University of Puerto Rico School of Medicine Case Study
Discover how a single in-class DDx session drove a 19% overall boost in diagnostic confidence.
Overview
Building differential diagnosis skills from day one
At the University of Puerto Rico School of Medicine, first-year students build differential diagnosis skills early through their Introduction to Clinical Reasoning workshop. Faculty identified DDx as a solution that would allow students to practice working through standardized cases in a live pilot session, actively applying their reasoning skills in class. 106 MS1 students completed an appendicitis DDx case in small groups — with results demonstrating meaningful gains in confidence across all key clinical competencies.
Overview
The challenge
Making case-based learning scalable and engaging from the start
The program sought a scalable case-based learning solution that would allow first-year medical students to practice developing differential diagnoses and clinical reasoning through realistic patient encounters early in their training.
Developing a well-reasoned differential diagnosis is a foundational skill in medical education. Faculty at the University of Puerto Rico sought an engaging and scalable approach to case-based learning early in the curriculum — one that would allow first-year students to actively work through standardized patient cases while building the reasoning skills needed throughout their clinical training. Traditional case formats lacked the interactivity and immediate feedback necessary to help students develop true diagnostic confidence.
The solution
Why DDx by Sketchy?
Deployed a single appendicitis DDx case as part of the Introduction to Clinical Reasoning workshop; Students worked in small groups through the full patient encounter in a collaborative in-class setting; Real-time AI feedback guided history-taking, physical exam interpretation, differential development, and diagnostic test ordering; Faculty used DDx’s self-proctoring feature to seamlessly manage small-group breakouts without additional logistical burden
DDx provided UPR students with a structured yet adaptable framework to hone their diagnostic skills in a dynamic, interactive format. Faculty appreciated the platform’s self-proctoring feature that facilitated seamless integration into the classroom setting — allowing instructors to break students into small groups easily and focus on guiding discussion rather than managing logistics.
How did DDx by Sketchy fit?
DDx was piloted during a single in-class session as part of the introduction to clinical reasoning workshop, with students completing an appendicitis case designed to align with the program’s early clinical reasoning curriculum.
Cases Included:
- Appendicitis
The results
What was the implementation's impact?
From pilot to core curriculum
The University of Puerto Rico’s pilot demonstrated clear benefits in strengthening students’ diagnostic reasoning skills, increasing engagement, and building confidence in history-taking from the very beginning of their medical education. The decision to incorporate DDx into the core clinical reasoning curriculum following the pilot speaks to both the platform’s impact and its potential to deliver scalable, high-quality diagnostic training at scale.
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