• A E F N Smeekens, D M Broekhuijsen-van Henten, J S Sittig, I M B Russel, O Th J ten Cate, N M Turner, and E M van de Putte.
• University Medical Center Utrecht, Utrecht, The Netherlands.
• Arch. Dis. Child. 2011 Apr 1; 96 (4): 330-4.

ObjectiveTo 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).DesignBlinded, randomised controlled trial using pre- and postintervention design.SettingThe ED of a University Medical Center in the Netherlands.Participants38 ED nurses were included, 25 nurses were analysed.InterventionHalf of the participants followed a 2-hour e-learning programme focused on the recognition of child abuse, the others acted as a control group.Main Outcome MeasurementsIndividual 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).ResultsDuring 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.ConclusionE-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.

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