There is currently no 'gold standard' model of clinical education. The perception that one model is superior to any other is based on anecdotes and historical precedents, rather than on meaningful, robust, comparative studies.

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Case Presentation: A 37-year-old man presented from jail reporting foreign body ingestion of a sprinkler head. While initial radiography did not reveal the foreign body, subsequent imaging with computed tomography demonstrated the sprinkler head. When confronted with this discrepancy the patient admitted to having the sprinkler head in his possession and choosing to swallow it after his initial radiography. Discussion: This case demonstrates the importance of maintaining a high threshold for real illness in situations where there is suspected malingering, a situation not infrequently encountered in the emergency department.