우리나라 아동학대 관리에서 임상법의학적 진찰 교육 및 훈련: 독일, 영국, 호주 및 미국과 비교
Education and Training of Clinical Forensic Examination in the Management of Child Abuse in Korea: Comparison with Germany, the United Kingdom, Australia, and the United States of America
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A physician is crucial in the early recognition and reporting of suspected child abuse cases to avoid fatal outcomes. In 2021, the reported rate of suspected child abuse by healthcare providers in Korea was only 1.1%. It appeared that the low reported rate by physicians are mostly due to lack of confidence in diagnosis. Clinical forensic examination by trained physicians is essential on the first physical examination on suspected cases of child abuse, focusing on documentation of injuries and preservation of evidence for legal processing. While Germany, the United Kingdom, Australia, and the United States of America have their own education and training system of clinical forensic examination stressed on undergraduate medical students and physicians, the concept of clinical forensic medicine remains insufficiently known in Korea. To effectively implement the clinical forensic examination in the management of child abuse, it is essential to understand the current status of the curriculum for medical students and physicians. A more practical and integrated education program for medical students should be developed based on real cases incorporated by the experiences of forensic pathologists. Considering the overall shortage of forensic pathologists, pediatricians, and emergency medicine physicians concerned with child abuse, postgraduate training should be focused on securing a small number of clinicians and forensic pathologists specialized in clinical forensic examination to seize the referred cases of child abuse.
Abstract
A physician is crucial in the early recognition and reporting of suspected child abuse cases to avoid fatal outcomes. In 2021, the reported rate of suspected child abuse by healthcare providers in Korea was only 1.1%. It appeared that the low reported rate by physicians are mostly due to lack of confidence in diagnosis. Clinical forensic examination by trained physicians is essential on the first physical examination on suspected cases of child abuse, focusing on documentation of injuries and preservation of evidence for legal processing. While Germany, the United Kingdom, Australia, and the United States of America have their own education and training system of clinical forensic examination stressed on undergraduate medical students and physicians, the concept of clinical forensic medicine remains insufficiently known in Korea. To effectively implement the clinical forensic examination in the management of child abuse, it is essential to understand the current status of the curriculum for medical students and physicians. A more practical and integrated education program for medical students should be developed based on real cases incorporated by the experiences of forensic pathologists. Considering the overall shortage of forensic pathologists, pediatricians, and emergency medicine physicians concerned with child abuse, postgraduate training should be focused on securing a small number of clinicians and forensic pathologists specialized in clinical forensic examination to seize the referred cases of child abuse.
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