What residents know about child abuse. Implications of a survey of knowledge and attitudes
A. Woolf, L. Taylor, L. Melnicoe, K. Andolsek, H. Dubowitz, E. De Vos and E. Newberger
Division of Ambulatory Medicine, Boston Children's Hospital, MA 02115.
Residency training programs are the appropriate milieu in which physicians
should receive specialized training in the diagnosis and management of
child abuse. The purposes of the present study were to assess and compare
residents' knowledge of child abuse and their attitudes toward the
propriety of different forms of childhood discipline. We surveyed 192
residents from seven different training programs with questionnaires
probing their knowledge of child abuse and their attitudes toward childhood
disciplinary measures; 161 (84%) of the questionnaires were satisfactorily
completed by residents in pediatrics (n = 87), family medicine (n = 51),
and surgery (n = 23). Both pediatric residents and family medicine
residents outperformed surgery residents in one subscale and the total
score on the test. Scores were not related to year of training or attitudes
toward childhood discipline but were correlated with self-reports of
previous child abuse teaching. Residents' performance on a childhood
disciplinary measure demonstrated wide latitude in their rating of the
acceptability of 23 different modes of childhood discipline. Our findings
indicate a need for a more systematic approach to residents' education in
childhood intentional injuries and some value clarification of their
attitudes toward various forms of childhood discipline.
