The Mystery Case series was initiated by the Neurology® Resident & Fellow Section (RFS) with the aim of honing the clinical reasoning skills of trainees. The idea was simple – take a nice teaching case submitted to RFS, and recast it as a brief vignette, typically presented with a set of relevant clinical- or neuro-images from the original case, and then generate a set of relevant questions that would serve to highlight the key teaching points of the case. The questions would generally move from general (key findings, differential) to specific (most likely diagnosis, best diagnostic test), mimicking the real-life diagnostic process.
For the past several years, this section relied on written responses to the Mystery Case questions from residents/fellows, solicited through group emails and social media. Respondents could email in their answers, or post their answer as a comment on our the Neurology Facebook page. However, we soon found that this was an inefficient method of engaging our audience, or gauging their understanding, as most respondents would only address the final question (regarding the diagnosis) and ignore the rest. Besides, for respondents who did not want to publicly disclose their identity – along with a possibly incorrect answer – in the form of a Facebook response, the task of crafting an email response was another barrier. As we struggled with low response rates, the RFS section realized that it was time for Mystery Cases to receive a makeover.
And so, last month, we piloted a new electronic platform with multiple-choice-style questions for gathering responses. With a few clicks of a button, respondents could participate in the Mystery Case, and would only need to disclose their identity if they wanted the platform to “keep score” of their responses over time for potential downstream shout-outs and bragging rights. The new format was a success – we received 725 responses, our highest to date! Keep your eyes peeled for the final writeup of this Mystery Case in a forthcoming issue of Neurology, in which we will disclose the correct diagnosis.
Thrilled by the success of the new format, we invite you to participate in this month’s Mystery Case – In Pain and Seeing Double. We look forward to receiving your responses – and do let us know your own thoughts about Mystery Case’s recent makeover!