Pediatric resident training in child sexual abuse: A scoping review

Abstract

Background

Pediatric sexual abuse is prevalent and the skills to evaluate and manage suspected cases are necessary for all pediatricians. However, pediatric residents have variable clinical exposure to cases of sexual abuse and have reported limited didactic teaching.

Objective

We aimed to describe the existing published educational strategies for training pediatric residents to assess and manage cases of suspected sexual abuse.

Methods

MEDLINE, EMBase, PsychINFO and SCOPUS were searched with main clusters being “education” and “abuse” terms. To be eligible, studies needed to provide information about a sexual abuse educational resource or training for pediatric residents. All articles in the first and second stage screening were reviewed independently by two authors and data was extracted by one reviewer and independently verified by a second reviewer.

Results and conclusions

Most pediatric residency programs report limited didactic and clinical teaching on child sexual abuse and many pediatric residents do not gain the skills necessary to assess and manage cases of suspected child sexual abuse. Educational interventions using a multi-faceted approach with a combination of self-study material, didactic lectures, case discussion, and simulation training or clinical placement have been effective in improving resident knowledge, skills and attitudes in assessing and managing cases of suspected child sexual abuse. We found few studies with reported outcome measures. Of those reported measures, knowledge gains waned several months following interventions and while knowledge scores in basic concepts increased, participants were not able to consistently apply the knowledge into interpretation of clinical cases. As a result, additional studies or strategies are needed to create effective educational interventions.