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Successful e-learning programme on the detection of child abuse in Emergency Departments: a randomised controlled trial
  1. A E F N Smeekens1,
  2. D M Broekhuijsen-van Henten2,
  3. J S Sittig1,
  4. I M B Russel1,
  5. O Th J ten Cate1,
  6. N M Turner1,
  7. E M van de Putte1
  1. 1University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Isala Clinical Centre, Zwolle, The Netherlands
  1. Correspondence to E van de Putte, KE04.133.1, University Medical Center Utrecht, Post box 85090, 3508 AB, Utrecht, The Netherlands; e.vandePutte{at}


Objective To evaluate the effectiveness of an electronic learning (e-learning) programme on the performance of nurses in the recognition of child abuse in a simulated case in the Emergency Department (ED).

Design Blinded, randomised controlled trial using pre- and postintervention design.

Setting The ED of a University Medical Center in the Netherlands.

Participants 38 ED nurses were included, 25 nurses were analysed.

Intervention Half of the participants followed a 2-h e-learning programme focused on the recognition of child abuse, the others acted as a control group.

Main outcome measurements Individual performance during a case-simulated parent interview to detect child abuse and self-reported self-efficacy for the detection of child abuse. Performance on the simulation was scored by an expert panel using a standardised assessment form which was designed to score quantity and quality of the questions posed by the nurse (minimum score 0; maximum score 114).

Results During post-test, nurses in the intervention group performed significantly better during the simulation than the control group, (89 vs 71, 95% CI 2.9 to 33.3), and reported higher self-efficacy (502 vs 447, 95% CI −25.4 to 134.7). Performance in detecting child abuse correlated positively with the self-efficacy score (Spearman correlation 0.387, p value 0.056). Comparing post- and pretest results separately for the intervention and the control group showed a significant increase in performance in the intervention group.

Conclusion E-learning improved the performance in case simulations and the self-efficacy of the nurses in the ED in the detection of child abuse. Wider implementation of the e-learning programme to improve the first step in the detection of child abuse is recommended.

Trial registration Protocol registration system of NCT00844571

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  • DMB-vH and JSS contributed equally to this work.

  • Funding The study was funded by Augeo foundation.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.