Interactive, performance-based case studies for educating tomorrow's clinicians

DxR Clinician

is web-based software that helps teach and evaluate clinical reasoning skills

DxR Clinician delivers proven, full-featured, professionally edited cases used with patient simulation software tools in a convenient web-based format. DxR Clinician features everything needed to teach, learn, and evaluate key clinical reasoning skills. Our catalog of more than 120 cases covers a broad range of clinical problems based on actual patient data.

Students will have the opportunity to assess and diagnose a patient’s problem online as their clinical reasoning process is recorded for evaluation at your convenience. DxR Clinician can be hosted on the DxR Group’s web server or installed on a secure, locked server and hosted by the licensing institution. 

How Healthcare Professional Schools Use DxR Clinician

Evidence supports the value of virtual patient simulations as an educational technique important to training healthcare professional students. To be effective, however, patient simulations need to be integrated into the curriculum in a way that promotes transfer of the skills learned to practice clinical medicine.

Healthcare professional schools around the world have integrated DxR Clinician, a virtual patient software program, throughout their curricula, from the preclinical years to the clerkship level. During the preclinical years when basic science is the focus of the curriculum, schools select cases designed to help students understand how basic science content is used to solve clinical problems. In the advanced years, such as during the clinical clerkships, DxR Clinician cases are used to give students an opportunity to virtually encounter patients and clinical problems beyond those they encountered during their clerkship rotation. While DxR Clinician cases are used most commonly to allow individual students to work up a patient virtually, schools use the cases in small groups, providing problem-based learning and team-based learning experiences.

Schools also use DxR Clinician cases to administer performance-based examinations.

Details of a student’s problem-solving decisions and clinical reasoning skills are recorded in a student record, which faculty members review and report using DxR Clinician’s Record Utility. Faculty members say DxR Clinician cases are valuable for assessment because they allow them to evaluate the student’s ability to interpret pertinent findings, as well as, see the specific patient history questions, physical examination procedures, and diagnostic studies the student collected to diagnose and treat the patient’s problem.

In addition to the Record Utility, DxR Clinician includes a robust set of cases management tools. With the Management Utility, faculty create new cases, as well as, modify the case content and edit the evaluation criteria of existing cases, thereby creating virtual patients that meet the educational objectives of the school’s curriculum.

over 250 questions

collect information regarding patient history from over 250 questions, including new interview questions designed to encourage better physician/patient communication.

over 425 physical exam

simulate physical exam procedures using 18 exam tools and patient pictures to make over 425 possible exam selections.

over 670 over 670 items

order diagnostic/laboratory tests from the database of over 670 items.

Scoring Paradigm (the Clinical Reasoning Score and the Level of Diagnostic Performance)

DxR Clinician provides faculty with both qualitative and quantitative evaluations of the way in which the student worked-up the simulated patient case. For example, the student’s Level of Diagnostic Reasoning performance is expressed as a qualitative description as well as a numeric value. Additionally, DxR Clinician renders numeric scores for Clinical Reasoning, Management, and Content Knowledge. These scores are weighted and then combined to produce the Overall Performance Evaluation Score.

DxR Clinician Demo


  • Simple set-up: Easily install cases and customize case delivery and access. Do it all online — no downloads required!
  • Convenient & Flexible: Use cases directly ‘off the shelf,’ or edit any case content or grading criteria to meet specific instructional goals.
  • Assign cases to individual students or to a group, for a team-based learning experience.
  • Insight: Clinician’s evaluation tools give faculty detailed data on learners’ performance, so instructors can tailor feedback to the needs of individuals or an entire group.
  • Powerful reporting & scoring tools: Leverage the DxR Record Utility for objective, quantifiable assessments of clinical reasoning skills. See statistical and graphical evidence of student performance compared to the scoring criteria for the case, adjust the criteria as you see fit, and produce detailed reports on learner performance.
  • Case Authoring option: Faculty can use the optional Authoring tool to create original cases and deliver those cases to students.


  • Practice effective clinician/patient communication skills while collecting a patient history (more than 250 interview questions available).
  • Simulate physical exams and interpret findings, including real heart and lung sounds.
  • Order pertinent lab tests from a database of more than 670 diagnostic studies, review findings, interpret imaging studies and videos as needed, and make decisions about their clinical relevance.
  • Develop a working hypothesis list and follow the evidence to support your final diagnosis.
  • Organize key findings and prioritize your problem list, record SOAP notes, and develop a treatment plan.
  • Learn from immediate performance feedback at the end of the case.


“DxR Clinician cases allow students to apply what they learn in lecture and to develop their clinical reasoning skills even before they reach the clinical setting. DxR cases are based on real patients with realistically complicated problems, so students quickly learn to appreciate the complexity of patient care. The free-inquiry method of history taking and the rich diagnostic tests section allow students to practice skills that directly transfer to the clinic. We routinely use DxR Clinician cases with small groups in preparation for the first clinical year. But the cases are also a huge benefit to me an instructor in helping students who are struggling. Tracking a student’s path through the case allows me to probe the student’s critical thinking and identify areas of weakness.”
James Van Rhee, MS, PA-C, DFAAP
Program Director | Yale Physician Assistant Online Program
The IUHS DxR Clinician program helps us to standardize learning concepts and patient encounters to a distributed student body throughout their pre-clinical and clinical education. Connecting critical learning concepts and contextualizing that knowledge using the DxR virtual patient interface provides the student with a much clearer understanding of “why” and “how” you apply what you learn to real patients. IUHS uses the DxR interface to allow students to complete assigned cases more than once so the process becomes intuitive and documentation skills can be perfected. We believe a clear understanding of process and intuitiveness that follows can only develop with repeated exposure to the patient setting, and DxR allows us to do that in a standardized controlled setting.
Juliana Furay PhD
International University of the Health Sciences Vice President, Strategic Initiatives IUHS Board of Directors, Chairman