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Table 2 Example of an SCT case with two questions

From: Virtual patients in the acquisition of clinical reasoning skills: does presentation mode matter? A quasi-randomized controlled trial

A 25-year-old, apparently sick female patient is presented to you in the emergency room by her boyfriend. She is complaining of nausea and severe pain in the right lower abdomen

If you were thinking of the following diagnosis...

...and then find...

...then your hypothesis becomes...

Acute appendicitis

Patient vomits in the emergency room

-2-1 0 +1 +2

Ectopic pregnancy

Acute, sudden onset of pain two hours ago

-2-1 0 +1 +2

  1. -2=ruled out or almost ruled out
  2. -1=less probable
  3. 0=neither more nor less probable
  4. +1=more probable
  5. +2=certain or almost certain