A Qualitative Description of Resident Physicians’ Understanding of Child Maltreatment: Impacts, Recognition, and Response

Laupacis, Megan; Acai, Anita; MacMillan, Harriet L.; Vanstone, Meredith; Stewart, Donna E.; Dimitropoulos, Gina; Kimber, Melissa

doi:10.3390/ijerph19063319

Cited by 2 publications

(6 citation statements)

References 74 publications

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“…Paradoxically, healthcare providers in our study reported a lack of specialized training in child maltreatment accompanied by a frequent lack of confidence in identifying and reporting child maltreatment in cases that are not clear-cut cases of assault. This finding is consistent with findings from another study conducted with Canadian medical residents ( 16 ), and this dearth of training represents a significant gap within medical education and training.…”

Section: Discussionsupporting

confidence: 91%

“…On the other hand, the decision to report is more nuanced in cases with more complex medical explanations of injuries/presenting concerns or those with other elements at play such as FDIA, caregiver/teen conflict, and some supervision concerns. Extant literature similarly states that healthcare professionals tend to hesitate to refer to child welfare in cases with increased complexity ( 16 , 21 ). Oftentimes, healthcare providers attempt to mobilize supports within the healthcare setting and consult many different members of the healthcare team before making a report, as they recognize and appreciate the repercussions their report may have for the family.…”

Section: Discussionmentioning

confidence: 99%

“…For example, one study examining healthcare professionals’ experiences seeking support from the child welfare system reported a lack of routine screening for maltreatment, discomfort with discussing maltreatment, and inadequate knowledge of community resources ( 1 ). A Canadian study of the experiences of resident physicians training in a variety of medical specialties (i.e., pediatrics, family medicine, emergency medicine, obstetrics and gynecology, and psychiatry) identifying and reporting child maltreatment found that residents felt they required further training on what constitutes child maltreatment and how to identify non-physical forms of maltreatment ( 16 ). Further, the authors highlighted that study participants reported confusion around the reporting process to child welfare services and what their role was following a report ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

“…A Canadian study of the experiences of resident physicians training in a variety of medical specialties (i.e., pediatrics, family medicine, emergency medicine, obstetrics and gynecology, and psychiatry) identifying and reporting child maltreatment found that residents felt they required further training on what constitutes child maltreatment and how to identify non-physical forms of maltreatment ( 16 ). Further, the authors highlighted that study participants reported confusion around the reporting process to child welfare services and what their role was following a report ( 16 ). It could be that physicians are well-positioned and yet ill-equipped to identify risk factors for child maltreatment in order to intervene early and hopefully mitigate the need for additional child welfare involvement.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the roles of the healthcare and child welfare systems in promoting the safety and well-being of children

et al. 2023

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IntroductionThe accurate identification and appropriate investigation of child maltreatment is a key priority for promoting the optimal health and development of children. Healthcare providers are often well-positioned professionals to report suspected child abuse and neglect, and, therefore, interact regularly with child welfare workers. Little research has examined the relationship between these two groups of professionals.MethodsWe interviewed healthcare providers and child welfare workers in order to examine the referral and child welfare investigation processes to understand strengths and identify areas of improvement for future collaboration. Thirteen child welfare workers from child welfare agencies and eight healthcare providers from a pediatric tertiary care hospital in Ontario, Canada were interviewed to meet the study’s objectives.ResultsHealthcare providers spoke about positive experiences making reports, factors impacting reporting decisions, areas for improvement (e.g., difficulties communicating, lack of collaboration, and disruption of therapeutic alliance), training, and professional roles. For interviews with child welfare workers, identified themes included healthcare professionals’ perceived expertise and understanding the role of child welfare. Both groups brought up the need for increased collaboration as well as systemic barriers and legacies of harm.DiscussionOur core finding was a reported lack of communication between the groups of professionals. Other identified barriers in collaboration included a lack of understanding of each other’s roles, hesitation for healthcare providers making reports, as well as legacies of harm and systemic inequities in both institutions. Future research should build on this examination by including the voices of healthcare providers and child welfare workers to identify sustainable solutions for increased collaboration.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding the roles of the healthcare and child welfare systems in promoting the safety and well-being of children

et al. 2023

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“…However, health care and social service organizations are frequently unsafe, alienating, and intimidating for Indigenous peoples; a lack of trust, as well as frequent stereotyping and racism, may prevent Indigenous peoples from disclosing health-related concerns, including family violence [ 19 ]. Evidence also indicates that health care and social service providers are inadequately prepared with the knowledge, skills, and behaviors to respond to disclosures of family violence in their practice encounters [ 20 , 21 ]. Unsurprisingly, Indigenous peoples have expressed a preference to use their familial- and community-based informal support networks when experiencing violence and only use formal providers when reaching a crisis point [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Indigenous Cultural Safety in Recognizing and Responding to Family Violence: A Systematic Scoping Review

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Acai

Ferdossifard

et al. 2022

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This systematic scoping review synthesizes the recommended approaches for providing culturally safe family violence interventions to Indigenous peoples in health care and social service settings. A total of 3783 sources were identified through our electronic database searches, hand-searching of Indigenous-focused journals, and backward and forward citation chaining. After screening those sources in duplicate, 28 papers were included for synthesis in June 2020. Forward citation chaining of these 28 included articles in June 2022 identified an additional 304 possible articles for inclusion; following the screening of those 304 articles, an additional 6 were retained in the review. Thus, a total of 34 articles were included for data extraction and narrative synthesis. Initial results were presented to members of the Six Nations of the Grand River Youth Mental Wellness Committee, and their feedback was incorporated into our inductive organization of findings. Our findings represent three thematic areas that reflect key recommendations for health care and social service provision to Indigenous families for whom family violence is a concern: (1) creating the conditions for cultural safety; (2) healing at the individual and community level; and (3) system-level change. These findings demonstrate the need to center Indigenous peoples and perspectives in the development and implementation of cultural safety approaches, to acknowledge and address historically contingent causes of past and present family violence including colonization and related state policies, and to transform knowledge and power relationships at the provider, organization, and government level.

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A Qualitative Description of Resident Physicians’ Understanding of Child Maltreatment: Impacts, Recognition, and Response

Cited by 2 publications

References 74 publications

Understanding the roles of the healthcare and child welfare systems in promoting the safety and well-being of children

Understanding the roles of the healthcare and child welfare systems in promoting the safety and well-being of children

Indigenous Cultural Safety in Recognizing and Responding to Family Violence: A Systematic Scoping Review

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