One well-chosen diagnosis case can support a useful twenty-minute teaching session. The objective is not merely to reveal the correct answer. It is to examine how learners used the clues, which alternative they considered and what made them change their minds.
This is a facilitator-led workshop using iatroX rounds. The game supplies a progressive clinical story and explanation; the teacher supplies the objective, discussion and closing question. There is no automatic workshop controller, and the timetable is a suggested allocation of teaching time rather than a claim about how long the game itself takes.
The plan suits a short tutorial, a clinical meeting or a small-group teaching slot. It preserves time for an independent attempt before discussion and ends with a takeaway that participants can explain without the answer on screen.
Prepare one case, not an entire curriculum
Choose a case from the rounds archive before the session. Review the available information, answer, explanation and supporting material. Prefer a case that illustrates a useful distinction over a rare diagnosis selected only because it is difficult.
Write one objective: "By the end, participants will explain which clue changed their leading interpretation and why." Make it more specific where the chosen case supports that, but do not promise competence across a whole specialty.
Check any clinical claim you plan to add. The workshop may naturally raise questions about investigation or management that go beyond the game's explanation. Those additions require their own source review rather than borrowing authority from the game.
Ask learners who have already played the case to say so. They can act as observers, identify alternative interpretations or join the debrief, without presenting a remembered answer as a new diagnostic performance.
The timetable
| Time | Activity | Intended output |
|---|---|---|
| Minutes 0-3 | Set the question and explain the task | A shared objective and clear expectations |
| Minutes 3-8 | Attempt the case and compare hypotheses | A private leading diagnosis, an alternative and a reason |
| Minutes 8-16 | Debrief the reasoning and test a variation | An explanation of what changed and what remains uncertain |
| Minutes 16-20 | Retrieve the principle and close | One personal takeaway and, where needed, a focused follow-up |
These intervals total twenty minutes. A difficult discussion may need a different allocation. Reduce the number of prompts rather than preserving every planned activity at the expense of understanding.
Use a visible clock for facilitation, not to judge the speed of a learner's thinking. A session can be time-bounded without turning every answer into a race.
Minutes 0-3: establish the task
Begin with the objective and the scope of the exercise. A suggested introduction is: "We will compare how our interpretation changes as information appears. We are not assessing who should have known the diagnosis from the first line."
Explain the game mechanics briefly. rounds permits up to six guesses; an incorrect guess reveals another clue. A result of 3/6 means that the diagnosis was identified on the third guess, not that three out of six independent questions were correct.
Make the conditions explicit. Learners should first form their own interpretation, then compare it with someone else. They may state uncertainty, and they should not assume that an unmentioned symptom was examined and found absent.
The game reveals a prepared sequence rather than allowing a free clinical interview. Learners can still record which question they would want to ask next; that is a discussion prompt, not an additional product function.
Minutes 3-8: make an attempt before hearing the group
Show the opening information. Ask each participant to write a leading diagnosis, one alternative and the feature that most influenced their choice.
Give them a quiet moment before inviting responses. Then ask two people with different interpretations to explain their reasons. The purpose is to expose different readings of the same information, not to collect as many diagnoses as possible.
As more information appears, return to the same comparison. What moved up the differential? What moved down? Did the clue supply genuinely new evidence, or clarify something that was previously ambiguous?
If the group identifies the diagnosis early, proceed to the explanation. Do not enter deliberate wrong answers to stretch the session. The remaining time can examine why other possibilities were plausible and what the correct answer still fails to establish about a real patient.
If the game is not solved quickly, protect the debrief. The teacher's objective is more important than using every available guess.
A learner worksheet that fits on a few lines
The following prompts can be written on paper or in an ordinary note. They are not a template that automatically enters an iatroX account or professional portfolio.
My initial interpretation:
The evidence I used:
My nearest alternative:
The clue that changed the balance:
Something the case did not establish:
The distinction I want to retain:
This worksheet keeps the reasoning separate from the final label. It also gives the quieter participant material to bring into the discussion.
Avoid requiring an exhaustive differential. One well-explained alternative is often more useful for this short session than a long list without priorities.
Minutes 8-16: compare reasons, not just answers
Start with the decisive clue. Ask whether participants noticed it and, if so, whether they interpreted it in the same way as the explanation.
Then examine the strongest competing hypothesis. A useful question is: "Which part of the case fits that explanation, and which part fits less well?" This avoids treating an incorrect answer as though it had no rational basis.
Separate missing knowledge from unsupported assumptions. A learner who did not know a mechanism needs a different follow-up from someone who knew it but overlooked the time course. Neither problem can be diagnosed reliably from the number of guesses alone.
Finally, ask what the case leaves unresolved. Identifying a diagnosis in a written exercise does not establish that an examination has been performed, an investigation completed or a management plan agreed with a patient.
Add one clearly labelled fictional variation
Prepare the variation before teaching and keep it distinct from the archived case. For example, suppose the original discussion depends on symptoms beginning before a medicine was started. A later summary reverses that sequence and makes the medicine appear to precede the symptoms.
Ask: "Which causal interpretation has become tempting, and what must we check before accepting it?" The intended response is to verify the chronology, not to declare that the medicine did or did not cause the problem.
This is a reasoning exercise constructed for the workshop. It is not another clue from rounds or an allegation that a live case contains an error.
A second possible variation changes the reliability of the information: the date comes from the patient's recollection rather than a contemporaneous record. Ask how that affects certainty, without assuming that either source must be correct.
Use only one variation when time is limited. A succession of clever twists can distract from the original learning objective.
Discuss the next action without inventing a complete consultation
After the diagnosis, ask: "What would you need to establish before deciding what happens next?" That question is often more appropriate than demanding an immediate complete treatment plan from an abbreviated case.
A learner may identify severity, current physiological state, a relevant contraindication or the patient's priorities. When a proposed management step is discussed, distinguish the general principle from a decision that depends on local services or additional assessment.
A brief communication prompt can also be useful: "How would you explain what is known and what remains uncertain?" The response should be the learner's account, not a memorised reading of the game's debrief.
The general clinical teaching guide provides alternative activities when the session is primarily about management rather than diagnosis.
Minutes 16-20: finish with retrieval and a decision about follow-up
Hide the answer and ask learners to explain the central distinction in their own words. Then invite one sentence beginning "I initially assumed...", "The clue that mattered was..." or "Before applying this, I would need to check..."
These are prompts for genuine reflection, not sample portfolio entries to copy. The sentence can be brief and need not claim that the learner's clinical practice has already changed.
Agree what happens to any unresolved question. It may need a source check, discussion with a supervisor or another case during a later session. A named question is more useful than a general instruction to revise the specialty.
Where a formal learning record is subsequently made, it should describe the activity actually undertaken. The GMC's CPD guidance emphasises relevant learning and reflection. Attendance at this workshop does not automatically confer accredited CPD or demonstrate competence in the condition discussed.
Keep extensions separate from the twenty-minute promise
A later stat session can focus on priorities, the next action or improving a plan. Its three scenes are independent decisions, and the initial editions use UK contexts.
A later clinical connections session can explore a mechanism or anatomical relationship. Its optional application question provides an additional task after the grouping puzzle.
Choose those editions deliberately. Sharing a date does not establish that the games concern the same patient or topic. Adding both complete games and their discussions would also change the duration of this workshop.
The practical strength of the plan is its restraint: one checked case, an independent attempt, a useful comparison and a clear finish.
Frequently asked questions
What should I do when someone already knows the case?
Invite them to contribute to the debrief or observe the reasoning. Keep prior familiarity visible rather than counting recall as an independent fresh attempt.
Must the group use all six guesses?
No. An early correct answer leaves more discussion time. There is no reason to submit artificial errors to make the activity last longer.
Are the other iatroX games automatically linked to the rounds case?
No automatic case-level connection is assumed here. Any stat or clinical connections activity should be selected separately for its teaching purpose.