WIP 36 - Design and Evaluation of a Child Welfare System Curriculum for Pediatric Trainees to Expand Trauma Informed Care Delivery

Publication Number: WIP 36.7521

Christina I. Hwang, The Children's Hospital at Montefiore, Bronx, NY, United States; Eleanor Bathory, Montefiore Medical Center, Bronx, NY, United States; Sandra F. Braganza, The Children's Hospital at Montefiore, Blauvelt, NY, United States

Background: Trauma-informed care (TIC) is an essential element of pediatric practice. Yet when the child welfare system (CWS) is involved, providing TIC may be complicated by the clinician's role as mandated reporter. Mandated reporters are legally bound to report suspected child abuse to CWS. However, surveys show that pediatricians have limited confidence and knowledge of this role, in the services provided by the CWS, and its ability to support families. Residency programs typically teach residents about tenets of TIC and separately educate on mandated reporting in the context of medical diagnoses of abuse. We addressed this knowledge gap with an educational session utilizing a TIC framework detailing key points of the CWS’s history, a step-by-step understanding of the investigation process and its impact on families, and referral to legal resources and ways to support families with CWS involvement.

Objective: To assess resident knowledge of the CWS and confidence identifying resources to support families with CWS involvement before and after an educational session.

Design/Methods: This is a single-center, IRB-approved pilot study at a large urban academic center to develop and implement an educational session for pediatric residents. This one-hour session was incorporated into the required weekly curriculum for available pediatric residents (88 total), but survey participation was optional. Pre- and post-session surveys assess change in knowledge of the CWS and confidence referring families to legal resources. Survey results from the first session with 26 residents (16 respondents) demonstrated an increase in knowledge and confidence. Based on feedback, a new 2.5 hour session was created, incorporating the didactic from the initial session, with a presentation by a community organization and small group discussions. Analysis of this training is ongoing, and will include pre and post surveys and qualitative analysis based on written free text survey responses and analysis of small group discussions and will be completed by March 2025.