Child Abuse Recognition Training for Prehospital Providers Using Deliberate Practice

Area of Science:

• Pediatric injury diagnosis
• Medical education technology
• Child abuse recognition

Background:

• Prehospital professionals (PHPs) are mandated reporters for suspected child abuse.
• Lack of training hinders PHPs' ability to recognize and report physical abuse.
• A novel learning platform was developed for diagnosing pediatric abusive vs. non-abusive burn and bruise injuries.

Purpose of the Study:

• To examine skill acquisition in visual diagnosis of pediatric abusive injuries among PHPs.
• To assess the effectiveness of an online educational intervention for improving injury recognition and reporting.
• To determine the amount and rate of skill improvement in differentiating abusive from non-abusive injuries.

Main Methods:

• Prospective cross-sectional study involving 253 PHPs in an online educational intervention.
• Participants reviewed 114 case vignettes, indicating concern for abuse and intent to report.
• Deliberate practice with immediate feedback was employed; learning curves, accuracy, sensitivity, and specificity were analyzed.

Main Results:

• Mean diagnostic accuracy increased by 4.9%, with final accuracy at 82.1% (sensitivity 75.4%, specificity 85.2%).
• Higher accuracy was associated with bruise cases (vs. burns), Advanced EMT/Paramedic level, and prior child abuse training.
• PHPs reported increased confidence in recognizing and reporting cutaneous signs of abuse.

Conclusions:

• An online module incorporating deliberate practice significantly improved PHPs' skills in differentiating abusive from non-abusive burn and bruise injuries.
• The intervention demonstrated measurable skill improvement, enhancing diagnostic capabilities for pediatric cutaneous injuries.
• This educational approach supports mandated reporting by equipping PHPs with better diagnostic tools.