Council on Medical Student Education in Pediatrics

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COMSEP 2010 Albuquerque Meeting

COMPREHENSIVE CHILD ABUSE CURRICULUM

Authors:
Jennifer B. Soep, MD; Julie M. Noffsinger, MD; Shale L. Wong, MD, MSPH, University of Colorado, University of Colorado, Aurora, CO

Background:  In 1962, Dr. Henry Kempe and colleagues at the University of Colorado first described “Battered Child Syndrome”.  The Department of Pediatrics has since continued promoting his vision to recognize and help prevent child abuse.  We begin teaching about child abuse in medical school so all students may develop a foundation of knowledge, regardless of their career choice. Objective: Because it is unlikely that all students will encounter patients suffering abuse, we implemented a comprehensive child abuse curriculum for 3rd year students. Methods:  Required curriculum includes: child abuse group discussion facilitated by Child Protection faculty, an interactive on-line case and a standardized patient (SP) for evaluation.  Results: In the past year, 95% of students rated the appropriateness of group discussion content as good/very good.  During SP evaluation, 82% explained the need to report to social services (SS), 84% were clear and firm about the necessity to call SS despite parental pleas, and 67% stated that the child could not go home without SS assessment. On the end of block survey, 80% of students agreed/strongly agreed that the on-line case helped them feel more confident with the SP and 77% agreed/strongly agreed that they had more confidence approaching difficult topics with parents as a result of the SP.  Sixty percent of students agreed/strongly agreed that they had adequate training in child abuse during medical school.  Discussion: A comprehensive child abuse curriculum implemented in the 3rd year pediatric clerkship effectively trains students to identify and manage suspected abuse cases, even without direct clinical encounters. Students demonstrate competence in critical recognition and communication skills, and develop confidence in managing complex care. Despite our extensive coverage of this topic, only 60% of students believe that they have had adequate training in child abuse.  Of note, a comparison group of senior pediatric residents who did not receive the curriculum but presumably have more focused training and greater clinical experience, performed poorer on many important elements of the SP, suggesting that this structured curriculum may develop better competence than traditional training with random clinical encounters