Hi Emma,
 
SOAP stands for: Subjective, Objective, Assessment and Plan.  It is a method of 
recording clinical notes and can be very time consuming.  The ‘S’ includes the 
patient’s reported difficulties, their goals, medical history and social 
history – anything that the patient says that is important to document is 
written here. The ‘O’ includes the clinician’s data based on formal and 
informal assessment – includes muscle strength, range of movement, visual 
perceptual results, etc. The ‘A’ is your opinion about what is happening – 
includes prognosis, diagnosis and goal.  The ‘P’ is your plan of action – how 
you intend to achieve the listed goals from ‘A’ and what sort’s of input may be 
needed.
I understand that the OT schools are trying to move away from using SOAP notes 
because they are such a lengthly process.  While they help to clarify your 
thought process they can take up a lot of time. Maybe try speaking to your 
supervisor about it?
 
Hope this helps,
Veronica


----- Original Message ----
From: Emma Cole <[EMAIL PROTECTED]>
To: [email protected]
Sent: Sunday, 9 July, 2006 4:24:37 PM
Subject: [OTlist] Some help.


Hi,
I am a OT in uk and have difficulty with my note writing due to my dyslexia. 
I was wondering if anybody have information on SOAP notes and information on 
writing them as it is getting me down at work.
Many thanks

emma
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