Knowledge, attitude, and practice regarding child maltreatment amongst Iranian medical students through internship course: An 18-month longitudinal study

Background: Child maltreatment or abuse has been a worldwide major problem and has remained a persistent public health challenge in all countries. Physicians have a significant role in the prevention and intervention of child maltreatment. An educated physician that can effectively identify and report child maltreatment, can fill one of the largest gaps in reducing child abuse.This study was performed to examine the knowledge, attitude, and practice regarding child maltreatment amongst Iranian medical students through internship course. Method: All the medical students (235 students) of the Iran University of Medical Sciences who passed the internship entrance exam in 2019-2020 academic year participated in this study. The participants completed the questionnaire about their attitude, knowledge and practice skills in the first month of their internship course and then completed the same questionnaire 18 months later, at the end-point of the internship period. Results: : 139 (59.1%) participants were female and 96 (40.9%) were male. The mean age of the subjects was 24.35±0.76. Only 7 (3%) of them formerly received any education about child maltreatment.There was a significant difference in scores of the knowledge of diagnosis (p-value< 0.001), the practice of prevention (p-value< 0.002) and the general subscale of the practice section (p-value< 0.001) during the internship course. However, the performance of participants decreased with a significant difference in the subscales of the attitude towards diagnosis (p-value< 0.001) and the attitude towards reporting (p-value< 0.001).At the end of the study, the result of graduated physicians was: The total knowledge and attitude of participants were satisfactory and the majority of the participants were at good levels. Although, in the practice subscale, 70.6% of the participants didn’t identify, 84.7% didn’t refer, and 86.4% didn’t report a case of child abuse in the past year. Conclusion: The knowledge and attitude of Iranian recently graduated physicians regarding child maltreatment are at a satisfactory level. Although, the practice level has deficiencies and needs more education. In addition, the change of the knowledge, attitude and practice regarding child maltreatment of medical students during internship course is not sufficient and there are multiple obstacles that need to be solved.