Last reviewed May 6, 2026 by NPBoardSlay Medical Review Board

SOAP

Progress Note Format

The note-writing template since the 1960s — and still the standard.

On the AANP exam, documentation questions hinge on whether information lands in the right SOAP section. Subjective (chief complaint, HPI, ROS, history — what the patient tells you), Objective (vitals, exam, labs, imaging — what you measure), Assessment (diagnosis or differential with reasoning), Plan (medications, follow-up, patient education, referrals). Pain rating belongs in Subjective; tenderness on palpation belongs in Objective. AANP vignettes test the boundary between sections and the requirement that the assessment justify the plan. Sloppy SOAP — vital signs in the assessment, diagnoses without reasoning — fails the documentation question regardless of how correct the underlying clinical decision is.

S
Subjective
What the patient says — history, symptoms, complaints, concerns.
O
Objective
Vitals, physical exam findings, labs, imaging — observable data.
A
Assessment
Your clinical impression, differential, and summary.
P
Plan
Diagnostics ordered, treatments, follow-up, patient education.

Clinical Context

Foundational progress-note format used in clinic notes, hospital progress notes, rehab, nursing assessments, and documentation across nearly every care setting. Introduced by Dr. Lawrence Weed in the 1960s as part of the problem-oriented medical record.

Variations: SOAPE adds Education, APSO flips the order (A/P first for readers who want the punchline up top), DAP combines data + assessment + plan. AANP professional-role questions test documentation format — SOAP is the baseline, and knowing when to use APSO (inpatient rounds) vs. SOAP (primary care) is worth points.