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Child Protection and Forensic Pediatrics - Jacksonville
PED E 12J | 4th Year Elective | Pediatrics | Clinical Science |
The information for this course is based on the 2009-2010 school year. It has not yet been updated for the 2010-2011 year.
Prerequisites
4th year medical student
Course Description
Course Description: Forensic Pediatrics is the study of child abuse as it relates broadly to pediatrics. This elective is both didactic and heavily experiential – combining study, lectures, and field experiences. Identification, diagnosis, management, and policy issues will be addressed. At the conclusion of this elective, the senior medical student will have a greatly increased understanding of child abuse and how it is a major component to child and adult health, and a set of skills in its identification. The didactic portion consists of readings in child abuse (books, articles, CDs, photographic atlases). The student will also have field experiences in a sexual and physical abuse clinic, observe child interviews, review current child abuse case records, participate in child abuse consultations on the ward, and observe community activities including DCF investigations, court, and child abuse prevention. In addition, the student will participate in telemedicine conferencing lectures and communication with other senior medical students at Emory and Morehouse Medical Schools taking the same elective. INTRODUCTION In many primate societies, its smallest and most vulnerable members are both cherished and occasionally abused by adults. Humans also mistreat their young – at a relatively high rate. The statistics about this are many, but a few to consider: 1. Child abuse has been experienced in one form or another by at least 25% of the adult population 2. Child abuse is the leading cause of death between 6 months of age and 12 months of age. It is the second leading cause of death between 6 months and 12 years of age. 3. Over 90% of prisoners were victims of child abuse; over 90% of prostitutes were sexually abused as children; and about 70% of adult psychiatric outpatients were victims of child abuse 4. It is conservatively estimated that there are an additional 36,000 violent criminals and 250 murders in the US each year because of child abuse 5. Child abuse is conservatively estimated to cost at least $94 billion per year to society 6. Each case of shaken baby syndrome costs at least $1 million 7. Medical schools in the US typically provide 2 hours of formal training about child abuse The goal of this elective is not to make you a specialist in the area (this would require a several year fellowship post residency), but to heighten your awareness as to the diversity and depth of the problem, and to enhance basic skills in identification and intervention. (At the conclusion, you should be more familiar with child abuse issues than most 3rd year pediatric residents.) Several key misconceptions that are common among the general public and many physicians include: 1. The primary means to determine if a child has been sexually abused is to send her to the doctor for an examination 2. Children can suffer a fair amount of physical abuse or neglect, but will turn out ok if they are then placed in a loving environment 3. Child abuse is an infrequent, abnormal condition of humanity and would not be caused by nice people such as themselves Welcome to one of the most interesting, sophisticated and diverse areas of medicine! The children and adults you care for during the rest of your career will be better because of your insights and the knowledge you obtain.
Course Faculty and Staff:
| Course Director(s): | |
| Course Co-Director(s): | Randell Alexander MD, PhD |
| Other Faculty | Frank Genuardi MD, MPH |
| Course Staff: | Eraina Carter , Brenda Carver |
Meeting Place and Time
Meeting Time/Place: 9:00 AM the first day. 1650 Prudential Drive, Suite 100 Jacksonville
Course Materials
READINGS Week 1 1. Shaken baby syndrome packet of articles 2. Reece R. [Ed] Child Abuse: Medical Diagnosis and Management (2nd edition). Philadelphia: Lippincott Williams & Wilkins, 2001. Chapters 1-9, 17-20. 3. CD – ROM Shaken Baby Syndrome A Visual Overview: Version 2.0 Jim Lauridson Week 2 1. Munchausen syndrome by proxy packet of articles 2. Reece R. [Ed] Child Abuse: Medical Diagnosis and Management (2nd edition). Philadelphia: Lippincott Williams & Wilkins, 2001. Chapters 12-16. Week 3 1. Reece R. [Ed] Child Abuse: Medical Diagnosis and Management (2nd edition). Philadelphia: Lippincott Williams & Wilkins, 2001. Chapters 10-11, 21. 2. CD – ROM The Anatomy of Child and Adolescent Sexual Abuse Week 4 1. U.S. Advisory Board Report on Child Fatalities, 1995.
Additional Information
Sample monthly schedule Field Experiences 1. Sexual abuse clinic 2. In-patient consultations on child abuse cases 3. Forensic interview center 4. Juvenile/criminal court 5. Child abuse prevention program 6. Child protective services Didactic sessions 1. Teleconference sessions
Classes Offered:
You are already signed up for this course. You may sign up for a different period in the same course, but be sure to give your request a different priority than any other request for this course. If you're not sure about where this course is in your schedule, go there and see.Evaluated Competencies
#1 Professionalism:
Educational Objectives: 1. The student will display interest and respect for patients, families, and professionals with whom she/he is in contact as evidenced by the evaluations of the professionals. 2. The student will display to the course directors’ discretion about sensitive child abuse issues and confidentiality in his/her discussions.
Method of Evaluation: 1. An evaluation form will be distributed to community professionals, which asks about professionalism and the student’s interactions with others. 2. The course directors will share their evaluation form at the beginning of the rotation with the student, and rate them at the end.
#2 Patient Care:
Educational Objectives: 1. The student will display the ability to produce a coherent and insightful medical report about a child abuse case.
Method of Evaluation: 1. The student will submit at least one report of an inpatient consultation or an external case review to the course directors for evaluation.
#3 Medical Knowledge:
Educational Objectives: 1. The student will learn genital anatomy (e.g. the location of the posterior fourchette and fossa navicularis – major landmarks that most physicians and all students do not know), normal variants, and abnormalities reflecting sexual trauma. 2. The student will learn normal variants and abnormalities reflecting physical abuse.
Method of Evaluation: 1. The student will take a pre-test and a post-test that comprehensively covers child abuse. 2. The student will take 3 weekly quizzes about child abuse. 3. Student participation in field experiences is vital, and evaluations by community contact persons will help form the basis for course evaluation.
#4 Practice-Based Learning:
Educational Objectives: 1. The student will demonstrate increased competency in knowledge about child abuse 2. The student will demonstrate increased competency in the ability to apply the knowledge about child abuse to actual cases.
Method of Evaluation: 1. Written examinations as noted above. 2. Direct observation and evaluation by course directors and community preceptors.
#5 Interpersonal and Communication Skills:
Educational Objectives: 1. The student will learn to take a more sophisticated history for child abuse, including demonstrating how to better elicit sensitive information.
Method of Evaluation: 1 Direct observation and evaluation by course directors and community preceptors.
#6 Systems-Based Practice:
Educational Objectives: 1. The student will receive education about the Florida system of Child Protection Teams, DCF, major child abuse organizations in the country, and the role of health both state-wide and nationally.
Method of Evaluation: 1 Written examination, discussions with course directors.
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