Abusive Bruising and Cutaneous Mimics Module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP)

OPEN ACCESSSeptember 30, 2025Abusive Bruising and Cutaneous Mimics Module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP) Katie L. Johnson, MD1,*, Emily C. B. Brown, MD, MS2, Mary C. Pierce, MD3, Danielle McCulloch, MBBCh, BAO4, Caitlin E. Crumm, MD, MS5 Katie L. Johnson, MD1,* https://orcid.org/0000-0002-6388-489X Assistant Professor, Department of Pediatrics, Mayo Clinic E-mail Address: [email protected] , Emily C. B. Brown, MD, MS2 https://orcid.org/0000-0003-4885-3785 Associate Professor, Department of Pediatrics, University of Washington , Mary C. Pierce, MD3 https://orcid.org/0000-0002-2256-0733 Professor, Division of Pediatric Emergency Medicine, Lurie Children's Hospital , Danielle McCulloch, MBBCh, BAO4 Resident, Department of Family Medicine, Mayo Clinic Health Systems Eau Claire , Caitlin E. Crumm, MD, MS5 https://orcid.org/0000-0002-8502-409X Assistant Professor, Division of Pediatric Emergency Medicine, Seattle Children's Hospital Author Information Katie L. Johnson, MD1,*, Emily C. B. Brown, MD, MS2, Mary C. Pierce, MD3, Danielle McCulloch, MBBCh, BAO4, Caitlin E. Crumm, MD, MS5 1 Assistant Professor, Department of Pediatrics, Mayo Clinic 2 Associate Professor, Department of Pediatrics, University of Washington 3 Professor, Division of Pediatric Emergency Medicine, Lurie Children's Hospital 4 Resident, Department of Family Medicine, Mayo Clinic Health Systems Eau Claire 5 Assistant Professor, Division of Pediatric Emergency Medicine, Seattle Children's Hospital ∗Corresponding author: [email protected] https://doi.org/10.15766/mep_2374-8265.11549 SectionsAboutPDF ToolsDownload Citations ShareFacebookXEmail Abstract Introduction: Despite the extensive amount of literature available on bruising and child abuse, there are few open access teaching materials on this topic. Methods: An interactive module on abusive bruising and cutaneous mimics was created as part of a comprehensive child maltreatment curriculum. The module was evaluated in four formats: pilot presentation to a large audience of pediatric practitioners at a CME conference; presentation to an audience of family medicine residents; individual, self-paced completion by a large cohort of medical students; and presentation by a family medicine resident to a group of colleagues, to evaluate the accessibility of presentation by a non–child abuse pediatrician. In all formats, the module took 45–60 minutes to complete. Module effectiveness was evaluated with pre- and postmodule assessments. Results: The CME conference audience (n = 137) provided favorable feedback about the content; four of 51 anonymous comments focused on areas for growth, which were used to improve the content. Among in-person resident (n = 18) and asynchronous medical student (n = 300) participants, increases in confidence were negligible but knowledge scores notably increased from pre- to postmodule, changing from a median of 25% to 100% and median of 50% to 100%, respectively. In evaluating accessibility, the presenting resident commented on increased engagement, ability to gauge the audience's understanding, and ease of use of the script and technical guide. Discussion: This interactive, versatile module on abusive bruising and cutaneous mimics was well-received and effective at increasing short-term knowledge among medical student and physician audiences. Educational Objectives By the end of this activity, learners will be able to: 1.Define high-risk bruising using the TEN-4-FACES-P rule.2.Respond to questions about timing of bruises in an evidence-based way.3.Distinguish abusive bruises from cutaneous mimics. Introduction Bruising is one of the most common indicators of child physical abuse,1,2 which afflicts nearly 100,000 children per year in the United States.3 It is one of the most often misinterpreted physical findings in cases that result in abusive fatalities or near-fatalities.1,4–6 Appropriate recognition and response to high-risk bruising in clinical settings is a critical step in the detection, intervention, and prevention of child abuse. Bruising that is high-risk for abuse has been extensively studied2,7–10 and is most commonly characterized using the TEN-4-FACESp bruising clinical decision tool.10 This clinical decision tool has been translated into visual aids11 and a freely downloadable app to assist with distinguishing abusive from nonabusive bruises.12 It has been translated into an emergency department screening protocol7 which demonstrated both feasibility and disparity reduction in the diagnosis of child physical abuse.13 Despite an extensive literature base and easy-to-use clinical application tools, there are no standardized, open access educational curricula for teaching medical students and physicians about abusive bruising. Child physical abuse is generally undertaught in medical education.14–16 The American Academy of Pediatrics (AAP) has a set of published child abuse review materials,17 but these are only available to subscribing members and were published before much of the recent key literature on abusive bruising.1,7,8,10,12,13 These materials contain only one PowerPoint presentation on abusive bruising—the AAP Cutaneous Findings in Child Abuse materials, published online in 2015.17 Our group has been developing an interactive core curriculum—the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP)18–21—to fill the gap in child abuse medical education. Topics published to date in MedEdPORTAL include child physical abuse fundamentals,18 abusive head trauma,19 abusive pediatric burns,20 and child sexual abuse.21 Regarding abusive bruising, MedEdPORTAL has one publication from 2009 that focuses on bruising and suspected child abuse,22 but the outcome of the case is a diagnostic mimic (hemophilia A) rather than child abuse. We aimed to create a single, accessible, succinct, up-to-date interactive module that combined key teaching about high-risk bruising alongside cutaneous mimics. We consider this pairing to be particularly important to support diagnostic precision, meaning that it provides a balance between the risks of over-reporting (false positive) and risks of under-reporting (false negative) cases of suspected child abuse. The module is intended for use in the education of physicians in a variety of specialties that see children (eg, pediatrics, family medicine, emergency medicine) and various stages of training (eg, medical students, residents, and practicing physicians), since the topic is generally undertaught in medical training. It contains high-yield content about abusive bruising and cutaneous mimics, prioritizes visual depictions and diversity in skin tones, and has been used in a variety of formats (ie, with large audiences, small groups, and self-paced completion). The module benefits from the design elements of a larger interactive curriculum18–21 and requires minimal equipment and personnel for implementation. Methods We created the Abusive Bruising and Cutaneous Mimics module (Appendix A) in 2022 as part of a core curriculum on child maltreatment (the CAP-CuP curriculum18–21). The module was created by a child abuse pediatrician with expertise in medical education (Katie L. Johnson) and reviewed for accuracy by three additional physicians with expertise in child abuse pediatrics (Emily C. B. Brown, Mary C. Pierce, Caitlin E. Crumm), two of whom also specialize in pediatric emergency medicine and conduct research specifically on abusive bruising (Mary C. Pierce, Caitlin E. Crumm).7,10 We incorporated interactive learning into the module, including multiple-choice, true/false, and free-response questions. These opportunities for generating a response prior to teaching the material were included to incorporate the science of learning into the module.23 This module is optimally implemented with the use of real-time audience polling software such as Kahoot! or PollEverywhere, but polling software is not required for implementation. We created a technical guide and script (Appendix B) to aid in the optional use of Kahoot! with the module. We prioritized the use of visual depictions over words—which were kept to a minimum on the slides—to match the primary learning objective, which is the ability to visually distinguish abusive bruises from cutaneous mimics. We included patients with a variety of skin tones to support diversity in the teaching of this material. We incorporated the well-known and well-studied TEN-4-FACESp mnemonic for abusive bruising to aid in memory of the material.10,11 The module was evaluated in four formats: pilot presentation to a large audience of pediatric practitioners at a CME conference; presentation to an audience of family medicine residents, with use of a pre- and postmodule assessment; individual, self-paced completion by a large cohort of medical students, with use of the same pre- and postmodule assessment; and presentation by a family medicine resident to a group of colleagues. The intention of these evaluations was to optimize the content, evaluate the educational impact (both in-person and asynchronously), and establish feasibility of presentation by a non–child abuse content expert. In all formats, the module took 45–60 minutes to complete. This project was approved by the Institutional Review Board and the Education Research Committee at Mayo Clinic (No. 22-009625, decision July 6, 2023). To optimize the content, we first presented a pilot module to a large audience of pediatric practitioners at a CME conference. The standard CME survey sent to participants after this conference asks participants to rate the practical value/content as well as the presentation skills for each presentation on a 5-point Likert scale (1 = poor, 5 = excellent). The CME survey also asks participants to provide open-ended feedback about strengths and areas for improvement for each presentation. We reviewed this qualitative feedback and organized the comments into common themes, which were used to improve the module content. To evaluate the educational impact of the module, we presented it to an audience of family medicine residents, with participants evaluating the module using a pre- and postmodule assessment. The first question on the assessment evaluated participant's self-rated confidence in identifying abusive bruises and cutaneous mimics on a 10-point Likert scale (1 = not at all confident, 10 = completely confident). In addition, four questions evaluated participant's knowledge about abusive bruising and cutaneous mimics (Appendix C). The questions were written by the primary author of the material and reviewed by all co-authors, three of whom are question writers for child abuse pediatrics board preparation content.24 The audience for this presentation included first-, second-, and third-year residents. The presenter was a child abuse pediatrician and author of the content. The optional Kahoot! link for large groups (Appendices A and B) was used for the presentation. After the presentation, we provided attendees with a copy of the TEN-4-FACESp bruising clinical decision tool11 (Appendix D) and a link to a freely downloadable app12 (Lurie Children's Child Injury Plausibility Assessment Support Tool [LCAST], available from the Apple and Google Play app stores), both of which were featured in the presentation (Appendix A). At the time of the presentation, there were 27 residents in the family medicine residency program, eight of whom had completed the interactive module previously during a child abuse elective. For this particular presentation, 18 family medicine residents participated, four of whom had previously completed the module. We calculated descriptive statistics for audience responses to the five pre- and postmodule assessment questions and completed a subgroup analysis to compare those who had versus those who had not completed the module previously. Descriptive statistics are expressed as the median with interquartile range (IQR) for ratings of confidence levels, and as the proportion of correct responses to the multiple-choice and true/false questions for each participant. During the same time period, this module was available to a select group of child abuse pediatricians by request after an oral presentation about the CAP-CuP curriculum at a child maltreatment conference (the Ray E. Helfer Society annual meeting in 2024). These child abuse pediatricians provided the module to the learners (ie, medical students and residents) rotating with their team for supplemental education. Submission of learner demographic data by the child abuse pediatricians was voluntary. The same pre- and postmodule confidence and knowledge metrics as described above were used for pre- and postmodule assessments completed by this group, with anonymous data extracted from the Kahoot! online platform. Lastly, to assess the feasibility of presentation by someone who was not a child abuse pediatrician and not a content author, we invited a family medicine resident to present the module to her colleagues at a residency didactic noon conference. This was meant to model the experience of any physician who wishes to present this module, regardless of their level of training or familiarity with the material. We recorded lessons learned about feasibility and accessibility of the material. No changes were made to the content or technical guide after this presentation. Results In the CME conference, there were 137 pediatric practitioners. Although detailed demographic data were not available, the audience was primarily composed of general pediatricians from across the United States. One hundred percent of the CME survey respondents (137/137) rated the module's practical value/content and presentation skills as excellent or very good. There were 47 comments detailing strengths of the presentation, and four comments suggesting areas for improvement. We organized a representative sample of the strengths and all four comments regarding areas for improvement into themes with illustrative quotations (Table 1). Based on this qualitative feedback, we added details about cultural practices and pathophysiology of cutaneous mimics to the module. Regarding the feedback asking for more cases and what to do next, this is covered comprehensively in a separate two-part module within the CAP-CuP curriculum,18 and therefore these details were not added to the current module. Table 1. Qualitative Feedback from CME Conference AudienceTable 1. Qualitative Feedback from CME Conference Audience In the session in which family medicine residents participated in the interactive Abusive Bruising and Cutaneous Mimics module, which included pre- and postmodule evaluations, a total of 18 family medicine residents participated. Residents' self-rated confidence levels demonstrated a negligible increase, changing from a median confidence score of 6 (IQR 4.25–7) premodule to 6.5 (IQR 5–8) postmodule. In contrast, their median knowledge scores increased notably after the module, changing from a median knowledge score of 25% (IQR 25%–44%) premodule to 100% (IQR 100%–100%) postmodule. Because four of the participating residents—three interns and one third-year resident—had completed this interactive module prior to the presentation, we conducted a subgroup analysis to compare those who had versus those who had not completed the module in the past. These residents had completed the module within the preceding 9 months, during their child abuse rotations. When these residents were removed from the analysis, the premodule confidence score was minimally lower, at a median score of 6 (IQR 4–6.75), compared to a premodule median confidence score of 6.5 (IQR 6–7) for the residents who were participating for the first time (Figure 1). Moreover, the premodule knowledge scores were notably lower in those participating for the first time, at a median score of 25% (IQR 6%–25%), compared to a premodule median knowledge score of 75% (IQR 63%–81%) for those who had previously participated in the module (Figure 2). Figure 1. Participants' self-rated confidence levels, rated on a 10-point Likert scale (1 = not at all confident, 10 = completely confident) on pre- versus postmodule assessments, in identifying abusive bruising and cutaneous mimics in children. Figure 2. Participants' performance in correctly answering four knowledge questions on pre- versus postmodule assessments regarding abusive bruising and cutaneous mimics in children. Regarding the participants who completed the module asynchronously, seven child abuse pediatricians from seven different states submitted voluntary learner data (Table 2). The child abuse pediatricians estimated that a total of 332 medical students and residents participated in the module asynchronously, with at least 77% of these being second- and third-year medical students from a single institution. Extraction of data from Kahoot! captured responses from 300 of these anonymous learners. In these 300 learners—a group made up of primarily medical students—there was a negligible increase in confidence level from pre- to postmodule, changing from a median confidence score of 5 (IQR 4.75–6) premodule to a median confidence score of 6 (IQR 6–8) postmodule (Figure 1). There was a more notable increase in knowledge scores, from a median knowledge score of 50% (IQR 50%–75%) premodule to a median knowledge score of 100% (IQR 75%–100%) postmodule (Figure 2). Table 2. Asynchronous Learner Demographics Submitted by Seven Child Abuse PediatriciansTable 2. Asynchronous Learner Demographics Submitted by Seven Child Abuse Pediatricians After the presentation of the module by a resident who was neither a child abuse pediatrician nor a content author, feedback was sought from the presenter about accessibility of the material and ease of presentation. This presenter appreciated the optional use of Kahoot!, as she observed increased engagement among her co-residents compared to baseline. The optional use of Kahoot! also helped gauge her co-residents' understanding of the material throughout the presentation. The presenter found the script to be intuitive and easy to use, even without practicing ahead of time. Discussion This interactive module on abusive bruising and cutaneous mimics was well-received among a large audience of pediatric practitioners, appeared to increase short-term knowledge among family medicine residents and medical students, and fills an educational gap in medical education. Perhaps the most noteworthy finding was the minimal increase in confidence level despite significant increases in short-term knowledge. This phenomenon was also seen in a prior CAP-CuP module.21 The negligible increase in confidence may represent appropriate caution and humility regarding this critical topic, a lack of anticipated long-term retention and clinical application from a single interactive presentation, or an increased appreciation for the complexity of the topic from before to after the module. Two tangible clinical resources were provided at the conclusion of the presentation, with the intention of bolstering confidence in clinical practice: the TEN-4-FACESp bruising clinical decision tool11 (Appendix D), and a link to the freely downloadable LCAST app.12 This module and the resources associated with it should not be a replacement for timely consultation with a child abuse pediatrician.25 Although increases in confidence were negligible, the participants' improved knowledge was noteworthy. Interestingly, the family medicine residents who had completed the interactive Abusive Bruising and Cutaneous Mimics module several months prior to the presentation had higher knowledge scores on the premodule assessment than those who had not completed the module, despite being some of the most junior members of the audience (ie, three of four were interns). This module provides an accessible, succinct, up-to-date interactive teaching tool on a critically undertaught topic in medical education. It draws on the science of learning in its design,23 is versatile in format and audience, and pairs high-risk bruising with cutaneous mimics for comprehensive education in this area. It serves as an educational bridge between the strong literature base7–10,13 and high-yield clinical tools11,12 on this topic. It demonstrates accessibility to other physician presenters as evidenced by the successful implementation by a family medicine resident to an audience of her colleagues. The most important lesson learned from the creation of this module pertained to navigating copyright permissions for use of patient photographs in teaching materials. It was a priority of the module author to build a primarily visual presentation that contained representative examples of classic bruise patterns and mimics while also respecting diversity through inclusion of a variety of skin tones. The initial intention was to use photographs from two excellent journal articles on the topic26,27; however, it was quickly discovered that copyright permission to reuse photographs from journal articles in an open access curriculum was an insurmountable barrier. We then turned to using photos from our own clinical experience and from our colleagues, which required navigation of each hospital's unique legal and privacy policies. The extensive work that went into finding appropriate photos and securing privacy and legal permission for each photo was worth the benefit of creating a high-quality educational module while upholding a high standard of patient privacy and confidentiality. It was also the most frequently noted strength of this presentation by the CME audience. The accessibility of the material to a resident presenter without requiring significant preparation time is invaluable, given that workforce issues in the field may hinder availability of child abuse pediatricians to teach this material,28 and given that there is a clearly demonstrated need for this teaching.14–16 Limitations of this project include its use of a short pre- and postmodule assessment that evaluates only short-term recall and self-rated confidence. The confidence levels of the audience exhibited negligible change despite an increase in knowledge. The increase in knowledge, furthermore, only represented short-term retention on four multiple-choice questions. The impact of having provided the TEN-4-FACESp bruising clinical decision tool11 and freely downloadable app12 on resident confidence and long-term retention of knowledge was not studied but is an opportunity for future research. Additional opportunities for further research include tailoring the module for presentation to multidisciplinary audiences, such as child protection case workers and law enforcement investigators. It could be expanded to other physician audiences, such as emergency department and urgent care practitioners. Lastly, the Abusive Bruising and Cutaneous Mimics module could be paired with a visual diagnosis quiz administered several months later, which would ask participants to identify high-risk bruises, patterned bruises, accidental bruises, and cutaneous mimics. References1. Pierce MC, Kaczor K, Acker D, et al. History, injury, and psychosocial risk factor commonalities among cases of fatal and near-fatal physical child abuse. Child Abuse Negl. 2017;69:263–277. https://doi.org/10.1016/j.chiabu.2017.04.033Medline, Google Scholar2. Atwal GS, Rutty GN, Carter N, Green MA. Bruising in non-accidental head injured children; a retrospective study of the prevalence, distribution and pathological associations in 24 cases. Forensic Sci Int. 1998;96(2-3):215–230. https://doi.org/10.1016/S0379-0738(98)00126-1Medline, Google Scholar3. Child Maltreatment 2022. U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau; 2024. Accessed July 25, 2024. https://acf.gov/sites/default/files/documents/cb/cm2022.pdfGoogle Scholar4. Letson MM, Cooper JN, Deans KJ, et al. Prior opportunities to identify abuse in children with abusive head trauma. Child Abuse Negl. 2016;60:36–45. https://doi.org/10.1016/j.chiabu.2016.09.001Medline, Google Scholar5. Petska HW, Sheets LK. Sentinel injuries: subtle findings of physical abuse. Pediatr Clin North Am. 2014;61(5):923–935. https://doi.org/10.1016/j.pcl.2014.06.007Medline, Google Scholar6. Sheets LK, Leach ME, Koszewski IJ, Lessmeier AM, Nugent M, Simpson P. Sentinel injuries in infants evaluated for child physical abuse. Pediatrics. 2013;131(4):701–707. https://doi.org/10.1542/peds.2012-2780Medline, Google Scholar7. Crumm CE, Brown ECB, Thomas-Smith S, Yu DTY, Metz JB, Feldman KW. Evaluation of an emergency department high-risk bruising screening protocol. Pediatrics. 2021;147(4):e2020002444. https://doi.org/10.1542/peds.2020-002444Medline, Google Scholar8. Feldman KW, Tayama TM, Strickler LE, et al. A prospective study of the causes of bruises in premobile infants. Pediatr Emerg Care. 2020;36(2):e43–e49. https://doi.org/10.1097/PEC.0000000000001311Medline, Google Scholar9. Harper NS, Feldman KW, Sugar NF, Anderst JD, Lindberg DM; Examining Siblings To Recognize Abuse Investigators. Additional injuries in young infants with concern for abuse and apparently isolated bruises. J Pediatr. 2014;165(2):383–388.e1. https://doi.org/10.1016/j.jpeds.2014.04.004Medline, Google Scholar10. Pierce MC, Kaczor K, Lorenz DJ, et al. Validation of a clinical decision rule to predict abuse in young children based on bruising characteristics. JAMA Netw Open. 2021;4(4):e215832. https://doi.org/10.1001/jamanetworkopen.2021.5832Medline, Google Scholar11. Pierce MC. TEN-4-FACESp. Stanley Manne Children's Research Institute. Accessed July 25, 2025. https://research.luriechildrens.org/en/community-population-health-and-outcomes/smith-child-health-outcomes-research-and-evaluation-center/tricam/ten-4-facesp/Google Scholar12. Pierce MC, Kaczor K. Lurie Children's Child Injury Plausibility Assessment Support Tool (LCAST) - a new, free app available for download. Stanley Manne Children's Research Institute. Accessed September 8, 2025. https://research.luriechildrens.org/en/community-population-health-and-outcomes/smith-child-health-outcomes-research-and-evaluation-center/tricam/lurie-childrens-child-injury-plausibility-assessment-support-tool-lcast/Google Scholar13. Crumm CE, Brown ECB, Vora SB, Lowry S, Schlatter A, Rutman LE. The impact of an emergency department bruising pathway on disparities in child abuse evaluation. Pediatr Emerg Care. 2023;39(8):580–585. https://doi.org/10.1097/PEC.0000000000002998Medline, Google Scholar14. Anderst J, Dowd MD. Comparative needs in child abuse education and resources: perceptions from three medical specialties. Med Educ Online. 2010:15. https://doi.org/10.3402/meo.v15i0.5193Google Scholar15. Christian CW. Professional education in child abuse and neglect. Pediatrics. 2008;122(suppl 1):S13–S17. https://doi.org/10.1542/peds.2008-0715fMedline, Google Scholar16. Narayan AP, Socolar RRS, St Claire K. Pediatric residency training in child abuse and neglect in the United States. Pediatrics. 2006;117(6):2215–2221. https://doi.org/10.1542/peds.2006-0160Medline, Google Scholar17. Child abuse review materials. American Academy of Pediatrics. Accessed July 25, 2025. https://www.aap.org/Child-Abuse-Pediatrics-Review-MaterialsGoogle Scholar18. Johnson KL, Brown ECB, Crumm CE. Child physical abuse fundamentals in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP). MedEdPORTAL. 2025;21:11516. https://doi.org/10.15766/mep_2374-8265.11516Medline, Google Scholar19. Johnson KL, Crumm CE, Brown ECB. Abusive head trauma module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP): Rehma's Story. MedEdPORTAL. 2025;21:11502. https://doi.org/10.15766/mep_2374-8265.11502Medline, Google Scholar20. Johnson K, Crumm C, Brown E. Abusive pediatric burns module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP). MedEdPORTAL. 2024;20:11429. https://doi.org/10.15766/mep_2374-8265.11429Medline, Google Scholar21. Bangash MK, Crumm CE, Brown ECB, et al. Child sexual abuse module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP). MedEdPORTAL. 2025;21:11515. https://doi.org/10.15766/mep_2374-8265.11515Medline, Google Scholar22. Larsen N, Sharma D, Winston K, Callender D, Allison-Burnett Y, Goff P. PBL Case on Child Abuse/Hemophilia A. MedEdPORTAL. 2009;5:3187. https://doi.org/10.15766/mep_2374-8265.3187Google Scholar23. Brown PC, Roediger HL, MA McDaniel, eds. Make it Stick: The Science of Successful Learning. Belknap Press: an Imprint of Harvard University Press; 2014. https://doi.org/10.4159/9780674419377Google Scholar24. Johnson KL, Mavis SC, Huber CM, et al. Validity evidence for a novel multiple-choice question bank in the field of child abuse pediatrics. Child Abuse Negl. 2024;153:106827. https://doi.org/10.1016/j.chiabu.2024.106827Medline, Google Scholar25. Powers E, Tiyyagura G, Asnes AG, et al. Early involvement of the child protection team in the care of injured infants in a pediatric emergency department. J Emerg Med. 2019;56(6):592–600. https://doi.org/10.1016/j.jemermed.2019.01.030Medline, Google Scholar26. Bentivegna K, Grant-Kels JM, Livingston N. Cutaneous manifestations of child abuse and neglect: Part I. J Am Acad Dermatol. 2022;87(3):503–516. https://doi.org/10.1016/j.jaad.2021.11.067Medline, Google Scholar27. Bentivegna K, Grant-Kels JM, Livingston N. Cutaneous mimics of child abuse and neglect: Part II. J Am Acad Dermatol. 2022;87(3):519–531. https://doi.org/10.1016/j.jaad.2021.12.070Medline, Google Scholar28. Slingsby B, Bachim A, Leslie LK, Moffatt ME. Child health needs and the child abuse pediatrics workforce: 2020-2040. Pediatrics. 2024;153(suppl 2):e2023063678F. https://doi.org/10.1542/peds.2023-063678FMedline, Google ScholarPDF download Sign up for the latest publications from MedEdPORTAL Add your email below APPENDICESReferencesRelatedDetailsAppendices Abusive Bruising and Cutaneous Mimics.pptx Bruising - Technical Guide and Script.docx Bruising - Assessment.docx TEN-4-FACESp Bruising Clinical Decision Tool.pdf All appendices are peer reviewed as integral parts of the Original Publication. Download CitationJohnson KL, Brown ECB, Pierce MC, McCulloch D, Crumm CE. Abusive Bruising and Cutaneous Mimics Module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP). MedEdPORTAL. 2025;21:11549. https://doi.org/10.15766/mep_2374-8265.11549 Copyright & Permissions© 2025 Johnson et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial license.KeywordsChild AbusePediatricsGamesPediatric Emergency MedicinePediatric Hematology-OncologyCase-Based LearningGamesAcknowledgmentsThe authors would like to acknowledge Dr. Nina Livingston for her provision of select bruising photos and Dr. Sarah Lallaman for her provision of select mimic photos, which were included in the module. The authors would like to thank Dr. Angela Mattke for providing the CME conference data reported in this module.Disclosures None to report. Funding/Support None to report. Ethical Approval The Mayo Clinic Institutional Review Board reviewed this project. Disclaimer The views expressed in the submitted educational material are the authors' own and not an official position of the institutions for which they work. tabs.loading