Anatomy and Physiology at the University of Canberra, Australia, as in many institutions, is taught to large cohorts at the foundational level. There is a requirement for students to not only retain information regarding physiological systems and their associated anatomy, but also the integration and relationship between systems. Furthermore, students are often employed in clinical settings post-graduation and the need for real-world understanding is paramount. Assessing this type of understanding is challenging and academics must move beyond tradition exam models. Using case studies as the basis for exam questions is an exciting format for eliciting student understanding of physiological systems which, at the University of Canberra, has resulted in 7% higher grades compared to traditional short answer exams. The benefits go beyond grades, with students appearing more confident in answering questions and better able to integrate information.