An observation at a problem-based learning, case-building meeting prompted the realization that building cases might itself be an effective educational intervention. We developed a process for a new continuing medical education technique that is peculiarly familiar that we call "build-a-case." Build-a-case has now been used for teaching and learning in many clinical situations and with several kinds of health professionals. Subjective evaluations of the approach are consistently positive, and people feel that they learn from it because it prompts the discussion of practice as it is in their clinics and communities. In what follows, we describe the build-a-case process and our experiences with it and suggest several theoretical constructs that might be useful in promoting thoughtful research on what may become a useful new tool for continuing education.