Case scoring in DDx is designed to evaluate both what you know and the thinking behind your clinical decisions.

This scoring emphasizes your thought process: how you gather information, prioritize differentials and adjust decisions as new data becomes available. DDx scoring reflects how clinical reasoning is defined in medical education: the process of collecting and interpreting patient information to guide diagnostic and management decisions.

Identifying a Clinical Reasoning case

You can identify a Clinical Reasoning case before you begin. Look for the note above the Start Case button that reads: "This case will use the Clinical Reasoning Assessment to provide feedback on your performance."

How scoring works

Clinical Reasoning cases use a developmental rubric in which each criterion is scored 1–3. Your overall score represents your total points out of the maximum possible, which is why scores may look different than a typical exam. Overall performance falls into one of three levels:

• Preliminary: below 47%

• Progressing: 47–80%

• Proficient: 81%+

Proficient scores are genuinely difficult to achieve and are designed to reflect a high level of clinical reasoning development. Your faculty will communicate the specific benchmark to aim for in your program.

How to approach a Clinical Reasoning case

The attached PDF provides a detailed guide to the rubric and how to do well. To learn more about the rubric and how it was developed, visit the Clinical Reasoning Rubric page. Video walkthrough coming soon!