@TheOncoPT (00:19)
Hey, Onco PT and welcome back to this episode of the Onco PT podcast. If you saw the title of today’s episode and got a little scared, got a little worried, I’m gonna calm you down here. This episode is prevention, is preventative care, is like prehab for your oncology case report. In fact, I want you to think of this, this is prospective surveillance model.

for your case report. This is the first visit before treatment starts where we are looking to see what, you know, are there any problems now? We’re gonna catch them early and we’re going to take care of them. That’s what this is for your case report, okay? So if you saw rejection in the title, don’t be scared. This is our PSM for your case report. One of the more frustrating parts of the case report writing process is that something,

is when something starts to feel off about halfway through writing and you can’t quite figure out why. Like there’s a gut feeling, an intuition you have that this isn’t coming together exactly how I thought it would. There’s something missing. There’s something that’s just not quite right about all this. And the worst part of all this is that you cannot

figure out why. And that sucks. It’s a really, really hard place to be. And how we make sure that we don’t get ourselves stuck in this point is by starting out the source. Because as you know, in cancer rehab, a lot of times the issue didn’t just start there, pop up randomly, out of the blue, unrelated to anything. A lot of times.

We know that these side effects, these impairments that our patients experience started a lot earlier in the process, right? Let’s take an example. If I have a patient who is dealing with fatigue, right? We know how common fatigue is in cancer rehab. If I have a patient who says, know, my fatigue is getting really bad. I don’t just look, you don’t just look at, well, what did you do yesterday?

because we know that’s not how cancer-related fatigue works. Oftentimes, there is treatment that contributes to this. Maybe it’s the treatment that they’re undergoing now. Maybe it also started with a cancer treatment that they had previously. Maybe even the cancer itself is what is causing this fatigue that this person is experiencing. It didn’t just start this morning. It didn’t just start yesterday. This has been an issue that has been building for a while.

And maybe the person didn’t necessarily notice it or get bothered by it until now. That doesn’t mean that it wasn’t a problem previously, albeit small, that has now made itself into a big problem that is really affecting us. Same dang thing for our case report. A lot of times, problems with your case report did not start because of the sentence that you just wrote. These issues started because of something

way, way early on in the case report writing process. And again, most oncology physical therapists do not struggle with their case report because of the writing. They struggle with writing their case report because of decisions that were made at the very, very beginning. You have heard me talk about in this podcast series, the importance of foundation, a strong, solid foundation.

Like with your house, if you don’t have a strong solid foundation, your house is gonna have cracks. It’s gonna have windows that don’t shut or open. It’s going to have doors that don’t close or don’t open. You’re going to have all kinds of problems that just cascade. They build up over time because of the foundation at the very, bottom of the house. Your case report has the same pattern. If it does not have a strong

patient case, a solid patient case at its core, at its foundation. Everything that builds on that is going to feel unstable, is going to feel shaky, is going to feel like these pieces of this puzzle are not fitting together. And dang it, everything feels so much more challenging, so much more difficult.

Case report writing can be challenging. It’s not necessarily easy. It does not have to be impossible. It doesn’t even have to be difficult. But a lot of times we bring that on ourselves because of these really important decisions that we make at the beginning that were not the best for our case report. So common mistake that I see, mistake number one,

is choosing a case that doesn’t give you enough info to work with, enough information or frankly just content to write about. And at first, this is a very appealing mistake. This is a very like seductive mistake to make because it seems like, ⁓ if I choose a case that’s maybe a little shorter, that’s maybe a little more straightforward, it’ll be easier to write.

I won’t have to write about as much. That is appealing. That is really, really attractive about picking a patient case. It feels easier at first. Because what happens here is as you start the writing process and trying to demonstrate your decisions, why you made the decisions, how you made the decisions, et cetera, there’s not actually that much to analyze.

When it comes to this case report and this kind of case report, it is entirely dependent on you showing, I made this decision intentionally. Here’s why I made this decision. Here’s why I didn’t make that decision instead of this decision. And if your case that you choose for this is easy, is straightforward, is really clean cut,

you’re going to struggle to really analyze what you did, why you did, and why you did not do the other thing over here. And this, again, it really comes from a place of, wanna make the writing process easier on myself. I wanna make sure, because I don’t feel very strong in my writing, that I’m going to make it easier on future Elise, on future self, when it actually ends up becoming so much harder.

because you’re either having to like pull things out of your case report that maybe don’t actually exist. ⁓ Side note, I hope this goes without saying, do not make things up in your case. Like the case that you choose needs to be a real life case that things happened in. This is not a fake case. This is not you making up a patient encounter. This is a real life patient encounter that you have with a real person.

with a real human person, just so we are abundantly clear. And what can happen when you choose a case that is really simple, that is really just like clear cut like this, you don’t have enough to write about. Do not ever embellish things that did not happen, that did not occur, that were not as important as what they actually are. Because those raiders, excuse me, the graders will absolutely see through your BS.

Do not make stuff up in your case report because they also can go back to the institution where you saw that patient and ask to pull records if they don’t think that you are telling the truth in your case report. I have heard that this can happen. I have never seen this happen with any of my case report writing workshop students. Thank God because we do not do that. We do not do that here at the Onco PT and my Onco PT students do not do this. Do not make stuff up.

to fill up the pages of your case report. If your case does not have enough depth for you to work with and to write about, it’s not the right case. You chose wrong, you chose poorly, pick a different one and move on because this is a hugely detrimental mistake that can absolutely kill your case report in the water before you even make it out. So mistake one, just don’t make it, okay? Moving on. Mistake number two.

which is evidence. The second mistake here is not having enough strong supporting evidence for the choices that you did make. So previously, mistake one, we talked about there’s not enough to work with. This is kind of a second layer on top of that, which is being able to connect the decisions you made to existing literature, to the research that is available out there for this patient population and for related patient populations.

A lot of times what can happen is if you encounter this mistake on your writing, you’ll be writing. And a lot of times you’ll be thinking to yourself, I know why I made this decision in the moment with this patient. I feel good about this decision, but I cannot support my decision with the evidence. I cannot connect that decision to available literature. And as I’ve mentioned earlier in this podcast series,

It’s okay that there might be gaps in the literature because cancer rehab research is always growing. We’re always getting more informed, getting better support for the interventions, for the approaches that we do in oncology physical therapy. There are gaps. That’s not totally what we’re talking about here. This is you made a decision and maybe it wasn’t the best decision. Maybe this decision

It made sense for the time. It doesn’t totally track with what we know is truly best practice in oncology physical therapy. And this becomes a problem very quickly because part of the requirement of this case report, your ABPTS oncology case report, you have to have, think at least, and no, caveat disclaimer here. This is based on early,

And I’ll be like, as of 2025, this is the information. I think you have to have at least 20 sources, like somewhere around 20 sources for your case report. Now, keep in mind, if you listen to this in the future, it might be slightly different. They haven’t released as the time of this recording, the 2026 guidelines. It’s probably gonna be about the same. You have to have a significant amount of literature in your case report. And there’s some very specific sections in your case report. You are required.

to have literature supporting your case report and your writing and what you did and what you chose to do. If you cannot find literature to support those decisions, that makes finding that support and truly backing up your case report so much more challenging. Again, more work, more problems. We’re trying to avoid that. So make sure that you pick a case that has enough evidence for you to connect to. There can be gaps.

Maybe this is a patient population that historically has not been well researched, but maybe the treatment they’re on has. Maybe a ⁓ similar diagnosis has more support. Maybe there’s other aspects of this patient care that do have really good support. That’s okay. Gaps exist. But when we have trenches or canyons between you and the evidence, that is a problem.

And that is the second most common mistake I see as to why case reports are rejected by the AB PTS graders. Now, mistake number three is misalignment with what’s being evaluated. In the second episode of this podcast series that we’re doing, we talked about what AB PTS graders are looking for in your case report. And a lot of times, PTs get stuck on this idea of

This case is interesting, so I’m going to choose it. This case is meaningful to me, so I’m going to choose it. Those are cool things. Those are important things to reflect on, to give us perspective, to become better oncology physical therapists. Those do not equate to a strong, solid case report. I know, I know.

the case might feel meaningful or impactful to you.

And it’s okay to have those. This is not a bad thing. But just because a patient case is meaningful or impactful to you does not always mean that it demonstrates clinical expertise, that it checks the boxes for what the AB PTS graders are looking for. They are not reading your case report and asking themselves, is this patient case interesting? Check, good to go.

They’re looking to see, does this demonstrate clinical expertise? Does this check off the boxes of criteria that we are looking for to say, this is an excellent, exemplary oncology case report? Pass.

Those are not always going to be the same thing. And that’s okay. That’s not necessarily a bad thing. That doesn’t mean that you can’t have meaningful, you can’t select a meaningful case. It can’t be the only reason why you pick a case for your oncology case report. So really being clear on what is ABPTS looking for in this case? Am I selecting a case that is going to really match those expectations for an outstanding specialist level?

oncology case report at the end of the day. Now, the reason that we talk about these mistakes early on in the process, instead of when you get to making them, we’re talking about them before you get to make them, before you get to that point. The reason we talk about this is so that you can think about instead of how to fix things later, here’s how to prevent them early on.

Or here’s how to maybe minimize the issues that you’ll experience as you write your case report down the road by making key decisions now in this process. Am I selecting a patient case that gives me enough to write about, to really analyze the choices that I made? Can I then take those decisions that I made and tie them to the evidence?

And also acknowledge these are some gaps and that’s okay. But at the end of the day, I made specialist level decisions in care for this person, for this patient. And then really choosing a case that aligns with what the graders are looking for. Again, is this a specialist level case report demonstrating specialist level thinking with all of this? Not solely resting on interesting or impactful. Is this demonstrative?

of your specialist level thinking. By going through this kind of audit now of reflecting on these mistakes and sitting with the some kind of discomfort that comes with like, ⁓ mistakes. I know you don’t want to make mistakes. I know that’s why you’re here. I know that’s why you’re thinking of these things and trying to implement them early on in your writing process. But by talking about these mistakes now, by sitting with the discomfort of like, this is what can go wrong. We are preparing ourselves.

to make better informed decisions now to avoid those mistakes and those subsequent issues down the road. Because once you are deep into the writing process, you’ve picked your case report, you have started writing, you have started researching, et cetera, it is so much more harder to change direction. It’s harder to pivot. It’s harder to fix these mistakes once they have already been made. And this is one of the perhaps most important

places where getting it right early on makes everything about writing your case report, everything that follows that much more easy. I’m not saying that this is going to you know, ⁓ help you avoid all mistakes that you could possibly write in your case report writing experience. I’m not saying that this is going to make case report writing easy.

What I’m saying is that this makes case report writing easier. And anything that you can do now to make this process easier so that you can get through it in time for the deadline, submit it and feel confident that this was the best case report that you could have written. That’s what we need to be working on. That’s what we need to be focusing on in all of this. So again, I don’t want you to shy away from this thought of like mistakes and whatnot.

If you face these mistakes head on early in the process, you can avoid them or avoid making them really, really big like this and derailing your case report at the end of the day. Because as you’ve heard me mention in the very first episode of the series, selecting your patient case is the strategic decision that often dictates if your case report gets finished or if it doesn’t.

not how good of a writer are you, not what kind of systematic reviews should I use to support my decision making and all of this. Literally, the very first decision that you make about your whole case report is the decision that dictates, do you finish, do you not finish? So I want you to feel really good making this decision now so that you can move forward with your case report and feel good about it.

and submit it and feel good about it. And then get that pass notification so that you can move on with your life. And ultimately also preparation for the oncology specialty certification exam. Now, with that said, I’m going to also walk through these mistakes in a little more detail on my YouTube channel later this week. I would really encourage you if you haven’t already.

make sure to subscribe to the Onco PT on YouTube so that you will get notification when that video drops and my future videos drop so you can get that goodness from the get-go and start implementing it into your case report writing process. I want you to feel not just good about writing your case report, I want you to feel great. I want you to feel confident that you can produce a really wonderful, competent, specialist-level case report and then move on with your life.

Yeah, the case report feels really big and really important right now. It is. This is not your entire life. This is one step in your journey to becoming the best oncopT that you can be for your patients in your community and elevating the expectation of excellence in cancer rehab. It feels big now. It is big now. But I also want you to make it through this process.

feeling good, knowing that you did the best you could with what you have and then move on so that you can continue your work, your journey to becoming the best possible onco PT for your patients in your community. So I look forward to seeing you over on that YouTube video. If you have not already, please subscribe to the onco PT on YouTube and I cannot wait to see you over there. But until next time, this is Elise with the onco PT and remember you.

are exactly the physical therapists that your patients with cancer need. So let’s get to work.