'Beyond Milestones': a randomised controlled trial evaluating an innovative digital resource teaching quality observation of normal child development

J Paediatr Child Health. 2014 May;50(5):393-8. doi: 10.1111/jpc.12485. Epub 2013 Dec 23.


Aims: The study aimed to create and evaluate the educational effectiveness of a digital resource instructing paediatric trainees in a systematic approach to critical and quality observation of normal child development.

Methods: A digital educational resource was developed utilising the skills of an expert developmental paediatrician who was videoed assessing normal early child development at a series of critical stages. Videos illustrated aspects of language, sophistication of play and socialisation, cognition, and motor progress. Expert commentary, teaching text and summaries were used. A randomised controlled trial evaluated the resource. Paediatric trainees were recruited from The Sydney Children's Hospitals Network. Outcome measures were repeated at three time points (pre-teaching, immediate-post and 1 month) and included self-rated attitudes, knowledge of markers of development and observational expertise. Qualitative data on teaching usefulness were obtained through open-ended questions.

Results: Fifty-six paediatric trainees (registrar 79%, women 82%; mean age 31 years) completed the pre-assessment, 46 the immediate-post and 45 the 1-month follow-up (20% attrition). Compared with the Control group, the Teaching group scored higher over time on markers of development (P = 0.006), observational expertise (P < 0.0001), confidence (P = 0.035) and satisfaction (P < 0.0001). Teaching participants valued the video and expert commentary and reported improvement in confidence and understanding and acquiring a more structured approach.

Conclusions: The 'Beyond Milestones' free online resource for medical professionals <http://learnpaediatrics.org/beyondmilestones/ password=cunningham> improves knowledge, increases confidence and is useful, providing a structured approach to developmental assessment. The techniques taught can be applied to every paediatric consultation.

Keywords: child development; developmental assessment; developmental milestone; developmental screening; medical education.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Australia
  • Child Development*
  • Child, Preschool
  • Clinical Competence*
  • Computer-Assisted Instruction / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Pediatrics / education*
  • Video Recording*