American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

ACS FSC Case Scenarios

Experience “Virtual Lives…Real Decisions,” an interactive scenario from the Respiratory Management Module. As you assume the role of a surgeon, this scenario puts you in the emergency room responding to a nurse’s call. You will examine the patient, order tests, review charts, interact with hospital personnel, and formulate a differential diagnosis.

Demonstration Scenario

This is a typical scenario from the On-Call Module Course on Postoperative Fever. The presentation will lead you through the scenario step-by-step, demonstrating in detail some of the functionality available in the ACS FSC. 

Scenario Features


In each of the scenarios, residents make decisions such as how urgently the patient needs to be seen, what questions are the most important to ask the patient or family, and to what extent the physical examination needs to be performed. For each action taken by the resident, immediate feedback is provided either supporting the action or providing information about when and where it would be appropriate. As the case progresses, residents are asked to view patient charts and records, order tests and diagnostic procedures, review references, then evaluate all the data to form a differential diagnosis and formulate an initial management plan. The scenarios end with a summary of key learning points. Opportunities to make “classic errors” are embedded within the scenarios. If, in certain scenarios, the residents’ actions result in poor patient outcomes, they are required to start over again. Residents are not permitted to progress to the next section of the scenario until they have selected all of the correct answers. At the end of each scenario, residents receive an overall summary of their appropriate and inappropriate actions (as opposed to a grade), and then are free to repeat the scenario as often as they wish.

Images and References

Each scenario includes a patient chart on which the findings from the history and physical examinations, as well as results from tests and procedures, are recorded for easy reference. Results from tests and procedures include appropriate images and reports for use by the resident. Underlying principles of pathophysiology are also addressed within the context of the scenarios. At the end of each scenario, key features of the case are presented to emphasize the learning points.

More than 275 references have been placed in the scenarios of the ACS Fundamentals of Surgery Curriculum® to provide residents with information about subjects relevant to the challenges they are being asked to solve.

This “just-in-time” learning feature takes advantage of the window of opportunity when a learner wants to know something by making information available instantly. The learner may see a chart or graph, an excerpt from a textbook or journal article, a completed patient monitoring form, or another piece of information the author believes will explain, illustrate, or reinforce the educational material. In addition, all of the references are accessible from a Reference Index. If residents want to review a reference, they can do so by accessing their accounts.

The scenarios do not represent a standard of care; rather, they present safe and effective approaches to managing patients. Residents are encouraged to discuss with their program directors anything in the scenarios that varies from practice at their institutions.