Reassessment Case: Acute Pulmonary Edema in a Boarding Patient

The target audience for this communication case is senior residents and junior faculty preparing for the American Board of Emergency Medicine (ABEM) Certifying Exam. Secondary audiences include junior emergency medicine (EM) residents.

Rapid identification of clinical changes, reassessment of previous diagnoses, and appropriate adjustment of interventions are critical skills in EM. This case highlights the skills needed to recognize and manage a change in condition with acute pulmonary edema, a life-threatening condition that requires prompt intervention.

By the end of the case, the learner should will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Reassessment case format, 2) demonstrate the ability to evaluate new information and integrate it into an existing care plan, 3) recognize signs and symptoms of pulmonary edema, 4) review possible etiologies of acute respiratory distress and the evaluation/work up to differentiate and diagnose those causes, and 5) manage pulmonary edema including implementing afterload reduction, positive pressure ventilation, and diuresis.

This is a standardized patient scenario, in alignment with the expected reassessment case format of the ABEM Certifying Exam. This educational modality is advantageous for assessing the learner's ability to acquire history and physical examination data in a clinical environment, as well as to communicate with a patient using clear, understandable, and appropriate language.

This case was iteratively evaluated using facilitator and learner surveys at three sites: an academic EM residency program, the 2025 Society for Academic Emergency Medicine Annual Meeting, and a second academic EM residency program. Feedback at each site informed further refinements. A total of 11 senior resident learners and four facilitators tested the case, providing feedback on its quality and usefulness.

Learners and facilitators found the case well-written and effective. All 11 learners felt that the case was helpful practice for the ABEM Certifying Examination. Additionally, all facilitators felt the case materials were easy to use and would use the case again in the future.

The case was well-received by both learners and facilitators and appears to be a good preparatory tool for the Reassessment case format of the ABEM Certifying Exam.

Pulmonary edema, sign-out, reassessment, Certifying Exam.