Cases and items from a gap you already have

What you’re making

Draft cases and assessment items for you to edit: a vignette, a lead-in question, plausible distractors, a rationale, and a flag wherever the draft went beyond the facts you supplied.

ACCME’s January 2026 AI guidance lists assessment items, distractors, rationales, and case-building as uses worth trying. It also says named humans still check for hallucinations and clinical validity. That split is the whole recipe. You supply the medicine. The tool supplies the shape.

What to have open

The gap and the objectives. The clinical facts in your words: the presentation, the numbers you are willing to stand behind, the decision the learner should make, the right answer, and why the wrong answers are wrong.

If faculty wrote a case last year that survived review, keep it handy as a style sample.

No patient identifiers. Composite and fictionalized only. If the source is a real chart, this is the wrong recipe until it has been through your approved de-identification path.

The prompt

You are helping me draft educational cases and assessment items for an accredited activity. I am the author of record. Use only the clinical facts I supply. If a detail would make the case better and I did not give it, write [NEEDS: the detail] instead of inventing it.

PRACTICE GAP:
[paste]

OBJECTIVES:
[paste]

LEARNERS AND FORMAT:
[who, how long, live / enduring / RSS]

CLINICAL FACTS THIS CASE MUST REST ON:
- Presentation: [paste]
- Numbers I will stand behind (labs, doses, ages, time frames): [paste, or "none"]
- The decision the learner should make: [paste]
- Correct answer, in my words: [paste]
- Why common wrong answers are wrong, in my words: [paste]
- Source I used (guideline, protocol, faculty note): [name and year I have verified]

HOUSE STYLE:
[paste one approved item, or "none"]

Draft:

1. VIGNETTE. One paragraph. No extra labs, drugs, or history. No brand names unless I used one.
2. ONE LEAD-IN QUESTION. Measurable. Tied to a named objective.
3. FOUR OPTIONS. One correct, three distractors drawn from the wrong-answer reasons I gave. If I did not give three reasons, make fewer options and say so.
4. RATIONALE. Two or three sentences. Quote my facts. Do not add a citation I did not supply.
5. TEACHING POINTS I DID NOT ASK FOR. If you think the case is missing something, list it as questions to me, not as new content.

Then list every number, drug, and threshold that appears in your draft, and next to each one write "supplied" or "I added this." Anything you added must also appear as [NEEDS:] in the draft.

That last inventory is the checking step built into the prompt. If the model “forgets” to mark an addition, your own number pass still catches it.

What good output looks like

The vignette is slightly plainer than you expected. That is a good sign. Fluency often means extra detail.

The option list does not contain a trick answer the faculty never taught. The rationale does not cite a guideline year you did not give.

How to check it

Inventory pass. Every dose, lab, age, and drug is on your supplied list, or it is deleted.

Objective pass. The question tests the objective you named, not a neighbouring one that was easier to write.

Brand pass. Class names unless you supplied a brand.

Answer key pass. Work the item yourself without looking at the rationale. If you cannot defend the key from the vignette alone, the item is not ready.

Where it goes wrong

It fills in the medicine. Thresholds, renal adjustments, pregnancy categories, “typical” starting doses. Delete them. Fetch them from the source.

It writes a novel. Two comorbidities, a social history, and a twist. You asked for one decision.

It uses brand names from training data. Even when you said not to.

It writes items that are only recall. If your objective is competence (Moore level 4), a “which of the following is true” knowledge item has slipped down a level. Same failure as in the objectives recipe.

If the items sit inside an on-demand module, outline the module first with the enduring-module recipe. Same split: you supply the medicine.

Cases and items from a gap you already have · bettermethod.ai/recipes/case-vignettes/ · Last reviewed August 2026
These tools change often. Check the review date before you rely on anything product-specific in here, and check the guidance against your own accreditor and organization policies.