About the Clinic Simulator

Purpose of the Clinic Simulator

The clinic simulator was designed to emulate the decision-making challenges facing a busy faculty member seeing complicated inherited retinal disease patients in a clinic with very competent house officers. Imagine that TONS of information has been gathered about the patient. How much of it do you want to or need to see before making a diagnosis? Can you get on the right track of the diagnosis right away and then zero in on a very specific diagnosis with a few well-chosen questions?


The simulator will score your efficiency in getting to the right answer in the following way. Each time you move toward the correct diagnosis on the diagnostic tree, the simulator will allow you to ask a question or look at another clinical image without detracting from your score. Also, whenever the correct answer has been chosen, any additional questions from then on are free.

Thus, if you think you know exactly what the diagnosis is after you read the introductory sentence and see the first photographs, you can just enter that diagnosis in the search box or choose it from the diagnostic tree pull down menus, ask as many confirmatory questions as you like, and you will get a high score for the case. Alternatively, you can just choose the major diagnostic branch that you think the disease belongs to, ask a question that helps you choose the next sub-branch and walk steadily down the diagnostic tree to the right answer and you will also get a high score. What you want to avoid is being way off base and asking lots of irrelevant questions. Doing so will cost you lots of points.

Predicting the Genetic Cause

After diagnosing the patient, you should always choose the most likely disease-causing gene because your choice here can only aid your score – there is no penalty for being wrong. The genes associated with the disease you have specified are always displayed in decreasing order of population prevalence, so unless you detect a gene specific phenotypic feature somewhere in the case, it is best to just choose the first one on the list. However, if you DO recognize a gene specific phenotypic feature and correctly choose a less common gene from the list, you will get a large point bonus.

False Genotype Rate

As you work your way toward the correct diagnosis, you should note how the number of possible genes and the associated False Genotype Rate both fall. The more you train yourself to make very precise pre-test diagnoses, the more statistical significance the resulting genetic findings will have, and the less likely you will make a serious mistake.

Submitting Your Diagnoses

When you submit your diagnosis, if you are incorrect, you will be given some very specific feedback about why you were incorrect and then be allowed to try again.

If you are correct, you will be given a summary of the patient’s clinical features that were key to the correct diagnosis and the number of points you earned. You will also be given some choices to see more information about the patient, review the details of the scoring, or to move on to another patient in the simulator.


You can view a summary of your simulator experience on the Track Your Progress page.

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