Abusive Head Trauma Module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP): Rehma's Story

Abstract

Introduction: Abusive head trauma (AHT) is the leading cause of death from head injuries in children under 2 years and a critically undertaught topic in medical education.

Methods: We created an interactive module on AHT for medical students, residents, and physicians who treat children. We evaluated the module in three formats: individual, self-paced completion by a multidisciplinary (primarily physician) audience; presentation to a small multidisciplinary (primarily physician) audience at a Child and Adolescent Neurology (CAN) educational conference; and presentation to a large group of first-year medical students as part of a neuropsychology and development course. All versions took 45 minutes. A five-question pre- and postmodule assessment was completed to measure participants' confidence levels and knowledge pertaining to AHT.

Results: Twenty-four individual, self-paced participants, 10 CAN educational conference attendees, and 62 medical students participated in the AHT module. Among the largest group (medical students), the median confidence level pertaining to AHT demonstrated a modest increase from 3 (interquartile range [IQR]: 2.00-5.00) to 6 (IQR: 6.00-7.75) on a 10-point Likert-type scale. The proportion of medical students answering knowledge questions correctly increased for every question: 27% to 84%, 50% to 90%, 2% to 90%, and 79% to 96%. Among the audiences composed of primarily physicians (i.e., the CAN conference and individual participants), baseline knowledge and confidence scores tended to be higher than the medical students and exhibited increases for every metric.

Discussion: This interactive module about AHT was associated with increased confidence and knowledge for a variety of medical audiences and delivery formats.

Keywords: Case-Based Learning; Child Abuse; Games; Multimedia; Pediatric Critical Care Medicine; Pediatric Emergency Medicine; Pediatrics.

Figure 1.. Medical students’ self-rated confidence level in recognizing and managing abusive head trauma in the pre- versus postmodule assessments. The median confidence level increased from 3 (interquartile range [IQR]: 2.00–5.00) to 6 (IQR: 6.00–7.75). The mean (X) increased from 3.6 to 6.5. The whiskers extend to a maximum of one IQR below the 1st quartile and one IQR above the 3rd quartile, with outliers beyond these ranges indicated by dots.

Figure 2.. Performance of medical students on knowledge-based questions in pre- versus postmodule assessments.

Figure 3.. Multidisciplinary (primarily physician) confidence levels in recognizing and managing abusive head trauma in the pre- versus postmodule assessments. The median confidence level increased from 6 (interquartile range [IQR]: 5.00–6.00) to 7 (IQR: 6.00–8.00). The mean (X) increased from 5.6 to 7.2. The whiskers extend to a maximum of one IQR below the 1st quartile and one IQR above the 3rd quartile, with outliers beyond these ranges indicated by dots.

Figure 4.. Multidisciplinary (primarily physician) performance on knowledge-based questions in pre- versus postmodule assessments.