Effectiveness of simulation-based training on child abuse recognition for clerkship students and residents

Child abuse is an important global public health issue, and early warning signs are often overlooked by clinical healthcare providers because of their limited experience. Injuries such as abusive head trauma (AHT), bruising, burns, and fractures are common and highly suggestive indicators of child abuse. Therefore, it is essential to improve healthcare providers’ ability to recognize abusive injuries. To compare the learning outcomes of clerkship students and resident physicians after participating in a training course on recognizing child abuse–related injuries, and to evaluate improvements in knowledge and diagnostic accuracy across different training levels. A pre- and post-test design was adopted using multiple-choice questions and simulation-based skill assessments to evaluate learning effectiveness. This study was conducted as part of a clinical physician training program at a single medical center. There were 26 participants, including 18 clerkship students and eight resident physicians. None of the participants had previously undergone high-fidelity simulation-based training on child abuse. The curriculum consisted of two major modules: (1) abusive head trauma and (2) bruising, burns, and fractures. Participants rotated through the modules. The pre- and post-course assessments were conducted using multiple-choice examinations. Both clerkship students and resident physicians demonstrated significant improvements in overall post-test scores (p < 0.05). Clerkship students showed significant gains in the bruising/burn/fracture module, composite question set, and fracture-related items, whereas residents showed significant improvements primarily in bruising-related questions. Significant improvement in AHT-related items was observed only in clerkship students. Residents displayed smaller learning gains, likely because of higher baseline scores from prior clinical experience. The training program effectively enhanced the ability of clerkship students and resident physicians to recognize abusive injuries in children, with notable improvements among less-experienced clerkship students. These findings suggest that early educational intervention strengthens clinicians’ sensitivity and accuracy in identifying common abusive injuries, and represents an important strategy for improving child protection in clinical practice.