Thursday, July 2, 2015

Can Web-Based Continuing Medical Education Improve Perceived Physician Competence in Dealing with Child Maltreatment?

Megan McGraw, MD, MEd
Nationwide Children's Hospital

Purpose: Numerous studies have demonstrated that physicians feel inadequately trained in child abuse, lack the knowledge and skills to identify and manage child abuse, and do not consistently report suspected child abuse to the appropriate agencies. However, what is not well established is the most effective educational strategy to improve these deficits that is also feasible and sustainable. The objective of this study was to develop a web-based, interactive case-based continuing medical education (CME) course on child maltreatment for pediatric healthcare providers and to evaluate the effectiveness of this course on perceived competency.

Methods: Adult learning theory and strategies were employed in course development, and a separate sample pretest-posttest design was used to evaluate the effectiveness of the program. Study participants were physicians who completed the web-based CME course on child maltreatment and the pretest or posttest survey. Study groups were assigned by alternating users. The CME course consisted of 4 clinical cases covering key concepts in the diagnosis, evaluation, and reporting of child abuse. Identical pretest and posttest surveys used 4 point Likert-type questions to measure perceived competency in the medical evaluation of child abuse.
Results: 66 physicians participated in the study (Pretest group N=31, Posttest group N=35). The posttest group’s mean perceived competency scores were statistically significantly higher than the pretest group’s scores in all domains assessed, including the history taking, medical examination, documentation, additional screening testing, and reporting to local authorities.
Conclusions: Our experience demonstrates that web-based education in child maltreatment is effective in influencing perceived competency in performing medical evaluations for suspected child abuse.