The Case Files series, developed by Dr. Eugene Toy from the University of Texas-Houston, is universally studied by almost all medical students on their various clinical clerkships. For the few among us who haven’t heard of it, Case Files consists of realistic cases and diagnostic discussions accompanied by several USMLE-type questions as well as clinical pearls to highlight key concepts related to the particular case. As most physicians and medical students can attest, the Case Files series represents an outstanding study resource for the clinical clerkships because of this case-based approach to education, as seen by the publisher’s claim that the series represents “the closest you can get to seeing patients without being on the wards.”
Now, McGraw-Hill, via Expanded Apps, Inc., has brought the Case Files series to the iPhone/iPad. Here, we look at the app version of Case Files: Internal Medicine. Read below to learn how the app version of Case Files compares to the popular traditional paperback version.
Here, we review the free version of the app, which features a demo case. The home screen includes tabs for a primer on approaching clinical cases, the cases themselves, study quiz options, scores, case notes, and more information.
The Primer, which represents a strength of the Case Files series and this app, includes 3 parts—approaches to patients, clinical problem solving, and reading.
While somewhat difficult to traverse in iPhone format because of its extensive length, the first part of the Primer includes valuable information for medical students on how to take a comprehensive history and perform a physical exam, as well as offering quick synopses on interpreting test results (via pretest probability and likelihood ratios).
Part 2 of the Primer discusses diagnostic reasoning, while Part 3 applies these principles to facilitating clinical thinking. Although the information presented in the Primer may be redundant with other texts and clinical teaching, the Primer represents a solid resource for medical students to consolidate their clinical thinking process.
Now, onto the cases – the foundation of the Case Files series. The app allows for listing the 60 cases by case number or by disease. As a student, I relished working through the cases by number in the paperback version, as I felt that seeing the diagnosis before attacking a given case detracted from the full potential of each learning opportunity.
The free demo version allows for the exploration of one of the 60 cases, but affords insight into the features of the app. Tabs on the bottom of the screen display the case itself, answers to the case, approach to diagnosis and management, clinical pearls, and questions.
Our demo case – STEMI—includes an EKG, which, like other images and figures in the app, can be zoomed and panned.
As noted above, reading the app text on the iPhone is a bit cumbersome, but the length of the cases themselves are manageable, and the app can be viewed horizontally as well.
While different users may tackle the tabs in different orders, the “Answers to” tab displays the most likely diagnosis and discusses next steps in management.
The “Approach to” tab provides an extensive discussion of related definitions, pathophysiology, and clinical considerations, including various tables and figures for enhanced understanding. These discussions are indeed appropriate for the level of medical students on clerkships and studying for shelf exams.
“Clinical Pearls” offers several useful take-home points related to the case.
Each case is accompanied by several USMLE-type multiple-choice questions which require the application of knowledge taught in the other tabs of the case.
For example, the question here involves management of a gastrointestinal etiology for chest pain – not the diagnosis of the related case, but a consideration for the presenting complaint of chest pain. The explanations for the questions are concise yet appropriate.
Other notable features of the app include a link to references for further reading on each case, as well as the ability to take in-app notes on each case for later review. These case notes can be reviewed via a link from the home screen, as well.
After completing the first (demo) case, clicking on another case will prompt a pop-up for the in-app purchase of the 59 remaining cases for $29.99.