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The Virtual Interactive Case System is flash-based software that was developed by The Department of Anesthesia at Toronto General Hospital and Perioperative Interactive Education. The software allows the creation of medical cases, which simulate encounters with patients in the clinic or ER setting. These cases can be used for the education of medical students, residents, nurses and allied health professionals. The cases bridge the gap between the theory learned in the classroom and seeing actual patients in real life. To further test students’ skills, it is possible to create multiple cases with the same presenting complaint but each leading to a different differential diagnosis.


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The virtual interactive cases start out by presenting the case of a virtual patient. The user can then gather information by selecting questions to ask and obtaining the answers. Areas for questioning can include any area the case developer chooses to include, but generally cover the history of the presenting illness and a past medical history. The user can then get the findings from a virtual physical exam. Imaging and lab tests can be ordered and the results are obtained. Cases can have associated images, sounds and video clips. After gathering all the information, the user makes their final diagnosis and management plan.


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A final score is given for the user’s performance on the case. Feedback is provided at the end of the case to cover essential actions the user missed or inappropriate actions the user took. Users are also provided with the time and cost associated with all the actions they performed.

How can you access the Virtual Interactive Case System to create your own virtual cases? If you are affiliated with the University of Toronto, this university has already purchased a user license. Other schools can purchase a license by downloading an order form from the VIC website. The VIC website also provides a list of institutions which already own a VIC license.

PIE is currently working on a mobile iPad app so that cases can be accessed on-the-go.

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