Board Review

Escape Intern Orientation! — A Capstone and Team Building Activity for New EM Interns

Megan Rivera, MD*, Meredith Thompson, MD, MAEd^

DOI: https://doi.org/10.5070/M5.52158 Issue 11:2[mrp_rating_result]
By the end of this small group exercise, learners will be able to: 1. Identify first, second, and third-degree heart block on a 12-lead ECG. 2. Recognize STEMI pattern on a 12-lead ECG. 3. Categorize appropriate images that make up an EFAST exam for a trauma patient. 4. Recall the proper management of a tension pneumothorax. 5. Identify an organized approach to emergency department rapid-sequence intubation (RSI). 6. Recognize acute otitis media (AOM). 7. Locate the appropriate antibiotic and pediatric dose to treat acute otitis media via the Harriet Lane Handbook. 8. Demonstrate how to apply evidence-based guidelines to a clinical case of neonatal pediatric fever. 9. Recall common clinical findings of basilar skull fracture. 10. Identify important concepts in the management of stroke syndromes. 11. Recognize vital sign abnormalities that could indicate sepsis. 12. Review important concepts related to the management of septic patients.
Current IssueBoard ReviewInfectious DiseaseNeurologyTrauma

Clinical Decision-Making Case: Febrile Infant

Carrie Maupin, MD, MPH, MHPE*, Ambika Anand, MD, MEHP*, Grace Hickam, MD, MEHP* and Danielle Nesbit, DO*

DOI: https://doi.org/10.5070/M5.52290Issue 11:1[mrp_rating_result]
By 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.
Board ReviewCertifying Exam CasesClinical Decision-MakingInfectious DiseasePediatrics

Simulation-Based Preparation for the American Board of Emergency Medicine Certifying Exam: A Comprehensive Curriculum for Residents

Kimberly Sokol, MD*, Alaa Aldalati, MBBS^, Michelle Hughes, MD†, Stephanie Stapleton, MD** and Charles Lei, MD^^

DOI: https://doi.org/10.21980/J8.53814Issue 10:5[mrp_rating_result]
The goal of this curriculum is to equip residents with the knowledge and skills needed to succeed on the ABEM Certifying Exam. It includes a comprehensive set of case types expected to appear on the Certifying Exam, with a focus on assessing competencies not currently evaluated by the existing written Qualifying Exam and retiring Oral Exam. The curriculum is designed to be delivered to current residents in a single-day exam format to closely replicate the structure and experience of the new Certifying Exam.
Board ReviewCertifying Exam CasesCurriculum

Difficult Conversation Case: Missed Testicular Cancer

Joshua Ginsburg, MD*, Sarah Zamamiri, MD*, Marshall Howell, MD*, Sam Parnell, MD*and Brian Milman, MD*

DOI: https://doi.org/10.21980/J8.52336 Issue 10:5[mrp_rating_result]
This 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.
Board ReviewCertifying Exam CasesClinical Decision-MakingUrology

Difficult Conversation Case: Death Notification

Charles Lei, MD1, Tiffany Moadel, MD2, Suzanne Bentley MD3, Amrita Vempati, MD4, David Fernandez, MD5, Daniela Ortiz, MD6, Anita Rohra, MD6, Stephanie Stapleton, MD7 and Hillary Moss, MD8

DOI: https://doi.org/10.21980/J8.52354Issue 10:5[mrp_rating_result]
This Observed Structured Clinical Examination (OSCE) is intended to cover the topic of Difficult Conversations. The overarching educational goal of this case is to assess learners’ communication skills, emotional responsiveness, and ability to facilitate a death notification conversation. Participants will be evaluated on their ability to communicate in an empathic, patient-centered manner while leading a difficult discussion. Successful participants will establish rapport, actively listen, disclose sensitive information clearly and compassionately, and respond appropriately to emotional reactions. By the end of the session, learners should be able to: (1) establish rapport with the patient’s family by initiating introductions and creating a supportive environment, (2) assess the family’s baseline understanding of the patient’s condition by using open-ended questions and active listening to elicit their perspective, (3) communicate the patient’s death clearly and compassionately, using concise, non-technical language, (4) demonstrate empathy by responding appropriately to emotional reactions, validating concerns, and addressing questions thoughtfully, and (5) provide closure to the conversation by summarizing key points, offering emotional support, and clarifying the next steps in the patient’s care.
Board ReviewCertifying Exam CasesCommunication

Managing Conflict Case: Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes

Monique Graf, MD*, Sonika Raj, MD, MS^, Jedidiah Leaf, MD^, Marshall Howell, MD^, Joshua Ginsburg, MD^, Brian Milman, MD^  and Samuel Parnell, MD^

DOI: https://doi.org/10.21980/J8.52341 Issue 10:5[mrp_rating_result]
The following objectives, which align with ABEM’s recommended objectives, address the nuances of managing conflict. By the end of the session, learners should be able to: 1) demonstrate familiarity with the ABEM Managing Conflict case format and structure, 2) establish rapport by developing connection and trust with the admitting physicians, 3) demonstrate understanding of the other party's position by verbalizing thoughtful and specific questions about his/her concerns, 4) explain his/her own position clearly and insightfully, 5) acknowledge divergent positions with thoughtfulness and insight, 6) identify interests shared by both the psychiatrist and hospitalist as well as what is in the best interest of the patient, and 7) propose a path forward which accounts for the interests of all parties involved.
Board ReviewCertifying Exam CasesCommunication

Managing Conflict Case: The Difficult Consultant

Amrita Vempati, MD1, Suzanne Bentley MD2, Anita Rohra, MD3, Daniela Ortiz, MD3, David Fernandez, MD4, Shagun Berry, DO5, Colleen Donovan, MD6, Nicole Novotny, MD7, Stephanie Cohen, DO8, Stephanie Stapleton, MD9 and Tiffany Moadel, MD10

DOI: https://doi.org/10.21980/J8.53815 Issue 10:5[mrp_rating_result]
By the end of the session, the learner should be able to: 1) review format and have become familiar with an ABEM Certifying Exam conflict management communication case, 2) demonstrate the ability to initiate the consultation call, establish rapport, and present a concise, evidence-based summary of the patient’s STEMI findings, 3) recognize concerns raised by the cardiologist and respond with an empathetic acknowledgment (eg, validating workload, uncertainty, or resource constraints) to support a collaborative tone, 4) articulate differing viewpoint by referencing objective clinical data (eg, ST-segment elevations, ongoing chest pain, risk from delays) when conflict is encountered and justify why urgent catheterization lab activation is indicated, and 5) identify shared goals in optimizing patient care (reducing myocardial damage and preventing deterioration) and use these to negotiate a mutually acceptable plan.
Board ReviewCertifying Exam CasesCommunication

Patient-Centered Communication Case: Threatened Miscarriage

Anita Rohra, MD1, Daniela Ortiz, MD1, Shagun Berry, DO2, Colleen Donovan, MD3, Nicole Novotny, MD4, Stephanie Cohen, DO5, Charles Lei, MD6, Alaa Aldalati, MBBS7, Stephanie Stapleton, MD8 and David Fernandez, MD9

DOI: https://doi.org/10.21980/J8.52360 Issue 10:5[mrp_rating_result]
By the end of this certifying exam practice case, learners will be able to:  1) establish a supportive and compassionate environment through verbal and non-verbal communication when engaging with a patient experiencing distress, anxiety, or grief related to potential pregnancy loss, 2) actively explore the patient’s understanding, concerns, values, and goals related to their pregnancy and presenting symptoms, 3) recognize and normalize a range of emotional reactions, offering validation and support regardless of the patient’s obstetric history or desired pregnancy outcomes, 4) clearly explain the diagnosis of a “threatened miscarriage,” outlining its clinical implications, inherent uncertainty, and potential outcomes, 5) review the results of any imaging or lab studies succinctly and empathetically, while verifying the patient's understanding, 6) collaborate with the patient to develop a mutually agreeable care plan, including medical recommendations, appropriate follow-up, monitoring, and return precautions.
Board ReviewCertifying Exam CasesCommunication