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‘Beyond Milestones’: A randomised controlled trial evaluating an innovative digital resource teaching quality observation of normal child development

Authors

  • Anne M Connolly,

    Corresponding author
    1. Department of Neurology, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
    2. School of Women's and Children's Health, University of New South Wales, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
    • Correspondence: Associate Professor Ann ME Bye, Department of Neurology, Sydney Children's Hospital, High Street, Randwick, NSW 2031, Australia. Fax: 02 9382 1580; email: annie.bye@health.nsw.gov.au

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  • Clare Cunningham,

    1. Department of Neurology, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
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  • Adriane J Sinclair,

    1. Department of Neurology, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
    Current affiliation:
    1. Department of Neurology, 6th Floor Atrium 6C, Hospital for Sick Children, Toronto, ON, Canada
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  • Arjun Rao,

    1. School of Women's and Children's Health, University of New South Wales, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
    2. Department of Accident and Emergency, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
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  • Amy Lonergan,

    1. Department of Neurology, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
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  • Ann ME Bye

    1. Department of Neurology, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
    2. School of Women's and Children's Health, University of New South Wales, Sydney Children's Hospitals Network – Randwick, Randwick, New South Wales, Australia
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  • Conflict of interest: None declared.

Abstract

Aims

The study aimed to create and evaluate the educational effectiveness of a digital resource instructing paediatric trainees in a systematic approach to critical and quality observation of normal child development.

Methods

A digital educational resource was developed utilising the skills of an expert developmental paediatrician who was videoed assessing normal early child development at a series of critical stages. Videos illustrated aspects of language, sophistication of play and socialisation, cognition, and motor progress. Expert commentary, teaching text and summaries were used. A randomised controlled trial evaluated the resource. Paediatric trainees were recruited from The Sydney Children's Hospitals Network. Outcome measures were repeated at three time points (pre-teaching, immediate-post and 1 month) and included self-rated attitudes, knowledge of markers of development and observational expertise. Qualitative data on teaching usefulness were obtained through open-ended questions.

Results

Fifty-six paediatric trainees (registrar 79%, women 82%; mean age 31 years) completed the pre-assessment, 46 the immediate-post and 45 the 1-month follow-up (20% attrition). Compared with the Control group, the Teaching group scored higher over time on markers of development (P = 0.006), observational expertise (P < 0.0001), confidence (P = 0.035) and satisfaction (P < 0.0001). Teaching participants valued the video and expert commentary and reported improvement in confidence and understanding and acquiring a more structured approach.

Conclusions

The ‘Beyond Milestones’ free online resource for medical professionals <http://learnpaediatrics.org/beyondmilestones/ password=cunningham> improves knowledge, increases confidence and is useful, providing a structured approach to developmental assessment. The techniques taught can be applied to every paediatric consultation.

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