Education for Child Abuse Medical Providers

About : 2018-2019 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:

  • Always a pleasure to attend your Web Education Programs!!
  • Outstanding presentation. Loved the interactive portion.
  • Excellent topic and extensive reference list!!
  • Great review of prior history of thoughts/terminology around AHT
  • This was a very helpful talk – I really enjoyed it, and it is very clinically relevant. Thank you!
  • This presented a lot of information regarding campaigns to provide education to both communities and professionals regarding abuse.
  • This was a wonderful presentation and we had many different people on our team watch.
  • The information given puts us on a track to be more proactive.

Completed Tasks

Educational Webcasts

There were six CHAMP webcasts this grant year:

  1. October 10, 2018 — The Art of Uncertainty & the Limits of the Child Abuse Diagnosis by Ann S. Botash, MD
  2. November 14, 2018 — Assessing the Burned Child for Child Abuse by Jamie Hoffman-Rosenfeld, MD
  3. December 12, 2018 — The Heart of Trauma-Informed Care by Mandy O’Hara, MD
  4. January 16, 2019 — Supporting Gender Diverse Youth by Karen Teelin, MD, MSEd
  5. February 13, 2019 — Consensus on Abusive Head Trauma by Vincent J. Palusci, MD, MS, FAAP
  6. March 13, 2019 — No Hit Zones: Creating Safe Spaces to Address the Most Prevalent Risk Factor for Child Abuse by Stacie LeBlanc, MEd, JD

Drs. Botash, Hoffman-Rosenfeld, O'Hara and Palusci are American Board of Pediatrics certified child abuse pediatricians. Dr. Teelin is the Director, Section of Adolescent Medicine and an Associate Professor of Pediatrics at SUNY Upstate Medical University. Ms. LeBlanc is Director of the New Orleans Children's Advocacy Center (NOCAC) and the Audrey Hepburn CARE Center Children's Hospital, New Orleans. 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, nurse practitioners, physician 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 998 registrants for the webcasts. Of those who registered, 491 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:

  • Empower PCPs to look at differential diagnoses rather than focusing on sexual assault
  • Recognize that uncertainty with diagnosis doesn’t mean I can’t advocate for the child
  • Consider child’s environment where injury occurred
  • Broaden my assessment pertaining to trauma
  • Provide comfort and choice approach with patients
  • Ensure that signs and forms recognize all patients
  • I will identify local resources for trans-identifying children
  • Have discussions with prosecutors about medical diagnosis vs legal terminology
  • Plan to give consensus statement to all attorneys on AHT cases
  • More effectively communicate the harms of hitting children
  • I will be more aware of parents and stressors that can be observed

The Evaluating Child Sexual Abuse Course

The online course Evaluating Child Sexual Abuse (ECSA) continues to be an effective educational tool for pediatricians, emergency department physicians, physician assistants, nurse practitioners and SANEs. This grant year 143 professionals registered for the course. By June 30, 62 had passed the 100-question test. Of those who passed the test, 11 applied for and received CME credit and 2 applied for Maintenance of Certification (MOC) credit. Although the course is free, there is nominal charge for the 12 CME credits and 12 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 trainees from St. Joseph’s Health and SUNY Upstate, Syracuse, NY, including family medicine residents, pediatric residents and a pediatric emergency medicine fellow 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 1344 registrants. Of those, 643 have passed the test and 307 have applied for and received CME credit.

Other CHAMP Website Resources

This grant year the CHAMPprogram.com website drew over 430,000 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 35,000 downloads. That total includes over 4,000 Practice Recommendations relating to Triage, Testing and Treatment, Skeletal Survey, and Photographic Documentation. In May, Trauma-Informed Care Guidelines and a Trauma-Informed Pocket Guide were added to the Practice Recommendations. In addition, the 24 questions and answers of Test Your Knowledge were visited over 75,000 times.

Statistics for the ChildAbuseMD.com website that posts the searchable webbook Child Abuse Evaluation & Treatment for Medical Providers had a total of more than 86,000 visitors.

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

CHAMP Network Members

This grant year two medical professionals became new CHAMP Network Members by successfully passing the Evaluating Child Sexual Abuse course and a completing a clinical observership. Lisa McDonald, NP, and Sarah Wren, CPNP, completed a CHAMP observership with Dr. Jennifer Canter in Westchester County. Twenty-one New York State counties have one or more CHAMP Network Members: Albany, Broome, Cayuga, Chemung, Erie, Fulton, Herkimer, Jefferson, Kings, Madison, Nassau, Oneida, Onondaga, Otsego, Saratoga, St. Lawrence, Schenectady, Ulster, Warren, Washington and Westchester.

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, 2018. Of those, 26 completed the continuing educational requirements by June 30, 2019. Five members retired or left the child abuse pediatrics field. Two new providers completed the observership and coursework requirements to become network members. As a result, there were 28 CHAMP Active Network Members as of June 30, 2018.

Other Educational Opportunities

Upstate Medical University established a child abuse pediatrics fellowship. Iram Ashraf, MD, began the 3-year training program in August, 2018.

The CARE program, a CHAMP Center of Excellence in Syracuse, provided scheduled learning experiences and rotations for 19 Pediatric and Family Medicine residents and a Pediatric Emergency Medicine fellow.

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, provide 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.

Recommendation

Collaborative Education

Again this year, CHAMP collaborated with the American Professional Society on the Abuse of Children-New York (APSAC) and the Vincent J. Fontana Center for Child Protection, New York Foundling, to present a webcast. The topic was No Hit Zones: Creating Safe Spaces to Address the Most Prevalent Risk Factor for Child Abuse presented by Stacie LeBlanc, MEd, JD, a nationally respected expert. This collaboration gave CHAMP participants access to a Toolkit of materials offered by the New Orleans Children’s Advocacy Center. In addition, APSAC and New York Foundling affiliates gained exposure to CHAMP program resources. Collaborations like this enable child abuse programs and organizations to share resources and expand access to information.

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