Timed physiology case
The student is handed a physiology scenario and a clock. Working against time, they trace a pathway or diagnose a failing system — following blood from the heart to a tissue and back, walking a nerve signal from stimulus to response, or reasoning out why a set of symptoms points to one organ system — deciding each next step from what the last one established. At the end they state the pathway or the diagnosis and justify it from the physiology. There is nothing to copy and no key to consult: the case is theirs to reason through, the time is real, and the conclusion has to hold up.
| Criterion | Not yet | Approaching | Mastered |
|---|---|---|---|
| Systematic approach under time | Jumps around with no plan and loses the thread of the case. | Has a rough plan but skips a step or doubles back inefficiently as the clock runs. | Works a logical sequence, letting each step set up the next, and keeps the thread of the case from start to finish. |
| Correctness of the pathway or mechanism | Gets the pathway or mechanism wrong, or cannot begin one. | Gets the broad path right but misplaces a step or skips a structure. | Traces the pathway or mechanism correctly, in order, naming each structure and what it contributes. |
| Justification at each step | Asserts steps with no reason behind them. | Justifies some steps but leans on memorized lines for others. | Gives a physiological reason for each step — why this structure, why this order, why this effect. |
| Adapting to the unexpected | Freezes or ignores a twist that changes the case. | Notices a complication but cannot fold it into the reasoning under time. | Takes a new symptom or constraint in stride, adjusting the reasoning without losing the thread. |
| Reaching & defending a conclusion | Guesses a pathway or diagnosis unsupported by the reasoning. | States a conclusion but cites only one piece of support, or hedges between two. | States the pathway or diagnosis and defends it by chaining the steps into a single, evidence-backed conclusion. |
“Blood leaves the left ventricle through the aorta already oxygenated, so low oxygen at the tissue has to be a delivery problem, not a loading one — that points me to circulation, not the lungs. The swelling in one leg says a blockage there, not a whole-body failure.”
“It’s a heart thing, probably. Blood goes around the body. I’d have to guess where it’s actually going wrong.”
This assessment is AI-proof by design: it happens live, with the guide watching, against a real clock. No chatbot can reason through a case in the room, adjust when the guide adds a symptom, or defend a diagnosis out loud on the spot. The cases differ from student to student, so there is no answer to look up — mastery is shown by reasoning and justifying in person, not by submitting.