2017-2018 CHAMP Program Annual Summary

Annual Summary PDF (printer friendly version)

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:

• Excellent organized approach to the practice of evaluation of abused children

• More awareness of the possibility of abuse that could be masked by cultural differences

• Indicators of Human Trafficking list will prove very helpful

• Enlightenment regarding the dynamics of child trafficking

• Outstanding Course!

• Absolutely excellent & comprehensive presentation of this burgeoning Pediatric problem in our society!

• Most amazing webinar ever! Many thanks for sharing this experience!

Completed Tasks

Educational Webcasts

There were six CHAMP webcasts this grant year:

1. October 11, 2017 — RIME & Reason: Teaching about Child Abuse by Ann S. Botash, MD
2. November 8, 2017 — When Culture is the Conundrum by Ingrid Walker-Descartes, MD, MPH
3. December 13, 2017 — SQUARES: Medical-legal paradigms in caring for minor victims of human trafficking by Dana Kaplan, MD, FAAP
4. January 17, 2018 — Sentinel Injuries: Reasons to Sweat the Small Stuff by Alicia Pekarsky, MD
5. February 14, 2018 — What We Know About the Harms Linked to Physical Punishment and About Interventions to Reduce it in Medical Settings by Elizabeth Gershoff, PhD
6. February 28, 2018 — Punishment and Discipline: Challenges and Strategies for Medical Professionals by Howard Dubowitz, MD

Webcast attendees identified themselves as being physicians, nurse practitioners, physician’s assistants and registered nurses working in pediatrics, emergency medicine and family medicine, many with SANE/SART/SAFE designation, and also social workers and non-medical members of multidisciplinary teams. There was a total of 875 registrants for the webcasts. Of those who registered, 470 applied for Continuing Medical Education (CME) credit. Both the webcasts and CME credits (one credit per webcast) are free to participants.

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:

• I will utilize the "suspected child abuse" printables – thank you
• Excellent teaching tools for Resident training
• I would like to implement No Hit Zones here in Pediatric Urology
• Will include interventions when hitting is witnessed in my resident training modules
• Using motivational interviewing in helping parents with discipline
• Utilize the SEEK resources for structuring discussions with parents
• I will identify needed resources in advance of evaluating patients
• Encourage all my Examiners to continue with trafficking training with the goal of identifying
• I would like to educate the ER nurses that I work with on the signs/symptoms they should be looking for that may be missed
• I will be less hesitant to speak up if I think another provider has missed a sentinel injury
• Get more through explanation of how injury incurred

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 120 professionals registered for the course. By June 30, 51 had passed the 100-question test. Of those who passed the test, 8 applied for and received CME credit. Although the course is free, there is nominal charge for the 12 CME credits and 20 ABP MOC points.

The ECSA course was originally created to be the first step for New York State 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. Twenty-five trainees from St. Joseph’s Health and SUNY Upstate, Syracuse, NY, including family medicine residents, pediatric residents and pediatric emergency medicine fellows completed ECSA as a part of their rotation in child abuse with CARE this year.

From the launch of the course in September 2011 through June 2018, there have been 1201 registrants. Of those, 581 have passed the test and 297 have applied for and received CME credit.

Other CHAMP Website Resources

This grant year the CHAMPprogram.com website drew over 325,000 visitors. In addition to viewing web pages, visitors downloaded a significant number of resources. Tracking the number of downloads from the top 150 resources offered on the website, there were over 26,000 downloads. That total includes nearly 3,000 Practice Recommendations relating to Triage, Testing and Treatment, Skeletal Survey, and Photographic Documentation. In addition, the 24 questions and answers of Test Your Knowledge were visited nearly 67,000 times.

CHAMP added a Child Victims of Human Trafficking feature to the website in order to support New York State pediatric medical providers and facilities. This section offers coursework, case studies, information about legislation and resources related to the requirements of amendment 2805-y to the public health law. This amendment pertains to the identification and assessment of human trafficking victims. It also requires that facilities establish and implement written policies and procedures and provide ongoing training for all facility personnel.

Statistics for the ChildAbuseMD.com website that posts the searchable webbook Child Abuse Evaluation & Treatment for Medical Providers had a total of more than 182,000 visitors.

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

CHAMP Mentors

This grant year, one medical provider, Dana Kaplan, MD, an ABP certified child abuse pediatrician, became a new CHAMP Mentor. This adds a CHAMP Center of Excellence in Staten Island, NY, expanding the geographic area of Centers of Excellence to Richmond County. Dr. Kaplan brings expertise in the area of child victims of human trafficking. She developed the new CHAMP on-line course, Trafficking of Children, and a series of case studies, What Would You Do? that are part of the Child Victims of Human Trafficking section of the website.

CHAMP Network Members

This grant year four medical professionals became new CHAMP Network Members by successfully passing the Evaluating Child Sexual Abuse course and a completing a clinical observership at the CHAMP Center of Excellence in Syracuse, NY. Kristina Ursitti, DO, Ulster County; Brooke Davidson, PA, Jefferson County; Roji Gurung, FNP, Broome County; and Kate Skipton, MD, Jefferson County were added to the roster of CHAMP Active Network Members. This expands the geographic area that CHAMP Members service, as Ulster County now has an Active CHAMP Network Member.

To remain on the Active Network Member roster, Members must attend at least three CHAMP educational webcasts annually. There were 31 Active Network Members at the start of the year, July 1, 2017. Of those, 28 completed the continuing educational requirements by June 30, 2018. One member moved out of state, and one left the child abuse pediatrics field. One former member completed requirements for reinstatement, and four new providers completed the requirements to become an Active Network Member. As a result, there were 31 CHAMP Active Network Members as of June 30, 2018.

In addition, Linda Cahill, MD, and Jamie Hoffman-Rosenfeld, MD, at the J.E. and Z.B. Butler Child Advocacy Center of the Children’s Hospital at Montefiore, provided 30 residents with an opportunity to 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.

Recommendations

Educational Opportunities

The May 2015 Medical Summit on Child Abuse, hosted by NYS OCFS and NYSCA, informed child abuse professionals on the need for state funding to support medical teams performing child abuse evaluations. Presentations and information sharing were a good first step in understanding gaps in care within different geographic regions in NYS. There may be a benefit for state agencies to collaborate and improve support provided to child abuse pediatrics professionals. Dialogue within local regions has continued and there are opportunities for systemic change to increase the quality of child abuse care in NYS.

CHAMP demonstrated its ability to use the expertise of its Mentors and its experience in producing internet-based education when it launched the Child Victims of Human Trafficking feature of the CHAMPprogram.com website in April. Dana Kaplan, MD, a child abuse pediatrician with expertise in trafficking, created Trafficking of Children, a free course that institutions can use to help meet the requirement of amendment 2805-y to the public health law that they educate all staff about human trafficking. The course includes a quiz and the option of receiving a certificate of completion. Dr. Kaplan also created nine case studies, What Would You Do?, to help pediatric medical providers better identify and manage suspected trafficking cases. In addition, the trafficking section offers a resources section and links to federal and state laws and announcements. This feature is rapidly increasing the number of visitors to its pages.