Case Based Teaching

Overview: Structure of the Cases

The structure and format of the case teaching modules have evolved over the past decade based on user feedback and a recent needs assessment. During the early years, we prepared simple case narratives with a list of questions for discussion at the bottom of the page. We learned that narratives are best when brief, and designed to lead the learner naturally to further inquiry. As the target group of learners for our project included residents at different levels, we determined that narratives should be broken into several parts, each of which is designed to help the discussion move from information gathering, to testing and assessment, diagnostic formulation, treatment planning, and clinician-patient communication. We quickly discovered that learners also needed handouts and lists of references for further reading. More recently, site users have expressed a need for quick “bullet point” messages for each case as well as post-assessment question and answers. We also learned users appreciate flexibility and the curriculum includes options for teaching via discussion or individual learning and provides additional suggestions for continued learning activities and skills development in some areas. These advances are now incorporated into each case.

Each module contains a 3-4 part case narrative, handouts, an annotated bibliography, a comprehensive facilitator’s (or teacher’s) guide specific to the individual case, clinical pearls, and knowledge questions and answers. The materials are designed in a manner that allows teaching sessions to be conducted by either faculty or properly prepared trainees. The best way to understand the construction of these cases is to read through one, and then use this page to guide you through each section.

Case Narrative

Most case narratives are divided into three parts. Part I describes how the patient first presented in the primary care setting and prompts a discussion of the differential diagnosis. Part II presents additional information on further history, physical examination and diagnostic tests and prompts a discussion of treatment possibilities. The third part of the case is the Epilogue, designed to give learners a general idea of the patient’s outcome.


Handouts either supply supplemental information to the case narrative (e.g., Growth chart, visual exam findings, psychological test results), and are distributed during the course of the case discussion; or they summarize evidence based guidelines and are distributed at the end of the teaching session. Specific suggestions on how handouts should be used are included in the Facilitator’s Guide.

Clinical Pearls

A bulleted list of the key take home points mirroring the educational objectives are included for each case.

References and Annotated Bibliography

Each case includes a bibliography. Several citations, usually general reviews or book chapters, are chosen for brief annotation and listed under “Suggested Readings.” Where appropriate, the reference page includes contact information for national organizations (e.g., National Down Syndrome Congress) and educational resources on the World Wide Web.

Facilitator’s Guide

This section begins with the case title, authors and reviewers, educational objectives and suggested facilitator preparation. The following pages present a step-by-step guide to teaching the case. Prompts for the facilitator (e.g. Distribute Part II of the case narrative) are indicated by bold-face type. Brief discussions of key teaching points are included after each guide question. This guide is intended for use by facilitators (teachers) and not designed to be handed out to learners (students).

Materials for Learners

A separate PDF will include relevant supplemental information (e.g. treatment guidelines), clinical pearls, knowledge questions & answers, and references to be handed out to learners (students)

Powerpoint Presentations

A separate powerpoint presentation includes case narratives and relevant handouts (e.g., Growth chart, visual exam findings, psychological test results) and can be used as alternative to distributing paper copies.

Boston Children's Hospital © 2013