In CASE-015, “the child is healthy” is now an ending of its own
For paediatric cardiology teachers: a run can now be paused for the whole group to see the route so far, with outcomes, score and verdict kept hidden, and students always see which stage they are in and how much time they have spent.
Version 1.28.0 of CASE-015, the six-month-old with tetralogy of Fallot in a hypercyanotic spell, went live on 2 November. Among the diagnoses offered there is «the child is healthy: no acute condition, no treatment needed». Choosing it now costs 30 points and ends the run at once in a seventh ending: the patient's state is critical and the grade is a critical error. The case's maximum score stays at 605.
What the student reads after that choice
The case's authors never wrote an outcome for a child assessed as healthy, so this ending's text is written by the platform from the case's own words. The spell goes on, the face and mucous membranes stay cyanotic, breathing stays laboured, and, in the case's words, a severe spell can progress to cardiac arrest within minutes with severe acidosis and hypoxaemia. The text then lists the steps the case itself sets for relieving the spell; the observation in intensive care that follows them is the platform's wording, not the authors'. It gives no dose and no prognosis figure.
A pause that does not spoil the second attempt
Next to the button that moves the case on there is now a «Graph» button. Pressed mid-run, it opens the case's event tree with the route taken so far; every outcome stays locked, and there is no score and no verdict. «Back to the case» or Esc returns the run to where it was. At the diagnosis and tactics decisions the button is absent, because those screens have no button to move on.
The screen tells the student where they are
The header now names the stage, «Stage 1 of 5» with its title, in every scene where the student acts. The timer digits count the time spent against the stated 13 minutes, «00:00 / 13:00», and a depleting bar beside them shows what is left; in the tactics scene the case's own minute countdown stays as it was. Our note of 28 October described the digits as time left; that is no longer the case.
An examination result now appears over the current picture instead of switching it. The monitor is gone from the history and examination scenes and appears in the tactics, with readings taken from the case: after oxygen, SpO₂ rises to the 75–78 the case gives. Heart rate does not change on the monitor, because the case states no pulse after treatment.
Three ways to use it in the seminar
Stop a run after the examination, open the graph on the projector and ask the group which stage they are in and which branches are still ahead.
In the debrief, ask the student who reached the critical ending to find the history findings that should have ruled out «healthy».
Compare two students' runs at the tactics stage by what the monitor showed them after oxygen.
Before you assess students with it
The case is written in Russian and does not yet carry a clinical reviewer's sign-off. Before grading by it, check its expected steps against the guideline your department teaches from. The text of the new ending is the platform's, not the case authors'.