Evaluation of a women’s safe shelter experience to teach internal medicine residents about intimate partner violence

Abstract

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...

Measuring the effectiveness of an intensive IPV training program offered to Greek general practitioners and residents of general practice

“…Moreover, current educational approaches need reassessment as many have not shown sustained changes in attitudes and actual rates of IPV screening in clinical practice [24-26]. The numerous educational interventions of mixed success [8,11,27-30], indicate that we still lack the knowledge on how to train GPs in this subject and several questions such as “what works better”, “when is better to train GPs on this subject?” remain unanswered [12,31,32].…”

Impact of Participation in a Community-Based Intimate Partner Violence Prevention Program on Medical Students: A Multi-Center Study

“…14 A number of authors have also emphasized the importance of experiential learning (i.e., learning by doing). [15][16][17][18] Currently, there are few studies of curricular approaches for training medical students to address adolescent IPV. The current study is a pilot program to compare the effectiveness of didactic education alone versus didactic education plus participation in a community-based outreach program to improve medical students' knowledge and attitudes toward working with adolescents and addressing the topic of adolescent IPV.…”

Hidden from Plain Sight: Residents' Domestic Violence Screening Attitudes and Reported Practices

“…Having a preceptor who advises to screen for DV and knowing where to refer victims were the only characteristics independently associated with definitely screening for DV, reinforcing the importance of mentorship in medical education and suggesting that providers are more inclined to ask about problems for which they have solutions 29,30 . Current educational approaches need reassessment, based on our findings, as many have not shown sustained changes in attitudes and actual rates of DV screening in clinical practice 31–33 …”