Although intimate partner violence (IPV) remains a major public health problem, physicians often fail to screen female patients. Reported IPV training approaches suffer from weak study designs and limited outcome assessments. We hypothesized that an educational experience for residents at a women's safe shelter would have significantly greater impact on IPV competencies, screening, and care for victims than a workshop seminar alone. In a pre-post randomized controlled trial, we compared residents exposed to the workshop seminar alone (controls) to residents exposed to these methods plus an experience at a women's safe shelter (cases). Competencies were assessed by written questionnaire and included knowledge, skills, attitudes, resource awareness, and screening behaviors. Of the 36 residents in the trial, 22 (61%) completed both pre-and postquestionnaires. Compared to controls, cases showed significantly greater pre-post improvement in the knowledge composite subscale. There were no significant differences between cases and controls in the subscales of skills, attitudes, or resource awareness. Cases increased their self-reported screening frequency but this did not differ significantly from the controls. Enhancing traditional IPV curriculum with a women's safe shelter educational experience may result in small improvements in residents' knowledge about IPV. Residency programs commonly offer lectures, seminars, videotapes, or role plays about IPV. We developed a curriculum that supplements these instructional strategies with an experience at a women's safe shelter, hypothesizing that directly interacting with victims would have a significant impact on residents, thereby improving IPV competencies, screening, and care for victims. In a randomized controlled trial, we evaluated the impact of the shelter experience on residents' knowledge, self-reported skills, attitudes, resource awareness, and screening behaviors concerning IPV. We isolated this effect by providing control residents with the identical curriculum with the exception of the shelter experience. METHODS Subjects and SettingWe studied residents in a university-based primary care Internal Medicine residency program. In the study year, this program had 69 residents (61 categorical, 8 preliminary), of whom 10% were Internal Medicine graduates, 42% minorities, and 43% female. The residents within the program rotate between 2 community hospitals and 1 large tertiary care university hospital.Residents were eligible for the study if assigned to the outpatient ambulatory block rotation during academic year [2001][2002]. Eligible residents were randomized using a random numbers table to either the workshop seminar alone (controls) or the workshop seminar plus shelter experience (cases). Educational InterventionsWorkshop Seminar (All Participants). The workshop seminar included a didactic session presenting background information about IPV, including definition, prevalence, risk factors, and specific instruction on ''how to'' screen, diagnose, and inter...
The use of an audiotaped analysis in a continuous case seminar is evaluated. We compare this case seminar to the traditional one in which an analyst presents process notes, and find that the use of the tape lends itself readily to teaching microanalysis, principles of technique, and observation of affect. Listening to anonymous taped sessions allowed for the possibility of a freer climate for discussion, as none of the seminar participants had a personal relationship with the taped analyst. The disadvantages posed by the absence of the analyst during the seminar also are addressed.
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