Face One: Market Focus

CASUS In.struct is a system developed in Germany beginning in 1994. It currently combines an authoring tool, player and learner tracking to create and deliver online cases for undergraduate and continuing medical education to help prospective physicians practice making diagnosis and other decisions about patients. It’s market focus is higher education and training related to continuing education.
Who we are. CASUS. 2009. Retrieved September 23 from

Face Two: Types of Offerings

CASUS In.struct is primarily an infrastructure provider offering an authoring tool software, some guides on how to use it to create case content, and a server to host the player and the cases created by the customer. The system has been developed to the extent that CASUS has several licenses for different uses of the system. An authoring license allows the customer to create cases on CASUS. The course license allows the grouping of several cases under a course administration tool which provides detailed assessment information on each student user. An Exam license allows the use of the cases as exams for testing students online, and a faculty model license is an arranged customization of CASUS In.struct at a negotiated cost.

Face 3: Who is the Buyer?

The buyers of CASUS In.struct are notably not medical students – not the end users. The buyers appear to be all in higher education or continuing education and are either medical faculty, medicine related programmes or departments.

Face 4: Global Markets

CASUS has clients both wired anglophone countries and “european” countries with language skills. The first clients were in Germany, and then new clients were established in North America. Most notably, a slight customization was dubbed CLIPP (Computer-assisted Learning in Pediatrics Program) and the 31 or more cases developed in it are in use by over 80 medical schools in the United States and Canada.

CASUS Projects. CASUS. 2009. Retrieved September 23 from

Face 5: Development of the Market

It appears that clients in Germany, Europe, and North America comprise a market that supports import of content and infrastructure. That they buy licenses to use the German server hosted system suggests that they support importing the infrastructure, and the sharing of content in the form of cases created by different clients and contributed to CLIPP in North America suggests that clients in the United States and Canada are willing to import content.

Face 6: Learning Technology Competing with Other Forms of Learning

The medical schools in Germany and North America already have well developed learning systems in the form of instructor-led courses. However, they are under pressure to achieve competencies in a growing curriculum as, for example, new illnesses, clinical treatments, technologies, and pharmacology are added each year. Many schools are under pressure to increase enrollments as there is a shortage of physicians and medical faculty to train them. Consequently, there is a little of all three levels of competition with other forms of learning. In some instances and aspects the cases are readily accepted into the existing mix of learning technologies which tend to be teacher led. In other instances, for lack of lecturers or scheduled class time, cases are used for independent study. In a third instance, the use of online cases is imposed on faculty and students who prefer lecture delivered content instead of problem-based learning or independent study.


1 David Vogt { 09.24.09 at 5:56 am }

A skeptic might say, “Gee, isn’t CASUS just another closed, proprietary LMS (learning management system) in a technology world that’s increasingly open?”. Over the last decade we’ve seen countless LMS’s and CMS’s come and go. Do you have a sense of what makes this one different?

2 Brian Powell { 09.24.09 at 8:53 am }


CASUS has a small niche market mostly among health education institutions where online patient cases are still an emerging learning technology championed by a few faculty. It’s proprietary but as in the instance of CLIPP it will collaborate on modifications. It has developed and maintained its clientele so far. I sense that it has a few more years of viability. It does have competitors such as WebSP which encourages medical schools to install their system locally but with limited freedom to modify it, and DiagnosisX which asserts that the case content is sharable.

Meanwhile, IMS standards and shareable content interests are catching up. some stakeholders of online patient cases are organizing to set standards for sharing of content among different case players or LMSs. Medbiquitous is one such group with representatives even from competing online case system providers. Medbiquitous is creating standards on which to base truly sharable case content and enable integration of the player with other campus systems. Somehow this will better meet their needs than more proprietary but less purpose focussed online module content tools such as Articulate and Adobe eLearning Suite.

However many universities still use LMSs which are not fully SCORM compatible or do not fully exploit it, and these universities will take several years to move to a new LMS. Medicine Schools with their unique needs don’t always have the IT infrastructure or funding to go their own LMS way.

IMS Definition. 2009 Accessed September 24.

About Us. WebSP. 2009 Accessed September 24.

Virtual patient cases. Medbiquitous 2009 Accessed September 24.

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