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Mandatory reporting: Professional resilience & resilience in

Presentation for considering mandatory reporting education within paediatric resident training

christine wekerle

on 15 December 2015

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Transcript of Mandatory reporting: Professional resilience & resilience in

First step in resilience is reflective dialogue (Fonagy, 1994)
Flexible CAN Learning
Visual Thinking Strategies Approach
Research Model
2015-2016 Funding Seeking
Use of Existing McMaster Survey: 15-item knowledge quiz
Creation of 4 OSCEs - Standardized Patient Scenarios
August 2016 or 2017 Start Date
Pre-LCC Survey; 2 Pre-OSCEs prompting mandatory reporting discussion
2 Resident CAN sessions
(standard curriculum)
6 TED Ed Lessons
: 5 Maltreatment Types Extension; 1 Visual Literacy Application (flexible curriculum)
Post-LCC Survey: 2 Post-OSCEs
March 3,4,5
Picturing Wellness Conference
, McMaster
Picturing Wellness: From Adversity to Resilience
exhibit, McMaster Museum of Art
Goal: Virtual Museum Tour for On-Going Education
CANMeds2015 & The Trainee Experience with Child Abuse and Neglect (CAN)
- Consulting with Team, CAN Specialist, Family Member, Child Welfare Authorities
- Knowledge of increased physical and mental health risks w/ CAN
- Injury prevention with re-victimization risk
- Duty to Report
Mandatory reporting of child Abuse & Neglect:
Professional resilience & resilience intervention

Developmental model of competence
32% of Cdn population report child abuse (Affifi et al., 2014)
10% of health professionals reporters to Canadian child welfare (CW) agencies; more likely to report younger children (Tonmyr et al., 2010)
Experiencing physical, emotional, sexual abuse together increased contact w/ CW, (AOR=15.8, Affifi et al., 2015, 2012 Canadian Community Health Survey)

What might a CAN training vision look like...
Resident Standard Education Proposed
2 sessions on CAN and mandatory reporting with
(Christian et al., 2015)
Pediatrics In Review
(Asnes & Leventhal, 2010),
Child Abuse & Neglect
(Pietrantonio et al., 2013) background articles
Discussion Cases with CAN & Child Welfare
McMaster Needs Assessment
N=220 Medical Undergraduates (37% of population; 50% of 3rd year; @ end-of-year)
56% reported no CAN training
CAN training was most likely during pre-clerkship (59%) vs. clerkship (10%) with average of 3.9 hours (Mode=3.0)

16% reported a case to CW (M=2.2 cases, SD=2)
Comfort with reporting significantly higher among reporters (M=3.21, SD=.85) than non-reporters (M=2.69, SD=1.06)

Survey of pediatric residents at 16 Cdn pediatric centres 92% reported a need for an educational program in child protection (Ward et al., 2004)
Most common format were class lecture (70%) and informal teaching (51%)
46% student reported involved in CAN case
(M=2.5 cases; SD=2.8)
Without any experience, majority rate as not comfortable on 5-point Likert
Scale (Not at all to Very Comfortable)
(1) Standardized Education:
LCC sessions
(2) Flexible Education
: TED Ed Lessons on CAN-related issues
(3 )Novel arts- and case-based approach to #picturingwellness
Research Study EVIDENCE-BASED Curriculum
TED Ed Lessons To Date
(1) Risk & Resilience in Youth Suicidality
(2) Dr. Nadine Burke-Harris & ACEs too high
McMaster Undergraduates - 2+ session (N=23) course
15-item multiple choice maltx survey
PRE 52% of items correct; POST 71%
Undergraduates (N=220) 37% correct
Increased comfort ratings in reporting
Increased Empathic Concern (IRI; trend)
Pre-to-post gains in verbal details (COWAT); visual details (Rey-O)

Visual Thinking Strategy or Formal Art Analysis Approach
Full transcript