· For each of these cases, there are student pages and instructor pages. · Student pages are the first two pages in each file. The student should be encouraged to review these pages, planning how to go about eliciting the additional necessary information. ·Instructor pages are the remaining pages. The student should not see these. The instructor imparts the information on these pages only as he or she is asked for it. The instructor, before beginning with the student, should read through both the case and the diagnosis entry in the medical manual, to become familiar with the disease and the manifestations thereof. This is essential, since the student might ask a question that is not covered in the print-out. The instructor should be able to give a reasonable answer. For students who are either bright or arrogant or both, it is helpful to challenge them by changing some of the details of the history, in order to suppress major diagnostic clues. In doing this, though, do not tamper with the information on the two student papers.
o Example:You might have a patient with enteric fever, without abdominal pain, or without a slow pulse relative to the fever.
o Example:Some patients with rabies can swallow water just fine, but they are paralyzed. The instructor should be flexible, giving the student the option of staying in the same place and time, or doing a fast forward for a matter of hours or days.