A Common concern that we receive from our customers is that they feel that certain orders are not being registered in the grading section. It typically is an e-mail like: "I ordered X and it's marking me that I did not order it. Your program needs to be fixed."
We investigate every concern. However, 99% of the time, the issue is either education or understanding how the program works, and the program is working as it should. Here are the most common reasons why customers feel that orders are not being registered.
#1 - The wrong order is entered. Many orders sound similar. For example, in case 66, the antibiotic Pyrazinamide. We have many people order Pyrimethamine instead of Pyrazinamide and feel that they were unjustly marked off. We go through their log and then discover that they ordered Pyrimethamine.
#2 - Some cases require multiple orders to receive credit. In the grading feedback, it will tell you if multiple orders are required to receive credit. This is typically true for antibiotics when multiple antibiotics are required for credit. Again, case 66 is a good example where the case requires Rifampin, Pyrazinamide, Ethambutol AND Isoniazid. Notice in the grading that multiple orders with be separated by an AND such as this:
#3 - The order is cancelled accidentally. Some people will order many order all at once like this:
Some will order as many orders at 10 at once. Each order must be verified. Some customers will accidentally hit the cancel button during the verification process which will make the order disappear like it was never ordered because it wasn't. The order will not show up in your log.
#4 - Some will order a harmful or incorrect order which is marked off which will show up red on the grading sheet. Typically we will receive an email saying, I have the log and a screenshot showing that I definitely ordered this medication, and it is marking me off and showing that it is red. An example that comes up is case 62, the patient is not to receive antiepileptics. Many users will order an antiepileptic such as Depakote, then tell us that they ordered it correctly and got marked off. We reply that they correctly got marked off for ordering something that should have been avoided. In the grading, it says "Should have avoided" and then lists the things that should NOT have been ordered.
#5 - Looking at the wrong feedback date. Another common occurrence happens when a user repeats a case, lets say case 62. They did the case on June 2, 2021 and then repeated the case on October 27, 2022. If they were reviewing the case results, some will accidentally click on a different test date and then get upset that their orders were not registering. For example, lets say that in the June 2, 2021 test date that the physical exam: Abdomen was NOT ordered but that the October 27, 2022 test date that it WAS ordered. The user could click on the June 2, 2021 date and assume that it is showing the October 27, 2022 date and think that the program did not register the Physical Exam: Abdomen. For the old grading UI, the grading date is on the left here:
For the new UI, it is under the button "View Previous Completions."
#6 - Ordering labs orders that different by sample type only. Another common issue is that users will sometimes order a urine lab order instead of a serum lab order. For example, a user could order a bacterial culture, urine instead of a bacterial culture, serum. These are two different orders.
#7 - Ordering a location change instead of using the Location Button. The USMLE and our program contain orders like "Move patient" which the result will come up "To change the location of the patient, please us the Change Location Button." The user will not read the popup and just click okay and then say that they changed the patient location which was not being registered.
#8 - Ordering medication groups. Some users will also order entire medication groups like "Corticosteroids" or "ART" or "B-blocker" or "Antacid". The program will come back with "To order a medication, please type the specific generic or trade name." Again, users will not read the popup and then get upset that they missed points for not ordering the correct medication.
These are the most common reasons users feel that their orders are not being registered. This software is well tested. We have over 1,500,000 first case attempts, so a lot of people have taken these cases! We do make mistakes, but we hope that you will try to verify first that one of these common issues does not match your concern. If you still feel that it is not registering, then email us again, and we will take a look at your log.