Princess of Wales Hospital, Bridgend, Friday 8thJune 2018
Annabel Greenwood Paediatric ST3 Trainee
Broadly speaking, I feel our exposure to safeguarding training in the early years of paediatric training is limited.
Before you know it, you are the registrar on-call, out of hours, contacted with a complex child protection referral. As a junior paediatric trainee about to transition to middle-grade training, I will inevitably at some point, be faced with this scenario, and if I’m to be completely honest, the thought has previously caused a slight degree of tachycardia, hyperventilation and perspiration on my part, at the uncertainty of such a situation!
I therefore searched for a way to dispel my fears and came across a child protection simulation course set-up by Dr Emily Payne, ST8 Community Paediatric Trainee in Wales. This fantastic one-day, multiagency simulation course has certainly enhanced my confidence in the management of child protection cases and I would certainly recommend the day to my fellow trainees.
The course facilitates approximately 6-10 trainees, a perfect sized group to allow plenty of opportunity to ask questions and share our experiences with each other.
The day began with a couple of short lectures, setting the scene for the day, addressing some key safeguarding principles, including the rights and responsibilities of all doctors, and an outline of the child protection process. We also discussed the ‘ACE’ (Adverse Child Experiences) Study, which has demonstrated that for every 100 adults in Wales, 47 have suffered at least one ACE during their childhood, and 14 people suffered 4 or more events. ACE are stressful experiences occurring during childhood that directly harm a child e.g. sexual, physical or emotional abuse, or effect the environment in which they live e.g. domestic violence, mental health, parental separation. It has been shown that ACE impact across the life course, e.g. affecting neurodevelopment in the early years, potentially causing social, emotional, and cognitive impairment, and perhaps leading to the adoption of high-risk behaviours and crime later on in life.
Later in the morning we divided into pairs for 3 workshop sessions focusing on physical, emotional and sexual abuse respectively. These informal, small-group workshops were based on a clinical scenario and provided an excellent opportunity to voice any queries or concerns we had regarding the different categories of abuse.
In the afternoon, we worked through a number of simulation child protection scenarios with actors playing the role of the child’s parents, making the situation as realistic as possible. At the end of each scenario we re-grouped to provide feedback and discuss the case in more detail. I felt that this was a completely safe environment to practice leading challenging safeguarding scenarios, and found it extremely useful to receive constructive multiagency feedback, from doctors, social workers and the police.
The day was brought to a close with a simulated strategy meeting, and we all played the role of a different member of the multiagency team. This provided a fantastic insight into the role of each member of the team, and demonstrated how everyone works together to collate the evidence in order to generate an accurate account of events, to ensure the safety of the child.
I thoroughly enjoyed the course and feel that I will now make the transition to middle-grade training with enhanced knowledge and confidence to manage challenging safeguarding scenarios.
Dr Annabel Greenwood