Mystery Cases bring skin disease and diagnostic uncertainty to preclinical medical students

Medical schools traditionally teach preclinical science by organ system, an approach that can leave students well drilled in isolated facts but underprepared for the collaborative, uncertain reality of clinical practice. A team at Harvard Medical School reports a new attempt to close that gap for skin disease, one of the specialties with the fewest interdisciplinary preclinical teaching models.

In a brief report published in Archives of Dermatological Research, the authors describe the design and implementation of five “Mystery Cases” built into the second-year Immunity in Defense and Disease course. The cases focused on complex dermatologic and rheumatologic diseases and were deliberately structured to mirror how difficult diagnoses unfold on the wards rather than how textbook chapters are organized.

Each Mystery Case used case-based collaborative learning, a format in which small groups work through a clinical scenario together. The sessions emphasized diagnostic uncertainty and multidisciplinary decision-making, and required no advance preparation from students. Faculty members and senior medical students built the cases, pairing experienced clinical judgment with near-peer perspectives on learning.

A total of 172 second-year medical and dental students took part across the five cases. During each session, students took histories, described physical examination findings, generated differential diagnoses, ordered laboratory tests and called consults, effectively rehearsing the full sequence of a real clinical encounter before ever meeting a patient.

Surveyed students rated the cases “above average” on average, describing them as appropriately complex and highly engaging. The quantitative headline from the survey is that 62.9 percent of respondents reported increased confidence in their clinical reasoning skills after the sessions.

Beyond the confidence measure, students reported that the cases better reflected actual clinical practice and sparked their curiosity.

The researchers argue that Mystery Cases offer a scalable, replicable framework for promoting interdisciplinary teamwork and knowledge integration early in medical education. The authors suggest that Mystery Cases offer a scalable, replicable framework to promote interdisciplinary teamwork and knowledge integration early in training, and to expose preclinical students to complex medical dermatology.

The report is careful about next steps rather than declaring success. The authors plan to compare outcomes from Mystery Cases with traditional case-based collaborative learning sessions and to extend the format to other organ systems. As a brief report based on student survey data from a single institution, the findings describe early reception and self-reported confidence rather than measured learning outcomes, which the planned comparisons are intended to address.

Subject of Research: A novel multidisciplinary Mystery Case curriculum for teaching skin disease to preclinical medical students

Article Title: Evaluating a novel, multidisciplinary “Mystery Case” curriculum: introducing skin disease through complex cases

Article References: Thompson, B., Kanwar, R., Baker, N., Ezzeddine, F. L., Kang, J. B., Charrow, A., Brag, K., Charles, J., & Nambudiri, V. E. (2026). Evaluating a novel, multidisciplinary “Mystery Case” curriculum: introducing skin disease through complex cases. Archives of Dermatological Research, 318(1), Article 542. https://doi.org/10.1007/s00403-026-05019-2

Image Credits: AI Generated

DOI: 10.1007/s00403-026-05019-2

Keywords: medical education, dermatology, case-based learning, preclinical curriculum, diagnostic reasoning, interdisciplinary teaching, rheumatology, Harvard Medical School, student engagement, clinical reasoning, Evaluating, novel