Incorporating Child Maltreatment Training into Medical School Curricula

Heather L Pelletier, Michele Knox, Heather L Pelletier, Michele Knox

Abstract

The Child Advocacy Studies Training (CAST) program has been implemented at the graduate and undergraduate levels, but has not been incorporated in medical school training. This study examines the efficacy of a modified version of the CAST program that is tailored to meet the educational needs of medical students. A total sample of 75 first year medical students (57 at 6 month follow-up) participated in the study and completed analogue vignettes depicting cases of maltreatment. It was hypothesized that, relative to the comparison group, students who completed CAST training would demonstrate better accuracy at identifying and reporting maltreatment. Results indicated that CAST students demonstrated improved accuracy at the conclusion of the CAST program and 6 months later.

Keywords: Abuse; Child; Efficacy; Maltreatment; Medical; Student; Training; Youth.

Conflict of interest statement

Heather L. Pelletier, PhD declares that she has no conflict of interest.

Michele Knox, PhD declares that she has no conflict of interest.

References

    1. Alvarez KM, Donohue B, Carpenter A, Romero V, Allen DN, Cross C. Development and preliminary evaluation of a training method to assist professionals in reporting suspected child maltreatment. Child Maltreatment. 2010;15(3):211–218. doi: 10.1177/1077559510365535.
    1. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences of childhood: a convergence of evidence from neurobiology and epidemiology. European Archives for Psychiatry and Clinical Neuroscience. 2006;256(3):174–186. doi: 10.1007/s00406-005-0624-4.
    1. Anda RF, Brown DW, Dube SR, Bremner JD, Felitti VJ, Giles WH. Adverse childhood experiences and chronic pulmonary disease in adults. American Journal of Preventive Medicine. 2012;34(5):396–403. doi: 10.1016/j.amepre.2008.02.002.
    1. Ashton V. The effect of personal characteristics on reporting child maltreatment. Child Abuse & Neglect. 2004;28:985–997. doi: 10.1016/j.chiabu.2004.03.012.
    1. Astin JA, Sierpina VS, Forys K, Clarridge B. Integration of the biopsychosocial model: perspectives of medical students and residents. Academic Medicine. 2008;83(1):20–27. doi: 10.1097/ACM.0b013e31815c61b0.
    1. Connell CM, Bergeron N, Katz KH, Saunders L, Tebes JK. Re-referral to child protective services: the influence of child, parent, family and case characteristics on risk factors. Child Abuse & Neglect. 2007;31:573–588. doi: 10.1016/j.chiabu.2006.12.004.
    1. Copeland WE, Keeler G, Angold A, Costello J. Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry. 2007;64:577–584. doi: 10.1001/archpsyc.64.5.577.
    1. Corso PS, Edwards VJ, Fang X, Mercy JA. Health-related quality of life among adults who experienced maltreatment during childhood. Research and Practice. 2008;98(6):1094–1100.
    1. Courtois CA, Gold SN. The need for inclusion of psychological trauma in the professional curriculum: a call to action. Psychological Trauma: Theory, Research, Practice, and Policy. 2009;1(1):3–23. doi: 10.1037/a0015224.
    1. Cuevas CA, Finkelhor D, Clifford C, Ormrod RK, Turner HA. Psychological distress as a risk factor for re-victimization in children. Child Abuse & Neglect. 2010;34(4):235–243. doi: 10.1016/j.chiabu.2009.07.004.
    1. Cuff PA, Vanselow N, editors. Improving medical education: enhancing the behavioral and social science content of medical school curricula. Washington: National Academies Press; 2004.
    1. Dubowitz H, Black M. Teaching pediatric residents about child maltreatment. Journal of Developmental and Behavioral Pediatrics. 1991;12(5):305–307. doi: 10.1097/00004703-199110000-00004.
    1. Dubowitz H, Lane WG, Semiatin JN, Magder LS, Venepally M, Jans M. The safe environment for every kid model: Impact on pediatric primary care professionals. Pediatrics. 2011;127(4):e962–e970. doi: 10.1542/peds.2010-1845.
    1. Dubowitz H, Lane WG, Semiatin JN, Magder LS. The SEEK model of pediatric primary care: can child maltreatment be prevented in a low-risk population? Academic Pediatrics. 2012;12(4):259–268. doi: 10.1016/j.acap.2012.03.005.
    1. Eckenrode J, Ganzel B, Henderson CR, Smith E, Olds DL, Powers J, et al. Preventing child abuse and neglect with a program of nurse home visitation: the limiting effects of domestic violence. Journal of the American Medical Association. 2001;284(11):1385–1391. doi: 10.1001/jama.284.11.1385.
    1. Feigelman S, Dubowitz H, Lane W, Grube L, Kim J. Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment. Academic Pediatrics. 2011;11(6):474–480. doi: 10.1016/j.acap.2011.07.005.
    1. Feng JY, Levine M. Factors associated with nurses’ intention to report child abuse: a national survey of Taiwanese nurses. Child Abuse & Neglect. 2005;29(7):783–795. doi: 10.1016/j.chiabu.2004.11.006.
    1. Flaherty EG, Sege RD, Binns HJ. Health care providers’ experience reporting child abuse in the primary care setting. Archives of Pediatric and Adolescent Medicine. 2000;154(5):489–493. doi: 10.1001/archpedi.154.5.489.
    1. Flaherty EG, Sege RD, Mattson CL, Binns HJ. Assessment of suspicion of abuse in the primary care setting. Ambulatory Pediatric. 2002;2(2):120–126. doi: 10.1367/1539-4409(2002)002<0120:AOSOAI>;2.
    1. Flaherty EG, Sege RD, Price LL, Christoffel KK, Norton DP, O’Connor KG. Pediatrician characteristics associated with child abuse identification and reporting: results from a national survey of pediatricians. Child Maltreatment. 2006;11(4):361–369. doi: 10.1177/1077559506292287.
    1. Flaherty EG, Sege RD, Griffith J, Price LL, Wasserman R, Slora E, et al. From suspicion of physical child abuse to reporting: primary care clinician decision-making. Pediatrics. 2008;122:611–619. doi: 10.1542/peds.2007-2311.
    1. Flaherty, E.G., Thompson, R., Dubowitz, H., Harvey, E.M., English, D.J., Proctor, L.J., & Runyan, D.K. (2013). Adverse childhood experiences and child health in early adolescence: ACEs and child health in early adolescence. JAMA Pediatrics, 1–8.
    1. Gunn VL, Hickson GB, Cooper WO. Factors affecting pediatricians’ reporting of suspected child maltreatment. Ambulatory Pediatrics. 2005;5(2):96–101. doi: 10.1367/A04-094R.1.
    1. Johnson RM, Kotch JB, Catellier DJ, Windsor JR, Dufort V, Hunter W, et al. Adverse behavioral and emotional outcomes from child abuse and witnessed violence. Child Maltreatment. 2002;7(3):179–186. doi: 10.1177/1077559502007003001.
    1. Knox, M., Pelletier, H., & Vieth, V. (2013). Effects of medical student training in child advocacy and child abuse prevention and intervention. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi:10.1037/a0031743
    1. Knox M, Pelletier H, Vieth V. Educating medical students about adolescent maltreatment. International Journal of Adolescent Medicine and Health. 2013;25(3):301–308. doi: 10.1515/ijamh-2013-0066.
    1. Lundahl BW, Nimer J, Parsons B. Preventing child abuse: a meta-analysis of parent training programs. Research on Social Work Practice. 2006;16(3):251–262. doi: 10.1177/1049731505284391.
    1. Reece RM, Jenny C. Medical training in child maltreatment. American Journal of Preventative Medicine. 2005;29(5, Suppl2):266–271. doi: 10.1016/j.amepre.2005.08.028.
    1. Reiniger A, Robinson E, McHugh M. Mandated training of professionals: a means for improving reporting of suspected child abuse. Child Abuse & Neglect. 1995;19(1):63–69. doi: 10.1016/0145-2134(94)00105-4.
    1. Repetti RL, Taylor SE, Seeman TE. Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin. 2002;128(2):330–366. doi: 10.1037/0033-2909.128.2.330.
    1. Rhodes AE, Boyle MH, Bethell J, Wekerle C, Tonmyr L, Goodman D, et al. Child maltreatment and repeat presentations to the emergency department for suicide-related behaviors. Child Abuse & Neglect. 2013;37(2-3):139–149. doi: 10.1016/j.chiabu.2012.07.009.
    1. Scarborough AA, Lloyd EC, Barth RP. Maltreated infants and toddlers: predictors of developmental delay. Journal of Developmental and Behavioral Pediatrics. 2009;30(6):489–498. doi: 10.1097/DBP.0b013e3181c35df6.
    1. Starling SP, Boos S. Core content for residency training in child abuse and neglect. Child Maltreatment. 2003;8(4):242–247. doi: 10.1177/1077559503257113.
    1. Sullivan PM, Knutson JF. Maltreatment and disabilities: a population-based epidemiological study. Child Abuse & Neglect. 2000;24:1257–1274. doi: 10.1016/S0145-2134(00)00190-3.
    1. Taylor SE, Lerner JS, Sage RM, Lehman BJ, Seeman TE. Early environment, emotions, responses to stress, and health. Journal of Personality. 2004;72(6):1365–1393. doi: 10.1111/j.1467-6494.2004.00300.x.
    1. US Department of Health and Human Services (DHHS), Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institute of Health, & National Institute of Mental Health (1999). Mental health: a report of the surgeon general-executive summary. Rockville, MD. Retrieved August 17, 2011, from
    1. Vieth VI, Bottoms BL, Perona AR. Ending child abuse: introducing a collection of new perspectives and practical techniques. Journal of Aggression, Maltreatment & Trauma. 2006;12(3-4):1–3. doi: 10.1300/J146v12n03_01.
    1. Warner-Rogers JE, Hansen DJ, Spieth LE. The influence of case professional variables on identification and reporting of physical abuse: a study with medical students. Child Abuse & Neglect. 1996;20(9):851–866. doi: 10.1016/0145-2134(96)00073-7.
    1. Zolotor AJ, Theodore AD, Runyan DK, Chang JJ, Laskey AL. Corporal punishment and physical abuse: population-based trends for three-to-11-year-old children in the United States. Child Abuse Review. 2011;20:57–66. doi: 10.1002/car.1128.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever