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11/13/24, 8\:12 PM Guide | SOCRATES

SOCRATES

Table of contents
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Introduction

The SOCRATES acronym is a useful way of exploring a patient's presenting symptoms. It is commonly used to take a
comprehensive pain history, but it can be applied to most other symptoms.
SOCRATES provides a structure during medical history taking and helps you remember the most important questions to ask
when exploring the history of presenting complaint.

Overview

Site
Onset
Character
Radiation
Associated symptoms
Timing
Exacerbating and relieving factors
Severity

Using SOCRATES

SOCRATES provides a structured framework for taking a medical history. Each section of SOCRATES is described below, with
example questions.
https\://app.geekymedics.com/osce-guides/history/socrates/ 1/411/13/24, 8\:12 PM Guide | SOCRATES
Depending on the patient's symptoms, not all parts of SOCRATES may be relevant. For example, some symptoms (e.g.
breathlessness or fatigue) will not have a speci

Site

Ask about the location of the symptom\:
“ W h e r e i s t h e [ s y m p t o m ] ?”
“ C a n y o u p o i n t t o w h e r e y o u e x p e r i e n c e t h e [ s y m p t o m ] ?”

Onset

Clarify how and when the symptom developed\:
“ D i d t h e [ s y m p t o m ] c o m e o n s u d d e n l y o r gr a d u a l l y ?”
“ W h e n d i d t h e [ s y m p t o m ]
“ H o w l o n g h a v e y o u b e e n e x p e r i e n c i n g [ s y m p t o m ] ?”

Character

Ask about the speci
“ H o w w o u l d y o u d e s c r i b e t h e [ s y m p t o m ] ?”
“ I s t h e [ s y m p t o m ] c o n s t a n t o r d o e s i t c o m e a n d go ?”

Radiation

Ask if the symptom moves anywhere else\:
“ D o e s t h e [ s y m p t o m ] s p r e a d e l s e w h e r e ?”

Associated symptoms

Ask if there are other symptoms which are associated with the primary symptom\:
“ A r e t h e r e a n y o t h e r s y m p t o m s t h a t s e e m a s s o c i a t e d w i t h t h e [ s y m p t o m ] ?”

Timing

Clarify how the symptom has changed over time\:
“ H o w h a s t h e [ s y m p t o m ] c h a n g e d o v e r t i m e ?”

Exacerbating and relieving factors

Ask if anything makes the symptom worse or better\:
“ D o e s a n y t h i n g m a k e t h e [ s y m p t o m ] w o r s e ?”
“ D o e s a n y t h i n g m a k e t h e [ s y m p t o m ] b e t t e r ?”

Severity

Assess the severity of the symptom by asking the patient to grade it on a scale of 0-10\:
“ O n a s c a l e o f 0-1 0 , h o w s e v e r e i s t h e [ s y m p t o m ] , i f 0 i s n o [ s y m p t o m ] a n d 1 0 i s t h e w o r s t [ s y m p t o m ] y o u’ v e e v e r
e x p e r i e n c e d ?”

Examples

These are three examples of using SOCRATES to explore di
and a rash. The examples show how SOCRATES can be used for a wide variety of symptoms, not just when taking a pain
history.

Using SOCRATES to explore chest pain

Site\:
“ W h e r e e x a c t l y i s t h e p a i n ?”
Onset\:
“ H o w q u i c k l y d i d t h e p a i n r e a c h i t s m a x i m u m i n t e n s i t y ?”
Character\:
“ W h a t k i n d o f p a i n a r e y o u e x p e r i e n c i n g?” (e.g. sharp, dull, crushing)
Radiation\:
“ D o e s t h e p a i n m o v e a n y w h e r e e l s e ?”
https\://app.geekymedics.com/osce-guides/history/socrates/ 2/411/13/24, 8\:12 PM Guide | SOCRATES
Associated symptoms\:
“ H a v e y o u d e v e l o p e d a n y o t h e r s y m p t o m s ?” (e.g. shortness of breath, pre-syncope, syncope)
Timing\:
“ H o w l o n g h a s t h e c h e s t p a i n b e e n p r e s e n t ?”
Exacerbating and relieving factors\:
“ D o e s a n y t h i n g m a k e t h e p a i n w o r s e ?” “ D o e s a n y t h i n g r e d u c e t h e p a i n ?”
Severity\:
“ O n a s c a l e o f 1-1 0 , h o w s e v e r e w o u l d y o u r a t e y o u r p a i n ?” (this can be useful later when assessing the impact of
treatment)
For more information, see the Geeky Medics OSCE guide to taking a chest pain history.

Using SOCRATES to explore shortness of breath

Site\: n / a
Onset\:
“ W h e n d i d t h e s h o r t n e s s o f b r e a t h
Character\:
“ H o w w o u l d y o u d e s c r i b e t h e s h o r t n e s s o f b r e a t h ?” (e.g.
“tight chest”
,
“can’t take a deep breath”)
Radiation\: n / a
Associated symptoms\:
“ A r e t h e r e a n y o t h e r s y m p t o m s t h a t s e e m a s s o c i a t e d w i t h t h e s h o r t n e s s o f b r e a t h ?”
Timing\:
“ H o w h a s t h e s h o r t n e s s o f b r e a t h c h a n ge d o v e r t i m e ?”
Exacerbating and relieving factors\:
“ D o e s a n y t h i n g m a k e t h e s h o r t n e s s o f b r e a t h w o r s e ?” “ D o e s a n y t h i n g m a k e t h e
s h o r t n e s s o f b r e a t h b e t t e r ?”
Severity\:
“ O n a s c a l e o f 1-1 0 , h o w s e v e r e w o u l d y o u r a t e y o u r s h o r t n e s s o f b r e a t h ?”
For more information, see the Geeky Medics OSCE guide to taking a respiratory history.

Using SOCRATES to explore a rash

Site\:
“ W h e r e i s t h e r a s h ?”
Onset\:
“ W h e n d i d y o u
Character\:
“ H o w d o e s t h e r a s h f e e l w h e n y o u t o u c h i t ?” “ W h a t i s t h e s h a p e o f t h e r a s h ?”
Radiation\:
“ H a s t h e r a s h s p r e a d a n y w h e r e e l s e ?”
Associated symptoms\:
“ A r e t h e r e a n y o t h e r s y m p t o m s t h a t s e e m a s s o c i a t e d w i t h t h e r a s h ?” “ H a v e y o u n o t i c e d t h e s k i n
l e s i o n i t c h i n g o r b l e e d i n g ?”
Timing\:
“ H o w h a s t h e r a s h c h a n g e d o v e r t i m e ?”
Exacerbating and relieving factors\:
“ D o e s a n y t h i n g s e e m t o m a k e t h e r a s h w o r s e ?” “ D o e s a n y t h i n g m a k e t h e r a s h b e t t e r ?”
Severity\: n/a (could be asked if associated pain with the rash)
For more information, see the Geeky Medics OSCE guide to taking a dermatology history.
https\://app.geekymedics.com/osce-guides/history/socrates/ 3/411/13/24, 8\:12 PM Guide | SOCRATES

Alternatives

OLD CARTS

for\:
OLD CARTS is an alternative mnemonic which can be used to explore the key aspects of each symptom. OLD CARTS stands
Onset
Location/radiation
Duration
Character
Aggravating factors
Relieving factors
Timing
Severity
For more memory aids, see the Geeky Medics collection of medical mnemonics.
Source\: geekymedics.com
https\://app.geekymedics.com/osce-guides/history/socrates/ 4/4