THE INFLUENCE OF CASE AND PROFESSIONAL VARIABLES ON IDENTIFICATION AND REPORTING OF PHYSICAL ABUSE - A STUDY WITH MEDICAL-STUDENTS

Identification and reporting of suspected cases of maltreatment are im portant precursors to intervention, as maltreating parents typically d o not Self-refer for treatment. Professionals from various disciplines are legally mandated to report suspected cases of child maltreatment, yet incidences of abuse can remain unidentified or unreported. Identi fication of physical abuse often depends on careful consideration of t he characteristics of the injuries and the plausibility of the explana tions provided for the injuries. Many variables impact identification, as well as the subsequent decision of whether or not td report the ca se if abuse is suspected. The study examined the influence of three ca se variables (injury severity, plausibility of explanation, and time t o seek medical attention) and two professional variables (gender of su bject and amount of clinical experience) on how medical students respo nd to hypothetical cases of abuse. As part of the study the responses of medical students were compared to those of practicing physicians. S ubjects evaluated 16 different vignettes, each describing an injured c hild, rated whether injuries may have resulted from physical abuse, an d indicated what further action should be taken with the case, includi ng whether it should be reported. Results indicated a significant thre e-way interaction between injury severity, injury explanation, and del ay. Subject gender and amount of clinical experience did not influence identification. Significant positive correlations between identificat ion and reporting were found. Correspondence between the responses of medical students and physician's was;quite strong: Implications for cl inical training of mandated reporters and directions for future resear ch are discussed.