User feedback: the exam steps were too generic (e.g. "Shoulder abduction
— 5/5 bilaterally" never explained what 5/5 means or HOW to test it).
The guide needs to serve as a teaching tool, not just a checkbox list.
Three changes:
1. GRADING SCALES reference card (new). Collapsible panel at the top of
each system showing the relevant scales:
- Neuro: MRC strength (0-5), DTR (0-4+), Plantar response
- MSK: Scoliometer ATR, Beighton hypermobility score
Each scale shows the grade AND its clinical meaning in a compact
table. No more orphan "5/5 bilaterally" without definition.
2. Per-component SIGNIFICANCE + PEARL fields (optional). Adolescent
neuro components enriched with:
- Significance: one-line clinical relevance (what this component is
actually for — what pathologies it detects)
- Teaching pearl: a Hutchison/Bates/Nelson-style tip that helps the
learner see past the mechanics to the reasoning
Visually distinct — pearl gets a warm amber accent, significance is
a crosshair icon under the name.
3. Method strings REWRITTEN for every adolescent strength step. Before:
"Shoulder abduction — 5/5 bilaterally". After: "Patient abducts both
arms to 90°. Examiner pushes down on each arm just above the elbow
while patient resists. Compare sides. — Holds against full resistance
— MRC 5/5 bilaterally". Same treatment for all 14 strength steps,
all 8 DTR steps, and tone/pronator-drift.
UI redesign:
- Accent bars on cards (cyan for MSK, purple for neuro) for visual
anchor
- Numbered step circles instead of "1." prefix
- HOW / NORMAL label badges on each step
- Watch-for block with red left-border for red-flag grouping
- System-level header with icon (bone for MSK, brain for neuro)
Other age groups (newborn through school-age) keep the old data shape
(steps without pearls) — they still render correctly, just without the
pearl/significance blocks. Enriching them is an incremental follow-up.