Toolbox Teaching: How to Alter the Diagnosis on a ReelDx Case

What happens when you discover a phenomenal ReelDx case with a compelling patient encounter video and all the symptoms you’re looking for, but the diagnosis isn’t the one you need? Luckily, there are ways that you can easily alter the case details to tailor it to your needs!

‍

Dr. Christopher Behringer had been using PVCs to teach pre-med students since 2020. In that time, he has created a host of tools and methods to adapt ReelDx cases to the diagnoses his students need to learn, which he is graciously sharing below. The case that Dr. Behringer uses in his example, 264 | Shortness of breath, lower leg edema, will be available for free in our public library until June 22, 2023, so that you can test out this technique for yourself.

‍

‍

What is Toolbox Teaching?

‍

The reason I like to think of teaching conceptually as a toolbox is that it leads you to look at how to use what you already have at hand as opposed to asking, “do I have to go get something new for this lesson?” .Instead of getting hung up on “Oh, this material is for this topic, and I can only teach it in this way”, it allows you to look at all of your materials, including your patient videos, and say “Okay, how can I flex this into my learning objectives for today? What do I have?”

‍

One great example of this is ReelDx case 264, which starts off looking very classically like a congestive heart failure case. But, in this case, the patient is actually diagnosed with COPD exacerbation. That’s the actual diagnosis of the patient, but I'm going to show you how we flex this into a CHF case simply by providing your students with some different test results than what’s included in the case.

‍

Download Our Toolbox Teaching Guide

‍

How to Adapt Case 264 to a CHF Case

‍

1. After students view the case video and begin listing their differentials based off the initial patient encounter and the Vitals & Demographics drawer, ask them to list which tests they’d want to order to start narrowing down their diagnosis.

2.  Use the links and lab tables provided in the “Adapting Case 264 to a CHF Case” of the Toolbox Teaching Guide to show the results for the tests requested by the students instead of the results provided in the case. If you’re doing the exercise online asynchronously, you can hide the case drawers with the results and provide students with your own labs to refer to instead.

3.  Discuss each of the test results with your students and ask them to determine which of their differentials the results either prove or disprove. For example, one of the tests they may request is a CBC to check for an infection, such as pneumonia. Show them the example lab panel for a normal CBC, then ask the students if they see anything abnormal. When they answer no, then you can remove any differentials from the list that involved an infection.

But what if you do want to teach this as a pneumonia case? You can easily take the CBC, bump up the white blood cell count highlighted in red and have it say 20 and find a chest X-ray with a pneumonia and turn this patient into a pneumonia case. With these two simple changes, boom, you have a pneumonia case.

‍