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Shadow Health Tina Jones MSN 572: Complete Guide

Shadow Health Tina Jones is a virtual patient simulation used in MSN 572 at United States University (USU) to teach advanced physical assessment skills across multiple body systems. Students complete focused and comprehensive assessment modules — including cardiovascular, neurological, musculoskeletal, and abdominal — and document findings in a structured SOAP note format that mirrors real clinical practice.

If you are enrolled in MSN 572 and struggling to understand what Shadow Health expects, how scoring works, or how to write up your findings correctly, this guide covers everything — from navigating the platform to a fully worked sample SOAP note for reference.

 What Is Shadow Health and Who Is Tina Jones?

Shadow Health is a digital clinical simulation platform developed by Elsevier that gives nursing students a safe, repeatable environment to practice health history interviews and physical exams. It is used in over 700 nursing programs across the United States, including MSN 572 at USU.

Tina Jones is Shadow Health’s primary standardized patient — a 28-year-old African American woman who presents for a pre-employment physical. She has a complex but manageable medical history: type 2 diabetes (controlled with metformin), well-controlled asthma (fluticasone and albuterol), and polycystic ovarian syndrome (managed with oral contraceptives). She also has documented allergies to penicillin, cats, and dust.

Her complexity makes her ideal for graduate-level assessment practice. Students must gather a thorough health history, perform system-specific physical exams, identify abnormal findings (including acanthosis nigricans, decreased plantar sensation, and mild facial pustules), and document everything in a clinically appropriate format.

How Does Shadow Health Fit Into MSN 572?

In MSN 572, Shadow Health modules are assigned across Weeks 2 through 7 and align directly with the weekly body system focus. Each module requires a minimum time investment — the comprehensive assessment alone requires a minimum of 120 minutes.

Scores from Shadow Health are included in your course grade, and the documentation you generate through the platform feeds directly into your weekly SOAP note and write-up assignments.

What Are the Shadow Health Tina Jones Modules in MSN 572?

MSN 572 assigns Shadow Health modules by body system across seven weeks, building from focused assessments to a final comprehensive exam.

Here is how the modules map to the course structure:

Week	Shadow Health Module	Focus
Week 2	Health History	Subjective data, HPI, social/family/medication history
Week 3	Respiratory	Lung auscultation, respiratory pattern, objective write-up
Week 4	Cardiovascular	Cardiac auscultation, peripheral pulses, SOAP note
Week 5	Musculoskeletal	ROM, strength testing, objective write-up
Week 6	Neurological	CNs, DTRs, cerebellar function, SOAP note
Week 7	Comprehensive	Full head-to-toe assessment (120 min minimum)

How Does Shadow Health Scoring Work?

Shadow Health scores are calculated based on the percentage of expected data points you collect during each module — both subjective (questions asked) and objective (exam techniques performed).

The platform distinguishes between three scoring categories:

• Subjective Data Collection: Points awarded for questions asked during the health history interview. The more clinically relevant questions you ask — including follow-ups and clarifications — the higher your score.
• Objective Data Collection: Points awarded for physical examination techniques performed. You must select and execute the correct assessment maneuvers for each body system.
• Documentation: Points awarded for the quality and completeness of your Electronic Health Record (EHR) entries. This is where most students lose the most points — documentation must mirror clinical standards, not a conversational summary.

What Is a Good Shadow Health Score?

A score above 80% in each category is considered strong performance in Shadow Health modules. USU’s MSN 572 grading rubric weights Shadow Health completion and scores as part of your overall course grade. Scoring below 70% on documentation — particularly in the comprehensive assessment — may require remediation or additional attempts.

The platform allows multiple attempts on most modules. Use your first attempt to identify gaps, then retry with a targeted strategy based on your missed data points. Shadow Health shows you exactly what you missed after each submission.

How to Approach the Shadow Health Health History Interview

The health history interview with Tina Jones is the foundation of every Shadow Health module and should be approached systematically using the standard OLDCARTS and PQRST frameworks.

Tina will not volunteer information she is not asked about. Students who rush through the interview or skip follow-up questions consistently score lower on subjective data collection. The platform rewards thoroughness.

Key Areas to Cover in Every Interview

• Chief complaint and HPI: Ask about the reason for the visit, onset, duration, severity, and what makes it better or worse.
• Medication reconciliation: Ask about all prescriptions, over-the-counter medications, and supplements. Tina takes metformin, fluticasone, albuterol, and oral contraceptives — each requires follow-up questions about dosage, frequency, and side effects.
• Allergy history: Confirm allergies and the type of reaction. Tina is allergic to penicillin (rash), cats, and dust.
• Past medical history: Document type 2 diabetes, asthma, and PCOS with onset dates.
• Family history: Tina’s mother has high cholesterol; her father died at 58 (car accident); maternal grandparents died of stroke.
• Social history: Tina is single, will move into her own apartment, does not smoke, used cannabis from age 15 to 21, drinks alcohol occasionally. She is active in her church community.

Review of systems: Complete a full review of systems even for modules that focus on one body system — Shadow Health rewards comprehensive interviewing.

How to Perform the Physical Exam in Shadow Health

Each Shadow Health module has a specific set of expected physical examination techniques, and performing them in the correct clinical sequence maximizes your objective data score.

Unlike the real-world video exam, Shadow Health does not time-limit your physical exam. Use the extra time to perform thorough assessments of every subsystem within each module’s focus area.

Key Findings to Document in Tina Jones

Several findings in Tina Jones are consistent across modules and must be documented correctly in the EHR:

• Acanthosis nigricans: Hyperpigmented, velvety skin on the posterior neck. This is a significant finding associated with insulin resistance and must be noted in the integumentary and general survey sections.
• Decreased plantar sensation: Tina has reduced monofilament sensation in bilateral plantar surfaces — a finding consistent with early diabetic peripheral neuropathy. Must be documented in the neurological exam.
• Scattered facial pustules: Present on facial assessment; document in integumentary.
• BMI 29.0 (overweight range): Height 170 cm, weight 84 kg. Document accurately in vitals and note relevance to diabetes management.
• BP 128/82: Slightly elevated; document both readings and note as Stage 1 hypertension per AHA/ACC 2017 guidelines (Whelton et al., 2018).
• Well-controlled asthma: Lungs clear to auscultation. Document as no acute wheeze or rhonchi despite asthma history.

Shadow Health Tina Jones Example SOAP Note

Comprehensive Assessment

SOAP Note: Shadow Health Comprehensive Assessment — Tina Jones

Patient	Tina Jones | 28-year-old African American female | DOB: 02/14
Date	Pre-employment physical examination
Provider	Advanced Practice Nursing Student — MSN 572, USU

S — Subjective

Chief Complaint (CC): “I came in because I’m required to have a recent physical exam for the health insurance at my new job.”

History of Present Illness (HPI): Tina Jones is a 28-year-old African American female who presents to the clinic for a pre-employment physical examination. She denies any acute concerns at this time. Her last healthcare visit was four months ago for an annual gynecological examination, at which she was diagnosed with polycystic ovarian syndrome (PCOS) and prescribed oral contraceptives, which she is tolerating well. She has a five-month history of type 2 diabetes managed with metformin and diet modification. She reports well-controlled asthma managed with daily inhaled fluticasone and a rescue albuterol inhaler, last used three months ago. She states she feels healthy and is looking forward to beginning her new position.

Medications: Metformin 850 mg PO BID (type 2 diabetes); Fluticasone propionate 110 mcg 2 puffs BID (asthma maintenance); Albuterol 90 mcg/spray MDI 2 puffs Q4H PRN (asthma rescue); Drospirenone/ethinyl estradiol PO QD (PCOS/contraception); Ibuprofen 600 mg PO TID PRN (dysmenorrhea).

Allergies: Penicillin (rash); cats and dust (rhinorrhea, ocular pruritus, worsening asthma symptoms). No known food or latex allergies.

Past Medical History (PMH): Type 2 diabetes mellitus (diagnosed age 24); asthma (diagnosed age 21.5); PCOS (diagnosed four months ago).

Past Surgical History (PSH): Denies prior surgeries.

Family History (FH): Mother (age 50): hypercholesterolemia. Father: deceased age 58, motor vehicle accident. Maternal grandmother: deceased age 73, cerebrovascular accident. Maternal grandfather: deceased age 78, cerebrovascular accident. Sister: asthma.

Social History (SH): Single, no children. Currently lives with mother and sister; planning to move into own apartment within one month. New position as accountant at Smith, Stevens, Stewart, Silver & Company. Never smoked tobacco. Former cannabis use ages 15-21, none currently. Occasional alcohol use 2-3 times per month, no more than 3 drinks per episode. Denies illicit drug use. Active in church community; uses faith and family for stress management. Diet: predominantly vegetables, lean proteins, and whole grains. Exercises regularly.

Review of Systems (ROS): General: Denies fever, fatigue, unintentional weight change. HEENT: Denies vision changes, hearing loss, sinus congestion, sore throat. Respiratory: Denies shortness of breath, wheezing at rest. Cardiovascular: Denies chest pain, palpitations, lower extremity edema. GI: Denies nausea, vomiting, abdominal pain, changes in bowel habits. GU: Denies dysuria, hematuria. Musculoskeletal: Denies joint pain or swelling. Neurological: Denies headache, dizziness, numbness (except plantar surfaces per exam). Integumentary: Reports facial breakouts; denies new rashes or lesions. Psychiatric: Denies depression, anxiety, suicidal ideation.

O — Objective

Vital Signs: BP 128/82 mmHg (right arm, seated); HR 78 bpm, regular rhythm; RR 15 breaths/min; Temp 37.2°C / 99.0°F; SpO2 99% on room air; Height 170 cm; Weight 84 kg; BMI 29.0 (overweight); Blood glucose 100 mg/dL (fasting).

General Survey: Patient is a well-nourished, well-developed, 28-year-old African American female who appears her stated age. She is alert and oriented x4, seated upright on the examination table, and in no apparent distress. Speech is clear and coherent. Dressed appropriately with good hygiene. Cooperative and provides detailed history without contradiction.

HEENT: Head normocephalic, atraumatic. PERRL, EOM intact, no nystagmus. Visual acuity 20/20 bilateral via Snellen chart. Conjunctivae pink, sclerae white. Otoscopy: tympanic membranes pearly gray, landmarks intact bilaterally. Hearing grossly intact to whisper test. Nasal mucosa pink, no polyps. Oral cavity: mucous membranes moist, no lesions; teeth in good repair; oropharynx clear; no tonsillar enlargement. Trachea midline. No thyromegaly or thyroid nodules palpated. No cervical, submandibular, or supraclavicular lymphadenopathy.

Cardiovascular: Regular rate and rhythm. S1 and S2 audible without murmur, rub, or gallop. No JVD. Peripheral pulses 2+ and equal bilaterally (radial, dorsalis pedis, posterior tibial). Capillary refill less than 2 seconds bilaterally. No lower extremity edema.

Pulmonary: Chest wall symmetric without deformity. Respiratory effort unlabored. Lung fields clear to auscultation anterior and posterior; no wheeze, rhonchi, or crackles. Percussion resonant throughout. Tactile fremitus equal bilaterally.

Abdominal: Abdomen protuberant and symmetric. No visible masses, scars, or lesions. Coarse hair from pubis to umbilicus noted. Bowel sounds normoactive in all four quadrants. Tympanic throughout to percussion. No tenderness or guarding on light or deep palpation. No organomegaly. No costovertebral angle tenderness.

Musculoskeletal: Muscle strength 5/5 bilaterally in upper and lower extremities. Full range of motion in all major joints without pain, crepitus, or swelling. Gait steady and coordinated. No joint deformity or asymmetry.

Neurological: Alert and oriented x4. Cranial nerves II-XII grossly intact. Deep tendon reflexes 2+ and equal bilaterally in biceps, triceps, brachioradialis, patellar, and Achilles. Romberg negative. Finger-nose test intact. Rapid alternating movements intact bilaterally. Sensation intact to light touch upper extremities. Decreased sensation to 10-g Semmes-Weinstein monofilament bilateral plantar surfaces — consistent with early peripheral neuropathy.

Integumentary: Scattered pustules present on face with mild facial hair on upper lip. Acanthosis nigricans noted on posterior neck — hyperpigmented, velvety skin consistent with insulin resistance. Nails without ridging, pitting, or clubbing. No rashes or open lesions on trunk or extremities.

A — Assessment

Tina Jones is a 28-year-old African American female presenting for pre-employment physical examination with the following active problems:

1. Type 2 diabetes mellitus (E11.9): Currently managed with metformin and lifestyle modification. BMI 29.0, acanthosis nigricans on posterior neck, and decreased bilateral plantar sensation suggest suboptimal glycemic control and early peripheral neuropathy risk. Blood glucose 100 mg/dL at time of visit.
2. Asthma, well-controlled (J45.20): Lungs clear to auscultation. No acute exacerbation. Last rescue inhaler use three months ago. Maintenance therapy with fluticasone appears effective.
3. Hypertension, Stage 1 (I10): BP 128/82 mmHg consistent with Stage 1 hypertension per 2017 ACC/AHA guidelines (Whelton et al., 2018). No current antihypertensive therapy.
4. PCOS (E28.2): Managed with oral contraceptives. No acute concerns reported.
5. Peripheral neuropathy, early (E11.40): Decreased plantar monofilament sensation bilaterally in setting of type 2 diabetes. Requires further evaluation and annual foot exams.

P — Plan

• Continue metformin 850 mg PO BID. Reinforce importance of medication adherence and self-blood glucose monitoring.
• Order HbA1c, comprehensive metabolic panel, lipid panel, urine microalbumin-to-creatinine ratio, and dilated eye exam referral per ADA Standards of Care (American Diabetes Association, 2024).
• Educate patient on diabetic foot care: daily inspection, appropriate footwear, and annual monofilament screening.
• Counsel on Stage 1 hypertension: sodium restriction, DASH diet, aerobic exercise 150 min/week. Repeat BP at follow-up visit. No pharmacological treatment initiated at this time.
• Continue fluticasone maintenance therapy and albuterol rescue PRN. Review inhaler technique. Return precautions for asthma exacerbation.
• Follow up with PCP within 4 weeks for results review and hypertension management.
• Patient education provided on diabetes self-management, asthma trigger avoidance, and PCOS monitoring. Patient verbalized understanding and expressed readiness to comply with recommendations.

Common Shadow Health Mistakes That Lower Your Score

The single most common reason MSN 572 students score poorly on Shadow Health is incomplete documentation — performing the exam correctly but failing to enter findings in the EHR with clinical specificity.

Here are the top mistakes and how to avoid them:

• Documenting normal findings with vague language: Phrases like “lungs clear” or “neuro intact” are insufficient. Shadow Health’s model documentation uses precise language: “Lung fields clear to auscultation anterior and posterior; no wheeze, rhonchi, or crackles.”
• Missing abnormal findings: Acanthosis nigricans, decreased plantar sensation, and facial pustules are always present in Tina Jones. Missing any of them in the EHR reduces your documentation score.
• Skipping review of systems: ROS is a required component of documentation even in focused modules. Students who omit ROS consistently leave 10-15% of subjective data points on the table.
• Not asking follow-up questions: Shadow Health rewards depth. If Tina mentions a medication, ask about dosage, frequency, side effects, and adherence. Each follow-up question is a separate scored data point.
• Using first-person documentation: Clinical notes use third-person objective language. “Patient states…” not “She told me…”

How Does Shadow Health Connect to Your MSN 572 SOAP Note Assignments?

Your Shadow Health documentation — particularly from the Week 4 cardiovascular and Week 6 neurological modules — forms the data foundation for your SOAP note assignments in MSN 572.

The weekly SOAP notes (Weeks 4 and 6) require you to synthesize Shadow Health objective findings with a subjective interview into a full Subjective-Objective-Assessment-Plan note. Students who document thoroughly in Shadow Health have a significantly easier time completing their SOAP note assignments because the objective data is already organized.

For more on the SOAP note structure and rubric requirements, see our companion guide: MSN 572 Head-to-Toe Physical Assessment Video: Complete Guide.

Frequently Asked Questions

What is Shadow Health Tina Jones used for in nursing programs?

Shadow Health Tina Jones is a virtual patient simulation used in advanced practice nursing programs to teach health history interviewing, physical examination, and clinical documentation skills. In MSN 572 at USU, she appears across six modules aligned to different body systems, culminating in a 120-minute comprehensive assessment.

How long does the Shadow Health comprehensive assessment take?

The comprehensive Tina Jones assessment in MSN 572 has a minimum time requirement of 120 minutes. Most students take 90-150 minutes to complete the full interview, physical exam, and EHR documentation with adequate thoroughness.

Can I redo Shadow Health modules to improve my score?

Yes. Shadow Health allows multiple attempts on most modules. After each attempt, the platform provides detailed feedback showing exactly which data points you collected and which you missed. Use this feedback to target specific gaps on your next attempt.

What abnormal findings does Tina Jones have?

Tina Jones has several consistent abnormal findings across all modules: acanthosis nigricans on the posterior neck, decreased monofilament sensation on bilateral plantar surfaces (early peripheral neuropathy), scattered facial pustules, a BMI of 29.0 (overweight), and a BP of 128/82 (Stage 1 hypertension). All of these must be documented accurately in the EHR.

How is Shadow Health documentation different from a regular SOAP note?

Shadow Health uses an Electronic Health Record (EHR) format with pre-structured sections for vitals, health history, and physical exam findings. Your SOAP note assignments in MSN 572 ask you to synthesize these EHR findings into a narrative clinical note with a formal Assessment and Plan section. The two formats are complementary — Shadow Health generates the data; the SOAP note interprets it.

What happens if I miss a Shadow Health deadline in MSN 572?

MSN 572 does not accept late assignments under any circumstances. The course closes on Week 8, Day 7, and all submissions — including Shadow Health modules — must be completed before that deadline. Plan to complete each module at least one day before its due date to allow for technical issues.

About the Author

Dan Palmer, MSN is a registered nurse and academic writer with over a decade of experience supporting graduate nursing students across MSN, FNP, DNP, and public health programs. He holds a Master of Science in Nursing from Walden University and an undergraduate degree from UC San Diego. Dan is the founder of Gradevia (gradevia.com), a specialized academic support service for working adult students in nursing, public health, business, and education graduate programs. His clinical and academic expertise spans advanced health assessment, psychiatric-mental health nursing, and evidence-based practice.

References

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• Bickley, L. S. (2021). Bates’ guide to physical examination and history taking (13th ed.). Wolters Kluwer.
• Dains, J. E., Baumann, L. C., & Scheibel, P. (2022). Advanced health assessment and clinical diagnosis in primary care (6th ed.). Elsevier.
• Elsevier. (2023). Shadow Health digital clinical experiences: Student user guide. Elsevier Health Sciences.
• Jarvis, C. (2020). Physical examination and health assessment (8th ed.). Elsevier.
• LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). McGraw Hill.
• National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Diabetic neuropathy. U.S. Department of Health and Human Services. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies
• Seidel, H. M., Ball, J. W., Dains, J. E., & Benedict, G. W. (2023). Mosby’s guide to physical examination (9th ed.). Elsevier.
• United States University. (2023). MSN 572: Advanced physical assessment across the lifespan — course syllabus (Version 2023-06-13). United States University School of Nursing.
• Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., … Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127-e248. https://doi.org/10.1016/j.jacc.2017.11.006

Article Update Log

Date	Version	Summary
June 18, 2026	1.0	Initial publish: full guide, sample SOAP note, module table, scoring tips, and FAQ for MSN 572 Shadow Health Tina Jones.