When Parents Hit: Providing Education to Physician Trainees About Corporal Punishment Through a Pilot Simulation and Debriefing.

ABSTRACT

OBJECTIVES: No studies have evaluated how training physicians intervene when corporal punishment (CP) is observed in a simulated hospital setting. The pilot study examined physician trainee performance in a simulation where hitting is observed between caregiver and child during a medical visit and to assess physician self-reported experiences, opinions, and comfort when observing CP in a simulation. METHODS: We ran 7 simulations where one pediatric resident, emergency medicine resident, or pediatric emergency medicine fellow participated in the simulation while a group of similar trainees observed. All participants were given a postsurvey, followed by a semistructured debriefing led by a child abuse pediatrician. RESULTS: Thirty-seven physician trainees participated; 7 engaged in the simulation while 30 observed. The majority (6/7) did not de-escalate the increasingly aggravated parent prior to hitting, 4 of 7 did not recommend that the caregiver refrain from CP, and most (5/7) did not provide education to the parent about more appropriate discipline. The majority (91.4%) believe that a physician should intervene when a parent hits or spanks his/her child in the hospital setting, highlighting the incongruity between this belief and their performance in/knowledge of intervening. All participants stated they would benefit from additional education and training on CP. CONCLUSIONS: The educational experience provided physicians in training with the opportunity to participate in or observe a situation in which CP occurs in the medical setting. The simulation and debriefing were an innovative approach to providing an educational opportunity for physicians to learn from difficult situations and discussions surrounding CP with caregivers.