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A Program for Pediatric Residents

Cynthia D. Johnson, MD; Joel A. Fein, MD; Carla Campbell, MD, MS; Kenneth R. Ginsburg, MD, MSEd

Arch Pediatr Adolesc Med. 1999;153:531-535.

Objective  To measure the effect of a violence prevention program on pediatric residents' violence prevention guidance during well-child visits.

Design  Prospective study of an educational intervention.

Setting  Inner-city tertiary care hospital and satellite site.

Participants  Pediatric residents.

Interventions  A 2-hour violence prevention program, consisting of an introductory talk, role playing, a printed resident guide, and supplemental reading materials.

Main Outcome Measures  Parent or guardian report of violence prevention guidance offered during the well-child visit, using a postvisit survey.

Results  Three hundred eight patient encounters were included in the survey: 93 prior to the program, 106 just afterward, and 109 after 6 months. Before the program, guns or violence was discussed at 9.7% of visits; this increased to 19.1% of visits after the program (odds ratio, 2.20; 95% confidence interval, 1.02-4.74). The improvement was sustained 6 months after the program. More than 80% of residents felt the program increased their fund of knowledge and taught them skills, and 93% stated that they would use these skills in the future.

Conclusion  This one-time educational intervention significantly increased the amount of violence prevention guidance provided by pediatric residents to their patients and families. The effect was sustained after 6 months. Residents regarded the program as a successful method of providing the skills and knowledge needed to address the issue of interpersonal violence in their primary care encounters.

From the Divisions of General Pediatrics (Drs Johnson and Campbell), Emergency Medicine (Dr Fein), and Adolescent Medicine (Dr Ginsburg), The Children's Hospital of Philadelphia and Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia.

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