PulmoHouse: A DECODE-based Case-Integrated Teaching–Learning Strategy for Postgraduates in Respiratory Medicine

Postgraduate medical education increasingly demands teaching strategies that go beyond factual knowledge to cultivate diagnostic reasoning, clinical adaptability, and reflective thinking. Conventional teaching–learning formats often fall short in reproducing the uncertainty and evolving complexity of real-world clinical decision making, particularly in respiratory medicine where overlapping radiological, immunological, and pathological presentations are common. We propose PulmoHouse, a novel case-integrated teaching–learning strategy grounded in the DECODE framework, designed specifically for postgraduate training in respiratory medicine. PulmoHouse employs a structured, stepwise diagnostic simulation in which real-world pulmonary cases are revealed progressively, encouraging learners to evolve hypotheses, integrate multimodal data, prioritize differentials, and engage in guided debate and reflection. By closely mirroring authentic diagnostic workflows, PulmoHouse promotes active learning, metacognition, and iterative clinical reasoning. The model integrates high-resolution imaging interpretation, laboratory correlation, and peer-facilitated discussion within a specialty-focused educational environment. Conceptually distinct from traditional case-based or problem-based learning, PulmoHouse emphasizes diagnostic ambiguity, hypothesis revision, and reflective closure as core components. Although currently conceptual, the model is designed to be scalable, adaptable, and amenable to future prospective evaluation using validated tools such as script concordance testing. PulmoHouse offers a theory-informed, specialty-specific approach that has the potential to enhance cognitive authenticity and learner engagement in postgraduate respiratory medicine education.