Overview
Public Foundations, the Lab, tutorial, academic cases, Crimson Circuit and quiz share physiological primitives but do not use identical content-selection workflows. A short foundation lesson, fixed teaching case, scripted tour and generated quiz round should not be mistaken for the same kind of simulation.
Clinical narratives and discussions are authored teaching material. Traces are synthesized from their linked state or explicit case waveform profile. Unreported data must remain distinguishable from supplied case measurements and later revelations.
Public Foundations and simulator preparation
Foundations provides three original, short public lessons on the normal circulation route, pressure versus forward flow, and ECG electrical timing. The lessons link to the references consulted while authoring them and do not expose protected case text. They are synthetic education, not patient measurements, validated patient forecasts, diagnosis or treatment advice.
An activity prepares the existing simulator through its reset/prepare bridge. Navigation, replay and reset perform a complete reset before preparing the requested scene, so diseases, interventions and repeated actions do not stack invisibly. Each scene uses a fixed simulation clock of 12 seconds. Normal starts from the existing sinus reference at 75 bpm and configured 120/80 mmHg; sampled arterial-pressure displays can differ from those configured inputs.
Foundation activities
The circulation activity reveals and highlights a numbered body → RA → RV → lungs → LA → LV → body route. The pressure–flow activity first restores normal, then sets systemic resistance to 1800 dyn·s/cm⁵ through the existing model. Its higher MAP and slightly lower output are an observation of that prepared state, not a universal response rule.
The ECG activity pauses the same live normal ECG for pointer or keyboard inspection, with a textual P/QRS/T legend. ECG voltage is not presented as pump strength, pressure or blood flow. Moving between or replaying activities prepares a fresh state rather than layering another change.
Local foundation progress
Versioned browser-local keys store only the current lesson location and completed lesson IDs. Answers and activity state are not saved; resuming prepares the lesson from its starting scene. The record contains no clinical measurements, patient information or account data. Storage failure is nonblocking: lessons remain usable without persistence. Progress has no built-in cross-device synchronization.
Academic cases and half-day figures
Teaching cases map stages to available history, hemodynamic values, rhythm/finding, oxygenation and pressure morphology. Progression reveals the next stage and its interpretation rather than exposing all later facts initially. The main-page case mode applies the linked stage to the simulator and retains discussion details in its case panel.
Case waveform profiles give distinct appearance to relevant physiology. Pleth/oxygen values appear as the case data become available. Core half-day static waveforms illustrate two cycles per trace; their stationary inspection uses the known signal and phase, not an embedded textbook recording.
The separate two-axis perfusion/congestion teaching widget is a deliberately simple LV-failure illustration: cardiac index varies from 3.6 to 0.8 L/min/m² with perfusion loss, while wedge independently varies from 6 to 30 mmHg with congestion. Its midlines are CI 2.2 and wedge 18; CO uses an assumed BSA of 1.8 m². It is not the full multi-pathology sandbox solver.
Tutorial and Crimson Circuit
The tutorial performs a scripted sequence of real interface actions on the embedded sandbox: selection, pause, ECG, inspection and intervention. It uses presentation timing and target visibility handling; the moving logo is a demonstrator, not control of the user’s operating-system mouse. Manual/automatic stage progression changes the tour, not the physiology.
Crimson Circuit uses authored dossiers and explicit diagnostic/management decisions with selected recovery snapshots. Some successful answers appropriately leave a trace unchanged because the decision is assessment or referral rather than a simulated cure. Easter eggs, points and unlocks are educational presentation features, not patient outcome probabilities.
Procedural quiz generation
The quiz chooses a diagnostic family and varies loading, output, resistance, rate and compatible rhythm. It solves those values through the shared circulation, rejects samples that no longer retain the intended phenotype, then builds four qualitative options from curated answer/foil families. A final constrained fallback prevents endless rejection.
There are five question kinds: dominant pattern, mechanism, atrial filling pattern, LVEDP interpretation and combined LA/LV filling interpretation. Wording templates and diagnostic families are finite; numerical waveform instances are procedurally generated. It is therefore incorrect to present the number of mathematical combinations as a count of independently authored questions.
Answer truth and score
Answers use the solved pressure metrics. Samples near rounding boundaries are checked so whole-number labels support the stated answer. Diagnosis and calculations are revealed after answering; arithmetic is not the scored task. Answer/next transitions prevent repeated credit for a single round.
Generated questions are not guaranteed to encompass every disease combination or be uniquely diagnostic from pressure alone. Families deliberately group causes that invasive tracings cannot reliably distinguish. Scores measure performance in this teaching exercise, not clinical competence.
References & further reading