Lesson 5 of 7 · about 12 minutes
A fictional example: Teresa prepares for a decision
This is a fictional story created for learning. Teresa is not a real person, and any resemblance to real people is coincidental. Her situation is simplified to show how the tools from this course can fit together.
The situation
Teresa is 58. For about two months, her right knee has been aching, especially going down stairs and after her morning walks with her neighbor. She’s been putting off a visit because, as she tells her sister, “It’s probably just getting older, and I don’t want to waste anyone’s time.” Her sister gently reminds her that asking about something that’s bothering her is never a waste of time.
Teresa makes an appointment with her family medicine clinician for the following week.
Getting ready
The weekend before, Teresa sits down with a cup of tea and the visit prep worksheet from this course.
Ranking her concerns. She writes down everything on her mind: the knee, a prescription refill, and a question about whether she’s due for any screening tests. She ranks the knee first because it’s affecting her daily life.
Her medicine list. She gathers her bottles: one prescription, a daily vitamin, and an over-the-counter pain reliever she’s been taking more often lately. She almost leaves off the pain reliever because “it’s just from the store,” then remembers that clinicians need to know about all medicines, including over-the-counter ones and supplements.
Her symptom story. Using the symptom framework, she writes:
- What: an ache, sometimes a sharp twinge
- Where: inside of the right knee
- Started: about two months ago, gradually
- Pattern: worse on stairs and after walks, a bit stiff in the morning
- Better: resting, a warm shower
- Worse: stairs, long walks
- Daily life: she’s cut her walks in half, which she misses
She also keeps a short timeline for a week, noting when the ache shows up.
Her questions. She uses AHRQ’s free QuestionBuilder online to pick a few questions, and adds the Ask Me 3 questions at the bottom of her page.
At the visit
Teresa opens with her headline: “The main thing I’d like help with is my right knee. It’s been aching for about two months, mostly on stairs and after walks, and I’ve had to cut back on walking, which I really miss.”
Her clinician asks questions, examines her knee, and explains what they think may be going on. Teresa notices a word she doesn’t know and asks, “Could you explain that in plain words?” Her clinician does, and sketches a quick drawing.
Her clinician says there are a few reasonable approaches. Teresa takes out her BRAN questions:
- “What are the benefits of each option?”
- “What are the risks?”
- “What are the alternatives?”
- “What happens if I just wait and see for now?”
Then she shares what matters most: “Getting back to my walks is really important to me. I’d also like to avoid anything that means a lot of appointments, because I help care for my grandson after school.”
Her clinician says that’s helpful to know and talks through how each option might fit with those priorities. Teresa realizes she’d like a little time to think and asks, “Is it okay if I take a few days to decide?” Her clinician says yes, explains what would make it important to call sooner, and mentions the Ottawa Personal Decision Guide as a free tool she could use at home.
Making sure she’s got it
Before the visit ends, Teresa checks her Ask Me 3 questions:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
She uses teach-back: “So, I’ll think about the options this week and send you a message through the portal with what I decide. Meanwhile, I’ll let you know if the knee swells up or if I can’t put weight on it. Did I get that right?” Her clinician confirms and adds one small detail she’d missed.
She also asks about her third concern, screening tests. Her clinician says they’ll go over which ones she’s due for at her next yearly visit, and Teresa writes that down so she doesn’t forget.
After the visit
At home, Teresa fills out the Ottawa Personal Decision Guide. Writing down what matters most helps her see that one option fits her life best right now. She sends a message through the online portal with her choice and one follow-up question. She also asks her pharmacist about the over-the-counter pain reliever she’s been using more often.
What we can learn from Teresa’s story
- Ranking concerns meant her most important issue got the most time.
- A clear symptom story gave her clinician a strong starting point.
- Listing every medicine, even “just from the store,” gave a complete picture.
- Asking for plain words helped her understand, and that’s always okay.
- BRAN and sharing her priorities made the options conversation about her life, not just the knee.
- Taking time to decide, when it’s safe to do so, gave her space to think.
- Teach-back caught a small detail she might have missed.
Notice that Teresa didn’t do anything complicated. She didn’t research her condition online for hours or memorize medical terms. She just organized what she already knew about herself and brought a few good questions.
Your turn
Think about a visit you have coming up, or one you might schedule. Which one or two of Teresa’s steps would help you most? Jot them on your prep worksheet.
Sources
- QuestionBuilder App (AHRQ)
- Ask Me 3: Good Questions for Your Good Health (Institute for Healthcare Improvement)
- Choosing Wisely UK and the BRAN questions (Academy of Medical Royal Colleges)
- Ottawa Personal Decision Guide (Ottawa Hospital Research Institute)
- Use the Teach-Back Method: Tool 5 (AHRQ Health Literacy Universal Precautions Toolkit)
- How To Prepare for a Doctor’s Appointment (National Institute on Aging)
Teresa’s story is fictional and for learning only. Every person’s situation is different, so please talk with your own healthcare professional about yours.
Something here not seem right? Report a concern privately to the Poéma team.