately recognize credits when the description is clear and understandable for humans as well.
Avoid Vague Terms
Do not expect the AI to infer meaning or fill in gaps.
For example:
❌ Protection
This could mean:
Physical safety
Financial security
Support for vulnerable individuals
Pregnancy prevention
STI prevention
If you want a specific type of protection, define it.
Examples:
✅ Pregnancy prevention
✅ Uses condoms for STI prevention
✅ Uses contraception to prevent pregnancy
✅ Has financial support from family
Creating a sexual health patient does not mean the AI will automatically interpret "protection" as sexual protection.
Don't expect the AI to infer information
The AI recognizes information that appears in the transcript. It should not be expected to infer diagnoses or fill in missing details.
Question: Any medical history?
Answer: I have some chronic bowel problems.
Credit results:
Credit Description | Result |
GI disease | 1 point |
Diverticulitis | 0 point |
GI disease, diverticulitis EITHER | 1 point |
Every Part of a Credit Counts
Every piece of information included in a credit description is required unless you use EITHER.
Example: hospitalization, 4 surgeries
The simulation transcript must include:
✅ Hospitalization
AND
✅ Four surgeries
If the simulation transcript only includes:
"I was hospitalized"
The credit will NOT be awarded.
How to Use EITHER
Use EITHER when any one of the listed items is enough to receive credit.
Example:
patient's hospitalization, patient's surgeries EITHER
Means:
Patient hospitalization
ORPatient surgery
EITHER Examples
Example 1
Credit description: hospitalization, surgeries EITHER.
Required information in the transcript:
Any hospitalization
ORAny surgeries
This could refer to anyone.
Example 2
patient's hospitalization, surgeries EITHER:
Patient hospitalization
ORSurgeries of anyone
Example 3
patient's hospitalization, patient's surgeries EITHER:
Patient hospitalization
ORPatient surgeries
Complex Credits: Be Careful
Long credits are allowed, but they must remain specific and unambiguous.
Example
Credit:
Family history of both inflammatory bowel disease and colon cancer, mother had ulcerative colitis diagnosed at age 42 and colon cancer diagnosed at age 61, maternal grandfather had colon cancer, diagnosed age 62, one male sibling who has ulcerative colitis that was diagnosed at age 19, EITHER
Possible ways to receive credit:
Family history of both inflammatory bowel disease and colon cancer
OR mother had ulcerative colitis diagnosed at age 42 and colon cancer diagnosed at age 61
OR maternal grandfather had colon cancer
OR diagnosed age 62
OR one male sibling who has ulcerative colitis diagnosed at age 19
Problems
Some parts are unclear:
"Diagnosed age 62" — diagnosed who?
"Grandfather had colon cancer" — if the credit requires maternal grandfather, this is not specific enough
Recommended Version
Instead:
family history of inflammatory bowel disease and colon cancer, mother had ulcerative colitis and colon cancer, grandfather had colon cancer, sibling has ulcerative colitis EITHER
Now the required information is clear.
Credit can be awarded for:
Family history of inflammatory bowel disease and colon cancer
OR mother had ulcerative colitis and colon cancer
OR grandfather had colon cancer
OR sibling has ulcerative colitis
Avoid Stacking Too Many Concepts Together
Stacked credits can reduce accuracy.
The more different information included in one credit:
The more difficult interpretation becomes
The more human disagreement can occur
The less accurate scoring becomes
Example: Stress
Too broad: worried her COPD is getting worse, worried she will have to move into a home, worried about breathing EITHER
Better:
Current stress: worried about breathing, worried her COPD is getting worse
Future stress: worried she will have to move into a home
Example: Sleep
Too broad:
has poor quality sleep, sleeps less than 6 hours, falling asleep with her COPD is tough, trouble staying asleep EITHER
Better:
Sleep quality: has poor quality sleep
Sleep amount: sleeps less than 6 hours
Sleep interruptions: falling asleep with her COPD is tough, trouble staying asleep EITHER
Recommended Credit Style: Generic vs Specific
Credit Name | Generic | Specific Credit |
Chief Complaint | why the patient is here | has terrible headaches |
Onset | symptom onset | headaches started 2 days ago |
Duration | symptom duration | diarrhea for the past day |
Frequency | symptom frequency | cough every five minutes, feels like coughing all the time EITHER |
Progression | symptom progression | more tired by the afternoon |
Location | pain location | pain on lower left side of stomach |
Radiation | symptom radiation | tingling from elbow to fingers |
Quality | pain description | sharp, pounding pain |
Severity | symptom severity rating | worst headache ever, headache 7 out of 10 EITHER |
Aggravating Factors | aggravating factors | loud noise makes it worse |
Relieving Factors | relieving factors | resting helps |
Medical History | patient's medical history | Crohn's disease, diabetes |
Hospitalizations | patient's hospitalization | 2 hospitalizations, one for childbirth, one for food poisoning |
Surgeries | patient's surgeries | no surgeries |
Allergies | patient's allergies | allergic to insect bites |
Medications | patient's medication use | Metformin, Epi Pen |
Immunizations | patient's immunizations | flu shots yearly, HPV, Hep-B, Hep-C |
Tobacco | patient's tobacco use | smokes two packs a day |
Alcohol | patient's alcohol use | drinks several beers every day |
Drugs | patient's recreational drug use | never tried drugs |
Living Arrangement | patient's living arrangement | lives with husband and children in a suburban condo |
Stress & Coping | patient's stress, coping EITHER | stressed from work, copes with running |
Exercise | patient's exercise | runs daily, pilates, salsa dancing |
Sleep | patient's sleep | sleeps 5 hours, restless nights |
Diet | patient's appetite, diet EITHER | fair appetite, all foods, irregular meal times |
Social Support | patient's support system | feels supported by parents and husband |
Sexual Health | patient's sexual health | sexually active, monogamous with husband |
Education | patient's occupation | accountant, works overtime regularly |
Occupation | patient's education | BS in accounting |
Family History | family history | mother: high blood pressure, brother: IBD |
Combining Credits
Credits can be merged when appropriate, simply use a comma:
patient's hospitalization, patient's surgeries
Requires:
Hospitalization
ANDSurgery
Example: Living Arrangement
Credit:
lives with husband and children in a suburban condo
Requires every piece of information:
Lives with husband
Lives with children
Lives in a suburban condo
Credit:
lives with husband, lives with children, lives in a suburban condo EITHER
Requires only one:
Lives with husband
OR lives with children
OR lives in a suburban condo
It does not mean:
Lives in any condo
Lives in a house
Final Checklist Before Creating a Credit
Ask yourself:
✅ Is this the exact information I want to score?
✅ Would two humans agree when the point should be awarded?
✅ Is the patient information specific?
✅ Did I avoid vague terms?
✅ Did I use EITHER only when appropriate?
✅ Did I avoid combining unrelated concepts?
✅ Could the AI find this information anywhere in the transcript?