Developmental Delay? Graduating Medical Students’ Knowledge of Child Development

Abstract

Abstract BACKGROUND: Knowledge of child development is fundamental to medical practice. Previous studies have demonstrated gaps in knowledge and training among trainees and practicing physicians. We conducted a longitudinal study of medical students’ knowledge of child development. Previously, we reported that students’ knowledge of developmental milestones was poor at baseline, did not improve after preclinical teaching and improved marginally after pediatrics clerkship. Here, we report the report the data on graduating medical students. OBJECTIVES: The present study aimed to describe graduating medical students’ knowledge of developmental milestones in comparison to their baseline knowledge. A secondary aim was to compare graduating students' knowledge to that of the general population. DESIGN/METHODS: We assessed medical students' knowledge of developmental milestones using a previously published 17-item questionnaire. Milestones were categorized as motor or non-motor. Students were surveyed at the start of medical school in Year 1 and prior to graduation in Year 4. Changes in students' scores were assessed using paired t-tests. Graduating medical students were compared to a published general population sample using t-tests. RESULTS: 56 students completed the survey in both Years 1 and 4 (33% of entering class). Overall, students’ percentage of correct answers increased from 24% at baseline to 32% at graduation (p<0.001). Knowledge of motor milestones did not change significantly between Years 1 and 4. Knowledge of non-motor milestones improved significantly between Years 1 and 4 (p<0.001). 85 medical students completed the questionnaire in Year 4 (50% of entering class). Compared to a sample of the general population (n=1198), graduating medical students answered 1.0 more questions correctly out of 17 (p<0.001). Students’ knowledge of non-motor milestones was greater than that of the general population (p<0.001). Knowledge of motor milestones did not differ significantly. CONCLUSION: Medical students' knowledge of developmental milestones improved only modestly over the course of their undergraduate medical education. At graduation, their knowledge of developmental milestones was marginally better than that of the general population. This level of knowledge is likely insufficient for generalist practice. At the undergraduate level, curricular improvements including innovative teaching strategies and greater student engagement are likely necessary to remediate this knowledge gap. Pediatricians supervising medical students and residents should not assume that trainees have an adequate knowledge of normal child development and may wish to highlight the developmental achievements of typically developing children as part of their clinical teaching.