Clinical Decision-Making
Clinical Decision-Making Case: Febrile Infant
DOI: https://doi.org/10.5070/M5.52290By the end of this CDM case, learners will be able to: 1) demonstrate familiarity with the CDM case format, 2) recognize the critical importance of fever in a neonate and initiate a thorough evaluation, 3) develop an appropriate differential diagnosis and understand the workup for febrile neonates, 4) identify and justify the appropriate diagnostic studies and interpret their findings in the context of a neonate with fever, 5) justify a treatment plan and understand the critical disposition of a neonate with fever.
Difficult Conversation Case: Missed Testicular Cancer
DOI: https://doi.org/10.21980/J8.52336This difficult conversation case is intended to assess the examinee’s ability to disclose sensitive, unexpected information to a patient regarding a missed diagnosis of testicular cancer. By the end of this session, learners should be able to, 1) demonstrate effective communication, including establishing rapport, acknowledging a prior misdiagnosis, and disclosing a revised diagnosis of cancer, 2) elicit and react to the patient’s emotional and informational needs in an empathetic and professional manner, and 3) convey a patient-centered plan of care, including appropriate next steps and coordination with specialist services.
Clinical Decision-Making Case: Intussusception
DOI: https://doi.org/10.21980/J8.52171By the end of this mock oral boards session, learners will (1) demonstrate familiarity with the CDM case format and case play, (2) model a problem-based history and physical exam, (3) generate a differential diagnosis for pediatric abdominal pain, and (4) demonstrate the ability to manage intussusception.
Clinical Decision-Making Case: Pediatric Sexually Transmitted Infections and Consent
DOI: https://doi.org/10.21980/J8.52335By the end of this case the learner will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Clinical Decision-Making Case format, 2) manage a simulated pediatric care encounter that requires navigating the details of pediatric consent, 3) explain common exceptions to requiring parental consent in emergency situations according to established guidelines as well as state and local laws, 4) report increased comfort managing ethical dilemmas related to pediatric consent in the ED.
Clinical Decision-Making Case: Seizing the Diagnosis: Eclampsia
DOI: https://doi.org/10.21980/J8.52338By the end of this Mock Certifying Exam session, learners should be able to: 1) demonstrate familiarity with the Clinical Decision-Making case format and structure, 2) elicit relevant historical information and connect that information to the diagnosis of eclampsia, 3) describe and interpret physical exam findings and their significance in establishing a pertinent differential diagnosis, which includes eclampsia, 4) initiate appropriate diagnostic testing, interpret results accurately, and formulate a stabilization and treatment plan for a patient with eclamptic seizures, and 5) reassess the patient's condition, modify the management plan as needed, provide relevant anticipatory guidance for disposition, and articulate the clinical decision-making rationale at each stage of the encounter.
Clinical Decision-Making Case: Pulmonary Embolism
DOI: https://doi.org/10.21980/J8.52339By the end of the clinical decision-making case, the learner will: 1) gain familiarity with clinical decision-making (CDM) case format to be used in the new American Board of Emergency Medicine (ABEM) certification examination starting in 2026, 2) demonstrate the ability to obtain a focused history and physical examination and develop appropriate differential diagnoses for chest pain and dyspnea, 3) demonstrate understanding of clinical decisions rules to estimate the pre-test probability for pulmonary embolism and the application of rules to guide appropriate diagnostic testing, 4) recognize high clinical suspicion for pulmonary embolism and indication for empirical treatment, 5) recognize the unstable patient and provide appropriate hemodynamic and respiratory support, 6) understand indications for thrombolytic therapy or embolectomy in unstable pulmonary embolism, 7) demonstrate communication skills with patients and specialists across the health care spectrum, and 8) arrange appropriate disposition for the unstable patient with a pulmonary embolism.
Clinical Decision-Making Case: A Giant Headache
DOI: https://doi.org/10.21980/J8.52322By the end of this clinical decision-making case, learners will be able to: 1) demonstrate increased knowledge pertaining to ABEM’s clinical decision-making case, 2) communicate the differential diagnosis of a new acute onset headache in patients over the age of 50 and the importance of giant cell arteritis in that differential, 3) acquire an appropriate history and physical exam in this clinical setting, 4) verbalize, interpret, and justify the appropriate diagnostic testing for this clinical case (at minimum CT head, complete blood count (CBC), basic metabolic panel (BMP), comprehensive metabolic panel (CMP), erythrocyte sedimentation rate (ESR), and 5) explain the appropriate treatment and disposition of a patient with temporal arteritis.
Clinical Decision-Making Case: Thyroid Storm
DOI: https://doi.org/10.21980/J8.53003By the end of the session, learners will be able to: 1) verbalize key pertinent historical and physical exam findings in a young female patient presenting with altered mental status; 2) formulate a prioritized differential diagnosis based on the history and physical exam; 3) order appropriate diagnostic studies and recognize abnormalities suggesting thyroid storm; 4) describe pathophysiology, management and rationale of sequential pharmacologic therapy in thyroid storm; 5) communicate patient’s medical care and course to family; and 6) review essential disposition actions including consultations and level of care for admission.
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