‘Virtual patient’ helps to train doctors in abuse recognition

A VIRTUAL child patient has been helping doctors in a major Irish paediatric hospital recognise suspected child abuse.

The learning tool was used in a pilot study by doctors from Temple Street Children Hospital in Dublin and the Royal College of Surgeons in Ireland.

Previous research has found that junior doctors working in a paediatric emergency department often fail to recognise standard indicators of abuse.

Other studies have shown that a doctor’s likelihood of reporting suspected abuse is related to the amount of training he or she has received.

“As a junior doctor is often the only doctor to assess children presenting with an injury or illness to the emergency department, it is crucial they are skilled in the identification of possible child abuse or neglect,” the authors of the Irish study said.

The Temple Street study, published in the latest edition of the Irish Medical Journal, used an interactive video-based virtual patient to provide formal training for paediatric basic specialist trainees in the recognition of suspected child abuse.

The virtual patient developed by the researchers was a seven-month-old child with suspected physical abuse who is brought to a hospital emergency department with viral upper respiratory tract symptoms.

The senior house officer fails to notice bruises on the infant’s cheek or diagnose posterior rib fractures on a chest X-ray. Progression of the case is dependent on participants’ response to questions.

In order to increase the authenticity of the case, the videos were filmed in the emergency department of a tertiary paediatric referral hospital. Professional actors were hired to play the role of the mother, consultant and junior doctor.

The “child” patient was used to facilitate a case discussion with basic specialist trainees and a questionnaire determined their perception of the value of the virtual patient as an educational tool.

More than 90% of the 25 basic specialist trainees who participated felt more confident about recognising and reporting cases of suspected child abuse.

All agreed that the virtual patient helped raise their awareness of the difficulties surrounding the diagnosis and management of child abuse and enabled them to identify deficits in their knowledge.

According to the study, the results identify the potential role of a virtual learning tool in enhancing post-graduate child protection training.

Interactive computer-based programs simulating real-life clinical scenarios are becoming increasingly common tool in medical education.