Paediatric health and diseases speciality educationevaluation of field physicians' level of knowledge about development in early childhood and approach to developmental problems

ntroduction: In recent years, there has been a significant national and international awareness of the importance of early childhood and more attention has been paid to the planning of studies on this subject in the health system and in the field of pediatrics. Especially in middle and low-income countries, the need to include prevention and early identification of developmental difficulties of children in the health system is emphasized. Today, it is recognized that pediatricians are also responsible for the developmental and social context due to their strong influence on children's well-being. Early diagnosis and early intervention are essential to ensure that children reach their highest developmental potential and should be a priority for child health care providers. Approximately 25%-30% of all complaints in general pediatrics are of developmental or behavioral origin. It has been shown that competence in the detection and early treatment of developmental problems depends on the quality of the education received in this field during pediatrics training. Providing evidence-based and accurate information about child development to families during the examination by a pediatrician is an important opportunity to support them and prevent developmental problems. Objective: The aim of this study was to evaluate the level of knowledge of physicians receiving specialty training in the Department of Pediatrics, Faculty of Medicine Ankara University, on early childhood development and approach to developmental problems, and to evaluate the relationship between the level of knowledge of physicians receiving specialty training and the duration of training in the specialty and having received training on early childhood development and approach to developmental problems. Materials and Methods: The study was conducted between 01/05/2022 and 01/05/2023 among pediatric residents who gave consent to the study and volunteered to answer the questionnaire. A 30-question questionnaire including the inclusion of developmental issues in clinical practice, difficulties encountered and related factors was administered to 106 pediatric residents in pediatrics residency training. Findings: A total of 106 (69.7%) physicians participated in the study. Of the physicians, 85 (80.2%) were female, 21 (19.8%) were male, and the median age was 28 years 17 (minimum: 24-maximum: 47 years). The median duration of specialty training of the physicians participating in the study was 24 months (minimum: 1-maximum: 68 months), 22 (20.75%) were first year residents, 26 (24.52%) were second year residents, 20 (18.86%) were third year residents, and 38 (35.84%) were residents over the third year. The number of residents who attended Developmental Pediatrics resident courses was 61 (57.5%) and the number of residents who did not attend was 45 (42.5%). The number of participants who did developmental pediatrics rotations was 11 (10.4%) and the number of participants who did not rotate was 95 (89.6%). The number of participants who thought that they had adequate developmental support skills and attitudes during healthy child follow-up (scoring 8-9-10) was 36 (34%). ¼ of the physicians reported that they knew the tools to be used in the early diagnosis of developmental difficulties and that they could provide effective guidance by early diagnosis of developmental difficulties (18%). Physicians rated themselves as competent in the detection, evaluation and guidance of developmental risks of premature infants with developmental difficulties or risks by 26%, and in the follow-up of children with chronic diseases such as cerebral palsy, they reported that they rated themselves as competent by approximately 20%. Regarding their experiences in approaching eating and sleep problems, which are common behavioral problems encountered in early childhood, 10% of the physicians reported that they found themselves adequate. The Pearson Chi-Square test revealed a statistically significant correlation between the median of the total score of the CSQ and age (p=0.001) and months of seniority (p=0.000), having taken a developmental pediatrics resident course during residency training (p=0.000) and having rotated in developmental pediatrics. Conclusion: According to the survey results, it was observed that most of our residents were not sufficiently familiar with the basic institutions that provide and support development during healthy child follow-up. It was observed that the residents were not confident especially in evaluating and supporting the development of patients with prematurity, cerebral palsy and underlying chronic diseases and the number of residents who gave themselves a score of 8 and above in these questions was low. Key Words: Pediatrics education, Developmental problems, Pediatrics specialty training