# Structured text Item type for [**Step 2 CS Patient Note**](/doc/step-2-cs-patient-note-YvVH2uJxc8) - developed in accordance with the USMLE Step 2 CS Patient Note format -, imitating the **medical record** composed after a doctor-patient encounter at a clinic, office, or emergency department. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/03fa1014-cf0e-4191-ba80-50d24eef65d4/c6229621-6ba7-4905-8eb6-a7d6e0b5217c/image%20%284%29.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=7d000c0092476b39c3348c395b3a844ac0c5cc4edbaa44c7cbff08a9a589c9bf&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject) **Columns** can be added, and the **maximum number of rows** can also be determined - by default, it is 3. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/9801b348-36a3-4c5e-b8a3-1f36c4cb9ee2/76907950.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=67004857ab1e7236356ebcb02bdb1728bc4ac08538d59ed9eed761dc37753cf3&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject) Use the buttons in the item panel for further options: ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/23d33624-f6b9-4153-88ee-8efff62428bf/76907944.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=51a47b17f9d2230312e192cea8eda98c6205b2b21e10e00ad1a393337c33abc8&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject "left-50")**Toggle phrase -** if activated, the phrase field will not be displayed. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/8a7521a8-333d-49d7-ab40-1009f365703b/76907945.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=0047589cc1c91de6628e934bcfe1d5a38fa5ad85160a871385b91a85cb5c1609&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject "left-50 =33x35")**Reported comment item -** if activated, the item (question) and the answer will be displayed in the [**Comments Report**](/doc/comments-report-Yq8S6AlN0R) of the **Preset Reports** in the Reports module. :::warning The **Comments Report** displays comments if: * The **Reported comment item** icon is selected for that particular item in the Case Manager * Comments are entered into the **Comments** field during the [**Open-Ended Question Scoring**](/doc/open-ended-question-scoring-oeqs-F51zi8XITN) process. ::: ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/2064ffe6-a9a3-4e79-bc8a-1e8058531779/76907946.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=d84dc44efb16d3d740e88697eb2c9c000455c1120786630c1e448e9291574007&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject "left-50")**Answer required -** if activated, a user cannot submit the checklist until that item is answered. That is, they cannot leave it blank. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/5d2b984b-a956-4e56-88c8-6621a614cf13/76907947.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=76c442b5494aeef62130bed35827facf8c02d4728ae3d54378a2531f00c02166&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject "left-50")**Comment box -** ***inactive*** *(lighter background)* ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/9ceb7009-d2f4-4e20-89a6-b210a1da7508/76907948.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=395e21cceeeda4386534efb5e17b406cba0a9ef895fa17d8876f37cd1570df86&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject "left-50")**Comment box** - ***activated*** *(darker background)*, a text field is displayed on the item during data entry, providing space for additional notes. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/71332959-5d83-46cc-893e-4aeb0fae4e43/76907949.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=35061c9a016bd93a0e24f3de42491210b5ce7d2a1dcb74cc0c2f515c253e3aca&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject "left-50")**Copy -** a fully created item can be duplicated by copying the question with all the settings. :::tip As with any added item, a copied one can be freely modified as desired. ::: ## Scoring :::info **Scoring notes** provide scoring instructions and are displayed to the OEQS user during evaluation. ::: Scoring textual items has three available techniques. When clicking the **Points** button, a drop-down menu appears for selecting the scoring method: ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/03fa1014-cf0e-4191-ba80-50d24eef65d4/1506f9fe-de37-4488-a6c1-ce200fdf6214/SCORING%20DROPDOWN_with%20joint.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=a6f5fb8d0a86c7a360d7af0b1d3ae2b07c76ba8293f854933f7f3bb767bae5b4&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject " =556x321") * **Direct -** when direct scoring is selected, a **Max. Score** field is displayed where the maximum point value has to be determined; OEQS users can choose to give any number between zero and the provided score value. * **Keywords -** selecting the Keywords method prompts the **Set Keywords** button to be displayed. Clicking the button opens the **Keywords Setup** pop-up, where any word can be set with a fixed value thus, when typed in, the system recognizes and calculates a recommended score for the response (from the sum of the point value of the matching words), which is displayed on the OEQS page by highlighting the relevant words in the response text and also listing them with their values and the recommended score. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/48ddf0a7-308b-4fe9-b28a-e3ce1797eaa8/6d956403-4f3a-4437-864e-3d746e6ea644/76907953.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=61512c3a89e3ce4079d2852822ad31619a88c30bbec3994bf35028edd2aac227&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject " =448x316") :::warning ***IMPORTANT:*** Setting up keywords should be treated as a guideline for scoring; answers should be double-checked and approved by OEQS users. ::: If multiple spellings are considered acceptable or typos might be disregarded, alternative spellings can be listed within the same keyword field, separated by comma(s). In such a case, the system will calculate the recommended score for either of the listed words. * **Questionnaire -** Evaluation completed by answering a set of questions. The questionnaire can be created in the [**Special Section**](/doc/d4be73f0-255a-49d9-b7bc-ba979bf9b75c) **and then selected via the drop-down menus that appear** when the Questionnaire method is selected. * **Joint Evaluation - Joint evaluation option** is available for [text](/doc/text-item-PjSbuSmn61) and [structured text items](/doc/structured-text-Ut7O0LkBNp) in the [**Pre-encounter**](/doc/pre-encounter-learner-part-3furatcpPi) **and** [**Post-encounter**](/doc/post-encounter-learner-part-Dsb7Mo6i7o) parts of a case. * :::info A **joint‑evaluation item** always relies on a **main item** that **uses a questionnaire scoring method**. **One or more joint‑evaluation items** can be linked to a main item simultaneously. ::: ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/03fa1014-cf0e-4191-ba80-50d24eef65d4/b4dfbb42-d1c3-4b3e-825f-24942b43eae6/joint%20evaluation_info%20bubble.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=379ac9e8bbea7c0626ebdbc6b32aa4b67e57d6996bbd44478b1620052234da6f&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject " =556x236") :::success **IMPORTANT**: A joint item can only select a main question from within **the same section**; the main question must be located in the same section as the joint item. ::: :::info **REUSE / COPY** * [**Question reuse/**](https://kb.learningspace.elevatehealth.net/doc/how-to-reuse-items-eYanyTEung)**copy:** If only a joint evaluation [question is reused](/doc/how-to-reuse-items-eYanyTEung) (copied), it will be set to **not-scored** by default (which can be manually modified if necessary). * [**Section reuse/**](/doc/how-to-reuse-sections-WkdqnNiBLf)**copy:** * **If sections** with joint evaluation groups are **reused** within case parts that allow joint evaluation, the ***main-joint question relation*** remains. * **If sections** with joint evaluation groups are **reused** within case parts that **do not allow** joint evaluation, the ***joint question*** will be set as **not scored.** ::: :::success For details, see [**How to set up Joint Evaluation**](https://kb.learningspace.elevatehealth.net/s/17639c1d-a746-4d46-8875-c5a8626d2928) **and** [**How to use Joint Evaluation**](https://kb.learningspace.elevatehealth.net/s/2ebef32a-04e9-456d-a260-8d8fd2fcb104)**.** ::: :::tip For further information, visit our [Case Manager](/doc/case-manager-QdAIr4bLwJ) and [Cases - How to](/doc/cases-how-to-S8rL7UJ2ib) pages or watch our [Case Manager Training Videos](/doc/case-manager-training-videos-r2kVtDydfr). ::: ### Share Scoring Note content for AI Admin or Case manager users can **mark additional scoring content at the question level** **for AI processing** in the OEQS AI Assistant. This way, they can feed additional OEQS scoring-related content to the AI, so the AI's answer suggestions will be based not only on the learner's response but also on the scoring notes. ![Share Scoring Notes with AI toggle](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/03fa1014-cf0e-4191-ba80-50d24eef65d4/9b042336-6504-4e28-b2c0-21b6e01e7289/share%20note%20with%20AI.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=b9164878c89aadedc61c5a094ae0d058ff0e7ac719d6d3a6f2fd7917e7293c3c&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject " =514x229") :::tip For details, go to [Items](/doc/334fb241-cca7-4339-99fd-3b1d6a701738) and [OEQS Scoring Page](/doc/d88f4205-143f-45a9-ac69-d65ad44c3bce) ::: --- **Documents** - [User Guide](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/user-guide-WPv4VxhtWB) - [FAQ](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/faq-YoxOQOjvnY) - [Training Videos](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/training-videos-D2ycsEwqPt) - [Module Introduction Videos](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/module-introduction-videos-I6OQ6H7SUT) - [Release Notes](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/release-notes-BcFFMsc0RV) - [Distance Learning with LearningSpace](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/distance-learning-with-learningspace-eAfwW23Hxg) - [Preventing Copy-Paste in LearningSpace](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/preventing-copy-paste-in-learningspace-sPD0IIUuk0) - [Important Technical Notification Regarding Adobe Flash Player](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/important-technical-notification-regarding-adobe-flash-player-eQtMLwLmTJ) - [iPad support - Technical information](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/ipad-support-technical-information-dLmeFvKofC) - [TeamViewer Link](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/teamviewer-link-QyKZBMqUT9) - [YouTube videos about LearningSpace](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/youtube-videos-about-learningspace-TMb3zdc0LC) - [Customer Aftercare One-Pager](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/customer-aftercare-one-pager-GBWMe1BcfS) - [Case Studies](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/case-studies-VcAbFqXSz7)