G85(P) Simulation improves medical students' confidence in recognising child safeguarding issues. (May 2019)

• Record Type: Journal Article
• Authors: McAvoy-Yau, A; Kelly, A
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A35
• Page End: A36
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.84
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Child protection is an essential responsibility of all doctors and forms an important part of undergraduate medical curriculums. Local undergraduate child protection training comprises of a half-day lecture-based safeguarding workshop for students rotating through paediatrics. Despite this teaching, our undergraduates reported a lack of confidence in recognising child protection issues. There is no published evidence for the use of simulation in undergraduate child protection training; we therefore instigated a child protection scenario as part of a compulsory paediatrics simulation day, to investigate whether this would improve medical students' confidence in identifying child protection issues. Methods: 118 medical students in paediatrics attended a simulation day on paediatric emergencies in 16 different groups over a 9 month period. Students underwent a 20 min trauma scenario using a high-fidelity mannequin where various safeguarding concerns were present, including a suspicious history inconsistent with the child's developmental age and covert injuries incompatible with the given mechanism. Students were scored on whether they highlighted child protection concerns during the scenario. Feedback on confidence scores was collected from students after each session. Results: Despite all groups identifying the additional history and examination findings pointing to a child protection issue, only 2 out of 16 groups (12.5%) raised safeguarding concerns during the scenario itself. The simulation was well received with excellent feedback and 94.6% of students reported increased confidence in identifying child protection concerns after the session. Average confidence scores increased from 2.4 to 3.7 on the Likert scale of 1–5 (rise of +1.3 points). Although average confidence increased to above neutral, the final scores suggest more training is required to maximise students' confidence in recognising safeguarding concerns. Conclusion: A child protection simulation scenario was successfully introduced into the simulation day and was well received by students. Confidence scores showed an increase after the session, but final confidence scores could still be improved. It would be beneficial to instigate further child protection simulation training for undergraduates to improve familiarity with the practical application of child protection in the workplace. The university has now recommended for students in paediatrics in all academies to undergo simulations on non-accidental injury.