Our pediatric hematology/oncology fellowship program set out to create a case-based learning curriculum for common hematologic malignancies that would apply principles of adult learning theory and improve fellows’ retention of information in a supportive, goal-oriented learning environment. A framework we employed in developing this curriculum is that of “flow theory,” which parallels many of the tenets of adult learning theory. After implementing this curriculum, which we call “the unknown case,” the percentage of fellows correctly identifying common hematopathologic diagnoses improved from 50% to 85%.

Background: Acute megakaryoblastic leukemia (AMKL) is a rare subtype of acute myeloid leukemia but is ~500 times more likely to develop in children with Down syndrome (DS) thro