It's usually generated by the dx or chief complaint. So I get several boxes to fill in on the computer and it may also prompt things like a neuro, neurovascular, etc assessment, or treatments like elevate HOB.
But yes, it's all about teaching you how to think. Most of it is in your head. As tedious as they are, it's worth it. Say you get an abd pain with n/v. Well, you need to remember to assess not just pain and nausea, but bowel sounds and habits, po tolerance, output, hydration status, etc. Taking that extra step. Then maybe even farther. Are they an SBO that's on the verge of septic shock and now we need to be even more diligent, where as pain and nausea are a little lower on the priority list.
And the biggest part it teaches you? what are you doing (meds and beyond) and is it helping? B/c you can document all day long but if you aren't showing how they respond to treatment, good and bad, we might as well go home.
I always think of it as where they are in the progression of their disease, and what is one step worse or better. Then I have my framework to work with. If it's an elderly person with a UTI, is their mental status clearing, is their urine output adequate and what does it look like, is their BP holding. Right there I can give a pretty good picture and someone can tell how they are progressing. Then I can go into decubs, etc if I need.
As much as I hated writing them, you'll be able to tell which people didn't pay any attention to them when you get out and start practicing. They don't show the whole picture.