| Sumario: | Objective Having developed a national paediatric undergraduate curriculum, canuc-paeds , our group identified a need for active learning resources aligned with it to support Canadian medical students and preceptors. We developed a formative e-learning resource, called Cards, that enables students to self-test, supplement their clinical experiences, and develop their clinical decision-making skills in paediatrics. Methods We present an educational innovation, Cards, describing the stepwise approach of its development; variability is introduced into the Card through both discriminating and non-discriminating variables. Unique vignettes are randomly generated in real time allowing for thousands of cases. The student plays individual Cards based on clinical presentations; a clinical vignette and an associated question about diagnosis, investigation, or management is presented; feedback and additional resources are provided. We present usage metrics to demonstrate breadth of use. Results While developed for Canadian students, this resource has been used by learners worldwide. Eighty-five per cent of students at one institution viewed Cards as an effective teaching tool and more effective than online lectures, case-based learning, flipped classroom, or self-directed modules. A web-based survey reported Cards more effective than other select resources. There were over 280,000 unique plays in 2024 and 2025, and over 1.5 million unique Card plays since launch. Conclusion Cards, based on paediatric clinical vignettes that reflect clinical practice, is a tool that may help learners develop clinical decision-making skills. Cards have demonstrated a high rate of return on authors' investment, as the technology generates thousands of unique vignettes from a single template. High-usage rates support Cards as a valuable open-access resource.
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