600 - Pediatric Hospitalists' Experience with, Training in, and Knowledge of the Legal System in Cases of Child Maltreatment

The National Association of Children’s Hospitals and Related Institutions notes children’s hospitals are “undisputed leaders in providing medical care to abused…children” and asserts hospitals should ensure medical staff is trained to comply with reporting requirements. Yet, there is a lack of research on pediatric hospitalists' experiences with, perspectives on, and knowledge of the medical legal system.

Objective:

Explore pediatric hospitalists’ experience with, training in, and knowledge of the legal system in cases of child maltreatment. 

Design/Methods:

A cross-sectional electronic survey was distributed to pediatric hospitalists in Arizona in June 2022. Seven of the eight medical centers with inpatient pediatric acute care units in Arizona agreed to participate. Attending physicians who spend at least 0.2 full time equivalence in the pediatric acute care unit and/or newborn nursery were included. The survey explored demographics, prior training in the legal process, and prior experience with reporting child maltreatment and appearing in court.  A quiz developed by the researchers explored participants’ knowledge of the legal system as it relates to child maltreatment.  Descriptive statistics were performed. Wilcoxon rank-sum tests were used to assess associations between years post-residency training, attitudes about adequacy of training, and performance on the quiz. 

Results:

Forty-seven pediatric hospitalists completed the survey (50.0% response rate). Respondents were a mean of 10.7 years post-residency training and 25.5% had practiced outside the field of pediatric hospital medicine (Table 1). While 51.1% felt adequately trained to report child maltreatment, only 19.1% felt adequately trained to testify in court (Table 2). Those with more years of experience were more likely to feel adequately trained (P < 0.05). On the quiz, respondents scored a mean of 77.6%. There was no significant correlation between quiz performance and years post-residency, prior training in the legal process, past receipt of a subpoena, or past experience testifying in court.

Conclusion(s):

Most pediatric hospitalists have reported suspected child maltreatment and feel adequately trained to do so. However, most do not feel adequately trained to testify in court. Although more experienced pediatric hospitalists feel more adequately trained, experience was not associated with improved performance on a knowledge quiz. Future efforts should address gaps in pediatric hospitalists’ education in this topic to ensure they are trained to comply with reporting requirements and prepared to be involved in the legal proceedings.