Education for Child Abuse Medical Providers

About : 2013-2014 CHAMP Program Annual Summary

CHAMP continues to be seen as a source for quality professional education regarding child abuse. The webcasts, online coursework, website features like Test Your Knowledge, and downloadable practice recommendations and other clinical resources draw a large number of visitors. Comments include:

  • Very thorough and informative presentation that included a lot of information not generally covered in child abuse courses.
  • I thought this was an awesome presentation. As a person who supervises mid-level practitioners, I am always working with them about their documentation and this hit home a lot of issues I attempt to address.
  • Will use content from webcast, as appropriate, during peer-review case conferences.
  • Absolutely wonderful. I could have listened for a whole other hour. Very informative and a lot for me to think about and review for my practice.
  • Will incorporate this information into an educational session which I have been asked to present to general pediatricians, emergency department physicians and family practice physicians.
  • Thanks for all the work you put into these educational opportunities! I GREATLY appreciate it and my nursing staff benefit tremendously from the information I share with them as do our victims!
  • I love these webinars and love the case-based approach. They are one of the best methods of teaching for us so far away.
  • I am taking SANE pre-certification exam next month. This was very helpful and a good prep!
  • I felt this was excellent! As a fairly new SAFE nurse the differentiations of non-abuse injuries was very helpful.
  • I cannot say thank you enough to you, and others at the NY CHAMP Program dedicated physicians, educators and support staff who take the time to provide educational opportunities to those of us wanting and willing to keep learning and respond appropriately to issues of child abuse.

Completed Tasks

Educational Webcasts

There were six CHAMP webcasts this grant year: Joyce A. Adams, MD, "Doctor, was there penetration?" Why we usually can’t tell by looking on November 6, 2013; Linda Cahill, MD, and Jamie Hoffman-Rosenfeld, MD, Understanding Femur Fractures – Accident vs. Abuse on December 4; Ann S. Botash, MD, What to Say and How to Say It on January 8, 2014; Cindy W. Christian, MD, Metabolic and Genetic Mimickers of Child Abuse on February 12; Vincent J. Palusci, MD, MS, Preventing Child Abuse on March 12; and Ann S. Botash, MD, Doctor It Hurts Down There on April 23. Drs. Botash, Cahill, Hoffman-Rosenfeld and Palusci are American Board of Pediatrics certified child abuse pediatricians and CHAMP Mentors. Drs. Adams and Christian are nationally-recognized experts and were part of an initiative to bring national speakers to the webcasts. All webcasts bring research-based information to the child abuse professionals of NYS and provide an opportunity for attendees to get answers from an expert.

Webcast attendees identified themselves as being physicians and nurse practitioners working in pediatrics, emergency medicine and family medicine; SANE/SART/SAFEs; and non-medical members of multidisciplinary teams. A total of 546 professionals registered for the webcasts. Of those, 337 applied for Continuing Medical Education (CME) credit. Both the webcasts and CME credits (one credit per webcast) are free.

In addition to these webcasts, on June 20, CHAMP partnered with the American Professional Society on the Abuse of Children-New York (APSAC-NY) to produce the webcast Everything You Need to Know About Psychological Maltreatment: Definition, Assessment, Incidence and Impact with Amy Baker, PhD, speaking. This webcast introduced CHAMP and its educational resources to social workers and other mental health professional working in the field of child abuse. A total of 156 professionals registered for this free webcast. Because of time and CME constraints, CME credit was not be awarded.

Attendees evaluated all webcast presenters as excellent and the content as being clear and helpful. From the responses to the surveys at the end of the webcasts, attendees planned to make significant changes in their practice, including:

  • Will be better able to explain why there is very often no physical signs/symptoms seen in genital forensic exams in cases of child sexual abuse.
  • Discuss in more detail with attorneys how important it is to remember that injuries do not have to be present in order to present a case.
  • Discuss "sentinel findings" with primary pediatricians when identified.
  • Be objective and aware of tendency to find what we want to find, see what we want to see, as well as deny what we cannot explain. Collaborate with other specialties.
  • Detailed history; review of all labs and the clinical course of the patient in determining abuse/neglect versus a rare genetic disorder.
  • Emphasize to pediatric residents the significance of screening families in a general practice setting.
  • Adolescent parents in particular need support. Recognize, teach, apply and evaluate preventive measures to help new parents anticipate normal and abnormal events and stresses, and plan healthy responses and coping, especially with crying during first 13-16 weeks of infant life.
  • Will see mandated reporting as a "prevention strategy."
  • Better awareness of other medical conditions that can have similar signs of child abuse.

The Evaluating Child Sexual Abuse Course

The online course Evaluating Child Sexual Abuse continues to be an effective educational tool for pediatricians, emergency department physicians, physician's assistants, nurse practitioners and SANEs. This grant year 170 professionals registered for the course. By June 30, 87 had passed the 100-question test. Of those, 60 applied for CME credit and 39 applied for American Board of Pediatrics Maintenance of Certification (MOC) credit. Although the course is free, there is small charge for the 12 CME credits and 20 MOC points.

The ECSA course was originally created to be the first step for NY medical professionals to become CHAMP Members. Its use has expanded to being part of child abuse training for medical residents and self-preparation for certification examinations. This year the Westchester (NY) FACT program used the course as part of its Emergency Department physician training. Twenty-two physicians completed the course and passed the test.

From the launch of the course in September 2011 through June 2014, 486 professionals had registered for the course and 248 had passed the test, with 169 applying for CME credit.

Other CHAMP Website Resources

This grant year the CHAMPprogram.com website drew over 174,000 visitors. That is 52,000 more visitors than last year. It addition to viewing web pages, visitors download a significant number of resources. Tracking the top 150 website downloads each month, there were over 23,000 downloads. That total includes nearly 3,000 Practice Recommendations relating to Triage, Testing and Treatment, Skeletal Survey, and Photographic Documentation.

In addition, the ChildAbuseMD.com website that posts the searchable webbook, Child Abuse Evaluation & Treatment for Medical Providers, had nearly 375,000 visitors. This is an increase of more than 87,000 visitors over the number of visitors last grant year.

Since ChildAbuseMD.com was launched in mid-2005 and CHAMPprogram.com was launched in mid-2007, there have been nearly three million visitors to the websites.

CHAMP Members

This grant year five medical professionals became new Members by successfully passing the Evaluating Child Sexual Abuse course and a completing an observership at a CHAMP Center of Excellence. Their names were added to the roster of Active Members. They are Michelle Gorski, FNP, Herkimer County; Amelia Komanecky, NP, Cayuga County; Barbara Lopez-Heffernan, NP, Nassau County; Lorraine Ronca, Westchester County; and Rebecca Clausen, FNP, Niagara County. The Mentors who provided the observerships were Jamie Hoffman-Rosenfeld, MD, Queens Child Advocacy Center; Jennifer Canter, MD, Children's Advocacy Center at Westchester Institute for Human Development; Ann Lenane, MD, the REACH program in Rochester; and Ann Botash, MD, Alicia Pekarsky, MD, and Nancy Mitchell, NP, the CARE program in Syracuse.

In addition, Linda Cahill, MD, at the J.E. and Z.B. Butler Child Advocacy Center of the Children’s Hospital at Montefiore had ten residents complete the CHAMP Residency Training Program. Residents who complete this program can become CHAMP Members when they are licensed to practice in NYS by submitting three of their recent child sexual abuse cases for review by a CHAMP expert.

To remain on the Active Member roster, Members must attend at least three CHAMP educational webcasts. Of the 29 Active Members that started this grant year, 22 maintained Active status by attending CHAMP webcasts. The other seven became Inactive by moving out of state or failing to meet the education requirement. In addition, five new medical professionals became Active Members and three Inactive members completed education requirements to become Active. As a result, there were 30 Active Members as of June 30, 2014.

Recommendation

The number of website visitors and professionals taking online courses and attending webcasts attests to the importance of CHAMP web-based education. The success of the CHAMP/APSAC webcast demonstrates the effectiveness of professional organizations joining to produce education for members of child abuse multidisciplinary teams. If the New York State Department of Health joined the New York State Office of Children and Family Services to fund a joint education project, CHAMP could produce an online course or lecture series that would reach a large number of health care and social service professionals dedicated to preventing and treating child abuse.

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