Writing a case study for Core Knowledge in Paediatrics Course

A typical case study on the Core Knowledge in Paediatrics Course has a clinical scenario followed by three questions. Each question has a five-option answer list with only one best answer. At the end of the case study, there is a discussion section with references.

Note: Case studies are published in blocks, which are made available for purchase via the EAP app. Contributors retain copyright to their text. No royalty is payable.

Guidance for writing a case and single best answer questions

• When writing a case, think about a patient you have seen rather than something complicated or vague. This should be a teaching case of a child that you would be expected to encounter and manage with towards the end of your paediatric training. We are not interested in rare cases that are normally published as case reports in the literature.
• Aim for a clinical scenario (stem) of 30-120 words. Be clear and concise. Use present tense.

Keep the scenarios patient focused and include the following:

• Age
• Gender
• Ethnicity
• Symptoms
• Duration
• The setting if relevant e.g., emergency department, clinic
• Relevant past medical history, family history and social history

Present the examination findings in the following order (as relevant):

• Temperature e.g., 38°Celsius
• Pulse e.g., 86bpm
• Blood pressure e.g., 120/70 mmHg
• Respiratory rate e.g., 24 breaths per minute
• Oxygen saturation (include % oxygen, rate and mode of delivery)
• Physical findings – include positive findings first. Be specific.
• Investigations and results should be presented in a logical order.

Pictures or videos are welcomed, but make sure you have a written patient (parent or guardian) consent where they state they are happy for the image to be published in the Core Knowledge in Paediatrics Course.

• When writing a question, choose a lead-in question. Avoid negative questions. Those are good examples of questions:
  • What is the most likely diagnosis?”
  • “What is the best advice to give to the parent?”
  • “What is the best description of the pathogenesis of this condition?”
  • “Which of the following would be the most likely explanation for these findings?”
  • “Which of the following investigations should be done next?”

• “Which of the following investigations will be most helpful in making a diagnosis?”
• “Which of the following is the best next step in management?”
• “Which of the following is the most appropriate management strategy?

• When writing answers, list five options which should all be possible answers to the same question.

One answer should be clearly (and justifiably) better than the others, but all should be similar length and plausible. Avoid mixing up investigation and treatment options in the answer options.  Either ask about investigations or about management/treatment

• The discussion should be between around 350 and 700 words max. It should address both the management of the case, but also the questions and right answers, clarifying why other answers were incorrect. It is important to explain the rationale of the answer you listed as correct in line with recent literature and national or international guidelines which can be cited as references.

• Reference to up to 5 papers is useful, but where possible these should be review articles, metanalysis or guidelines rather than single research studies. The references should be in English and easily accessible to all. If there is a hyperlink to the full article please include it. Please use the same citation style for all the references that you list.