| Course | PA 502 Evidence Based Medicine |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 540 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 502 Week 1
Week 1 Discussion: Initial Post
"Should My Number Be Lower?": The Question a 76-Year-Old Asked in Clinic, the Hedge I Gave and the Foreground Question Hidden in It
Initial Post
The moment. On my family medicine rotation last week, a 76-year-old patient with treated hypertension asked, while I was taking their blood pressure, "Should my number be lower? My neighbor's doctor wants his under 120." The reading I had just taken was 146 over 82. The patient takes two blood pressure medicines, has mild kidney disease and no diabetes or history of stroke.
What I said in the room. I said something like, "It depends on a lot of things, and I'll ask your PA what she thinks." My preceptor later told the patient that "under 140 is fine at your age." Neither of us gave a reason the patient could weigh, and I am not sure either answer was right.
Foreground, Not Background
A background question would be: what is hypertension, and how does it damage blood vessels? I know the answer to that well enough. The patient's question is a foreground question: for a person like this, does aiming for a lower target change what happens to them? Written in the usual structure, it is: in a 76-year-old with treated hypertension, chronic kidney disease and no diabetes or prior stroke, does a systolic target below 120 mm Hg, compared with a target below 140 mm Hg, reduce heart attacks, strokes and deaths, and at what cost in side effects?
The Alternative, Named
The comparison matters. The alternative is not "no treatment"; the patient is already treated. The alternative is the current target, under 140, and the question is whether adding a medicine or raising doses to reach under 120 is worth it. Naming the comparison also names the harm side: lower targets mean more medicine, and in older people more medicine can mean dizziness, falls and kidney problems.
Why It Matters
I have since learned that the neighbor's doctor was probably drawing on a large trial that tested a target below 120 against one below 140 in people at increased cardiovascular risk without diabetes, and that the trial was stopped early because the lower target reduced cardiovascular events and deaths, though with more of some serious adverse events (SPRINT Research Group, 2015). Whether that result applies to my patient is exactly the kind of question this course is for.
Over to You
What is the last question a patient asked you that you could not answer with evidence on the spot? I am curious how many of them turn out, like mine, to be questions about a target rather than about a diagnosis.
Reply to Noelle
Noelle, your patient's question about whether to stop a statin at 85 is a strong foreground question. What is the comparison? Stopping the statin is one option; reducing the dose is another, and the evidence for each may differ.
Reply to Andre
Andre, you wrote your question as "What is the best treatment for knee osteoarthritis?" That sounds like a background question. Could you narrow it to the choice your patient faced, such as an injection versus physical therapy, so that a study could answer it?
References
SPRINT Research Group. (2015). A randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine, 373(22), 2103-2116. https://doi.org/10.1056/NEJMoa1511939
PA 502 Week 1 instructions, in plain terms
The first post asks you to describe a moment when a patient or colleague asked a clinical question that you could not answer with evidence. Keep the setting brief: who asked and what they wanted to know. Record honestly what was said in the room, even if it was a hedge. Then separate the background knowledge you already have from the foreground question about a specific choice. Write the foreground question in a structured form, naming the patient group, the intervention, the comparison and the outcomes. Name the alternative even when it is doing nothing or continuing current care. End with a question for classmates, and in replies help peers sharpen their questions rather than answering them.
How the PA 502 Week 1 example is put together
The sample opens on a rotation visit in which an older patient with mild kidney disease asks whether the target should be lower, after hearing about a neighbor's goal of 120. The student's reply was a hedge, and the preceptor said under 140 was fine at that age. The post sets aside the background question of how hypertension damages vessels and writes the foreground question comparing targets of 120 and 140 for major events and side effects. It names the alternative as the current target, not no treatment, and mentions the trial the neighbor's doctor likely had in mind. Replies ask Noelle to name a comparison and Andre to narrow a background question.
Where the points sit in the PA 502 Week 1 rubric
The costliest thing a PA student does with this post is write the encounter as a case presentation, with chief complaint, history, examination and assessment, and no question anywhere. It reads as competent clinical work and answers nothing the week asked. Running close behind is a question with no comparison, so no study could answer it. Posts that hide the answer actually given in the room, or that confuse background and foreground questions, also lose points. Strong posts keep the moment brief, record the real answer, separate background from foreground, write a structured question, name the alternative and ask the group something useful. Replies earn credit when they sharpen a classmate's question instead of answering it, and when they name the missing comparison.
PA 502 Week 1 help from the desk
Many students arrive with clinical questions that are really requests for textbook knowledge, and turning one into a foreground question is a learned skill. Describe a moment when a patient or preceptor asked something you could not answer, and we will help you separate background from foreground, write the question with its comparison and outcomes and name the alternative honestly. Replies that sharpen rather than answer are a skill of their own, and drafting one together is often the fastest way to learn it. Your moment and your question remain your own. Patient details can be kept general so nothing identifiable reaches a discussion board. If your instructor prefers a specific question format, such as a named mnemonic, we can follow it so the structure is easy to grade.
Get a PA-502 Week 1 example written to your instructions
The encounter belongs to you and we do not invent one, so send three or four lines about what was asked and who asked it, along with your assignment instructions or rubric. A custom PA-502 Week 1 post written to your section's requirements comes back inside 24-48h, and the first one costs nothing.
More PA 502 papers and MPAS samples
- PA 502 Week 2: Bedside Question Brief
- PA 502 Week 3: NNT Calculation
- PA 502 Week 4: Surrogate Outcome Critique
- PA 502 Week 5: Applicability Write-up
- PA 502 Week 6: Guideline Comparison
- PA 502 Week 7: Decision Aid Draft
- PA 502 Week 8: Journal Club Brief
- PA 501 Week 1: Defining the PA Role Post
PA 502 Week 1 questions, answered
Does the encounter have to come from a clinical site?
In most first-year sections it does not. A shadowing visit, a family member's appointment, a conversation across a pharmacy counter or something you were asked at work all produce the same object, which is a question somebody wanted answered and nobody could answer with a number. Check your section wording, since a few ask specifically for a patient encounter.
What if I already know the answer to my question?
Then it is probably a background question, and the week wants the other kind. Look at the part of the moment you were genuinely unsure about, which is usually not the diagnosis but the size of something: how much better, how often, in how many people. That uncertainty is the foreground question hiding inside the one you asked.
How much of the patient's own wording belongs in the post?
A sentence, sometimes two, and it does more work than a paragraph of paraphrase. Keep the identifying material out: no employer, no dates, an age band rather than an age. What earns marks is that the question on the page can be traced back to something a person said, rather than to a topic the writer picked in advance.
Where can I find a free PA 502 Week 1 sample paper?
This page holds a complete PA 502 Week 1 post turning a patient's question about blood pressure targets into a foreground question, with two replies.
What is the foreground question in the PA 502 Week 1 sample?
Whether a systolic target below 120, compared with below 140, reduces heart attacks, strokes and deaths in a treated 76-year-old with kidney disease, and at what cost in side effects.