What the examination tells the mother: CASE-015 now sends students back to the history
For teachers of paediatrics and paediatric cardiology who run case-based seminars: the tet-spell case can now be started for a whole group without anyone reading the case aloud, debriefed on a map of choices that does not spoil a second attempt, and timed against its stated duration. Its vital-sign wording now follows PALS 2020 age norms.
A six-month-old boy with tetralogy of Fallot, confirmed at one month, is brought in by ambulance after a morning spell: he cried, turned blue all over and went limp for about five minutes. That is how CASE-015 in the Paediatric Cardiology programme now begins: five slides titled «Ребёнка везут на скорой», each with a picture, a caption and a narrator's voice. A slide moves on when its recording ends, or at a click; «Пропустить» goes straight to the patient. The mother's eleven answers are voiced too, and her answer about earlier spells is a short video clip. A sound switch sits in the player's header; with sound off, every line stays on screen as text.
A finding that reopens the interview
A new question appears in the examination only after the student has assessed the cyanosis: how today's blueness differs from his usual one. The mother explains that he has been slightly blue since birth, with SpO₂ of 80–85% at home, and has never looked like this. The question earns no points; it is there to make students connect a finding with the history.
The way to the decision is no longer blocked until pulse oximetry and heart auscultation are done. A student who skips them loses their 30 and 25 points instead of being stopped. From the diagnosis, students can step back to the examination until they make a scored choice; scored choices cannot be undone.
Pulse and pressure read against PALS 2020
The numbers have not changed: heart rate 178, respiratory rate 64, SpO₂ 64, blood pressure 78/45. Their wording now follows the age norms of the AHA PALS Provider Manual, 2020 edition: an awake heart rate of 100–190 per minute is normal from three months to two years, and hypotension in an infant is a systolic pressure below 70 mmHg. So the case now calls the heart rate high-normal for a crying child in a spell, the pressure low-normal with no hypotension, and the respiratory rate marked tachypnoea (the infant norm is 30–53). The monitor no longer alarms on heart rate or pressure; respiratory rate and saturation still raise critical alarms. That gives a ready seminar question: which of these numbers is actually abnormal?
Debrief on the map, against the clock
After the ending, the event tree is a left-to-right flowchart that can be dragged, zoomed and fitted to the screen. Each stage shows its picture and «выполнено N из M»; the current run is bright, earlier attempts are dimmed, and branches nobody opened stay locked and unnamed, so showing one student's tree does not hand the group the answers. The optimal route is marked, and a run can be replayed from any stage.
The player's header shows time played against the stated 13 minutes, for example «04:12 / 13:00». The clock starts at the first action after the opening, pauses while the tab is hidden and stops at the outcome. Running over only changes its colour; the case is not cut short and the score is unaffected. A run in progress survives a page reload in the same tab.
Plan the session around the case language
The case text and the voices are Russian; the player's interface is translated, the clinical content is not. Of the 41 scenarios published on the platform, CASE-015 is so far the only one played as a scene with these features. The scenario page opens without registration.