CME in child sexual abuse

From Anne Taylor-Vaisey: Arch Pediatr

Adolesc Med.

2005 Jun;159(6):561-6:

Continuing medical education in child

sexual abuse: cognitive gains but not expertise.

Botash AS,

Galloway AE, Booth T, Ploutz-Snyder R, Hoffman-Rosenfeld J, Cahill


State University of New York, Upstate Medical University,

Syracuse, NY 13210, USA. [email protected]

OBJECTIVE: Describe the

effect of an educational intervention on medical provider knowledge and

competency regarding child sexual abuse. DESIGN: Using a before and after trial

design with an educational intervention, the study assesses knowledge changes in

specific content areas and describes a post-intervention competency

assessment.Setting/ PARTICIPANTS: Voluntary participation of practicing medical

providers and pediatric residents.Intervention Completion of a self-study,

case-based, published learning curriculum on child sexual abuse, including a

work book and videotaped genital examinations. MAIN OUTCOME MEASURES: Pre- and

post-intervention multiple choice and short answer (30 questions) test results

as well as a written response to a clinical case scenario. RESULTS: Sixty-four

participants completed pre- and post-tests. The average posttest score (26.9/30,

SD = 4.13) was significantly higher (P< .001) than the average pretest score

(20.4/30, SD = 1.65). More than half (59.4%) of providers did not correctly

interpret the exam findings, 28.1% did not correctly reassure the child and

family, and 39.1% did not indicate an appropriate understanding of the legal

implications. CONCLUSIONS: Motivated medical providers demonstrated significant

knowledge gains regarding the evaluation of child sexual abuse following

participation in the educational program. This new knowledge was not enough to

provide competency in the interpretation of genital findings or in offering

legal advocacy to the families. Competence in these areas may in fact represent

the domain of experts, not primary care providers, and further studies are

needed to determine how much experience is necessary to provide competency in

these areas.

PMID: 15939856 [PubMed - in process]

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