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Related Concept Videos

Flail Chest-II01:26

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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Reason and Intuition01:37

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The human brain processes information for decision-making using one of two routes: an intuitive system and a rational system (Epstein, 1994; popularized by Kahneman, 2011 as System 1 and System 2, respectively). The intuitive system is quick, impulsive, and operates with minimal effort, relying on emotions or habits to provide cues for what to do next, while the rational system is logical, analytical, deliberate, and methodical. Research in neuropsychology suggests that the...
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Updated: Jan 13, 2026

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
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Clinical Decision-Making Case: Non-Accidental Trauma.

H Michelle Greene1, Anne P Runkle1,2, Jennifer M Mitzman1,2

  • 1The Ohio State University College of Medicine, Department of Pediatrics, Columbus, Ohio.

Journal of Education & Teaching in Emergency Medicine
|January 12, 2026
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Summary
This summary is machine-generated.

This clinical decision-making case trains emergency medicine residents to identify non-accidental trauma (NAT) in children. Early recognition of abusive injuries is crucial for timely intervention and preventing severe outcomes.

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Area of Science:

  • Medical Education
  • Pediatric Emergency Medicine
  • Clinical Decision-Making

Background:

  • Non-accidental trauma (NAT) is a significant cause of pediatric morbidity and mortality.
  • Missed abusive injuries can lead to escalating or fatal abuse.
  • Timely identification of NAT in acute care is vital for effective intervention.

Purpose of the Study:

  • To evaluate emergency medicine residents' ability to diagnose non-accidental trauma using a clinical decision-making case.
  • To assess residents' knowledge of historical information, physical exam findings, diagnostic studies, and disposition for suspected pediatric abuse.

Main Methods:

  • A clinical decision-making (CDM) case focused on non-accidental trauma was developed for emergency medicine residents.
  • Learners were paired with instructors, assessed using a 25-point checklist, and provided feedback.
  • Case sessions lasted 20 minutes, including 15 minutes for the case and 5 minutes for debriefing.

Main Results:

  • Thirty-nine residents participated, with an average score of 16.85/25.
  • Second-year residents (PGY-2) scored higher (18.9) than third-year residents (PGY-3) (18.0) and first-year residents (PGY-1) (14.7).
  • Learner feedback suggested widening differential diagnoses and highlighted the importance of caregiver identification.

Conclusions:

  • The CDM case is valuable for all levels of emergency medicine residents in identifying high-risk pediatric pathology, particularly non-accidental trauma.
  • Performance varied, indicating areas for targeted didactic sessions.
  • Formative assessment using this case can enhance learning and improve diagnostic skills for suspected pediatric abuse.