Worked examples

Sample cases.

Two short examples showing the shape of a worked case: the problem, the student's prepared reasoning, the discussion in the session, and the feedback.

Cardiology · Ischaemic heart disease

Chest pain in a 58-year-old

A 58-year-old man describes central chest tightness that comes on when he walks uphill and settles after a few minutes' rest. He smokes and has high blood pressure.

Prepared reasoning (before the session)

The student lists possible causes — stable angina, heart attack, musculoskeletal pain, reflux — notes the cardiovascular risk factors, and proposes initial steps such as an ECG and blood tests.

In the session

The advisor explores why the exertional pattern points towards stable angina, how the risk factors fit, and what would change the assessment if the pain occurred at rest.

Feedback and next steps

Feedback on how the reasoning was structured, with follow-up reading on the assessment and management of stable angina.

Respiratory · Acute breathlessness

Breathlessness in a 24-year-old

A 24-year-old becomes acutely short of breath and wheezy after exercise. She had eczema as a child and has had similar, milder episodes before.

Prepared reasoning (before the session)

The student considers asthma, allergic reaction, pneumothorax and anxiety, sets out the features that separate them, and notes the immediate assessment, including peak flow and observations.

In the session

The advisor discusses how the history points towards asthma, the role of peak flow measurement, and the signs that would indicate a severe attack needing urgent care.

Feedback and next steps

Feedback on ordering the differential diagnoses by urgency, with follow-up on the management of an acute asthma attack.

These are illustrative examples showing the format only. Worked examples for the site will be prepared and reviewed by PBL Coach's advisors.

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