The Portal of Geriatrics Online Education

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The Interactive Confusion Assessment Method (iCAM)

The Interactive Confusion Assessment Method (iCAM)

University of Miami Leonard M. Miller School of Medicine
Rosanne Leipzig, MD, PhD, Anita Bagri, FACN, Marcos Milanez, MD, PhD, Michael Mintzer, MD, PhD, Jorge G. Ruiz, MD, PhD
Donald W. Reynolds Foundation
POGOe Id: 
Date Posted: 
Date Reviewed/Updated for Clinical Accuracy: 

This self-learning web module will teach learners to administer, score and interpret the Confusion Assessment Method.

Educational objectives: 

By the end of this product, learners will be able to administer, score and interpret the CAM.

Additional information/Special implementation requirements or guidelines: 

This product was developed through the joint efforts of University of Miami Miller School of Medicine and its affiliated VA Medical Center, Mount Sinai School of Medicine and the Harvard School of Medicine. The Interactive Confusion Assessment Method (iCAM) has been adapted with permission from: Inouye SK et. al, Clarifying Confusion: The Confusion Assessment Method: A New Method for Detecting Delirium. Ann Intern Med. 1990; 113:941-8.

The web module consists of the following components:

  1. Introduction: CAM is a simple, reliable test that has been validated in several populations.
  2. Using the CAM: Because the test can be administered and scored in a few minutes during clinical care, it represents a minimal burden on hospital staff. The CAM algorithm follows 4 steps in determining whether a patient is likely to have delirium. These steps are briefly outlined below and in more detail in the accompanying form titled "CAM shortened version worksheet", which can also be used to record the results.
  3. CAM Steps:
    • Step 1. Acute Change and Fluctuating Course
    • Step 2. Inattention
    • Step 3. Disorganized Thinking
    • Step 4 Altered Level of Consciousness
  4. Scoring CAM: A brief explanation is provided on how to score the CAM in order to determine whether delirium is present.
  5. Interpretation: Using the CAM is just the first step in the assessment of patients who are confused or at high risk of becoming delirious. After scoring the CAM you must interpret the results in light of the patient's H&P examinations as well as any other conditions diagnosed with this patient.
  6. Practice Case: Learners have the chance to apply the knowledge acquired to a case. After reviewing the video and browsing the patient's virtual chart, learners will be able to score the CAM and decide whether the patient is delirious.
  7. Glossary
  8. References
  9. Credits

You will need Adobe Flash Player to view this module. Download it for free at .

Estimated time to complete: 
30 minutes
Already Expired Email Date: 
Tuesday, February 27, 2018 - 10:54pm
Already Expired Email 1 month date: 
Thursday, March 15, 2018 - 9:34am
Expired Email Date: 
Friday, March 30, 2018 - 3:22pm
Contact Person/Corresponding Author:
GeriU Coordinator

Suggested Citation:
MD Anita Bagri, Rosanne Leipzig, MD PhD, MD Marcos Milanez, Michael Mintzer and Jorge G. Ruiz. The Interactive Confusion Assessment Method (iCAM). POGOe - Portal of Geriatrics Online Education; 2010 Available from:


Submitted by mroansteis on

I think this is a wonderful online tool to introduce the CAM.  I would like to use this as a training tool for research assistants.  My only suggestion is to slow down the progression of the slides that have narratives on them.  I was trying to read them and they advanced before I finished.  The wording was a bit blurry so not easy to read.  Great job!!  Thank you.  Mindy Steis

Submitted by Christine_Thomas on

This is a very good tool to train nurses and other staff in delirium screening.

Is there a way to receive the video to work on a German translation? I have validated the CAM in German and would like to use the video for training.

Submitted by Craig on

The video was created in English and unfortunately there are no translations available.  - POGOe Editor

Submitted by barb_schrage on

This is very comprehensive.  I would like to use this for upcoming training seminars for nurses.  

Barbara Schrage RN, MS, FNP-BC