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Education & Training

 
 National Recommendations on Family Violence Education for Health Care Providers



“Training should be part of staff orientation; ongoing, repeated and institutionalized; and mandatory for all employees. Providers who will be assessing and documenting in the medical record should receive training on dynamics and clinical response as well as other staff and allied health professionals. Receptionists and security, which can play an essential role in identifying victims, should receive general awareness training on IPV. Interpreters in particular should be trained in advance about the dynamics of IPV and the importance of confidentiality and non-judgmental interpretation and appropriate word choices for translation of routine assessment questions.” National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings, Family Violence Prevention Fund, 2002. Appendix M: Preparing Your Practice

If you are planning a training for health care practitioners on intimate partner violence or would like to evaluate the training you already do, the following recommendations on educational content and methods can provide guidance. They were drawn from the Institute of Medicine publication Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence (Committee on the Training Needs of Health Professionals to Respond to Family Violence, Institute of Medicine, Washington D.C.: National Academy Press 2002.)

For training curricula that meet these recommendations, go to The Vermont Curriculum  or More Curricula.

 

Basic Level of Core Competencies Needed for Addressing Family Violence by Health Care Professionals 

Competency

Performance Indicators

Identify, assess, and document abuse
  1. Recognize risk factors for victimization and perpetration
  2. Recognize physical and behavioral signs of abuse and neglect […]
  3. Screen for family violence experiences using valid and reliable instruments that are developmentally appropriate
  4. Assess clients via interview and appropriate health examination processes.
  5. Document injuries and health effects, using forensic guidelines in obtaining and recording evidence
  6. Identify and address problems of emotional, physical and sexual abuse and neglect.

Intervene to secure safety and reduce vulnerability
  1. Assess for immediate safety
  2. Develop a safety plan with victims and families
  3. Consult with and refer to specialists and community resources for safety, education, caretaking and support services […]
  4. Maintain appropriate clinical follow-up

Recognize that cultural and value factors influence family violence
  1. Communicate non-judgmentally and compassionately
  2. Recognize the cultural factors important in influencing the occurrence and patterns of responses to family violence
  3. Provide culturally competent assessment and intervention to victims and perpetrators of family violence
  4. Explain culturally normative behaviors and relationship patterns that could be misconstrued as dysfunctional and/or violent. Recognize potential dilemmas in providing care and accessing resources that may arise from cultural differences

Recognize legal and ethical issues in treating and reporting family violence
  1. Know state reporting laws and mandates, local and state reporting agencies, and their procedures and regulations, including potential liability for failure to report.
  2. Know ethical principles that apply to patient confidentiality for victims as well as the limits of that confidentiality.
  3. Understand the need to balance respect for individual autonomy with concerns for safety vulnerable of persons when making reporting decisions
  4. Understand the health professional’s role in court testimony […]

Engage in activities to prevent family violence
  1. Promote activities to increase public awareness of family violence.
  2. Promote activities to address populations at risk.
  3. Participate in health policy activities to address family violence
  4. Promote community action to establish and enhance programs to support victims and family members and for perpetrator interventions […]
  5. Understand the impact of services (such as home visitation nurses) on the prevention of physical abuse and neglect.
  6. Understand the principles of prevention of family violence […]

 

Effective Training Methods:

In a recent systematic review of formal continuing medical education, researchers found 64 studies between 1970-1999, 14 of which met their selection criteria (randomized controlled trials). The education approaches were categorized as didactic (i.e. passive, presentation-based), interactive, and mixed. The authors concluded that “didactic interventions analyzed in this review failed to achieve success in changing professional performance or health care outcomes. In contrast, studies that used interactive techniques such as case discussion, role play, or hand on practice sessions were generally more effective in changing those outcomes [...]”.[1]

In order to develop the prerequisite attitudes, knowledge and skills effectively, the curriculum needs to cater to adult learning styles and needs. This means emphasizing experiential and interactive techniques and applying the material to health professionals’ real-life situations. The training needs to encourage multidisciplinary and community collaborative approaches to domestic violence intervention and prevention, ideally by modeling these approaches in the training delivery

 

Other Publications on Domestic Violence Education for Health Care Professionals:

  • Intimate Partner Violence and Sexual Assault: A Guide to Training Materials and Programs for Health Care Providers, Alison Osattin and Lynn Short, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 1998 (out of print, available online at http://www.cdc.gov/ncipc/pub-res/ipvasa.htm)

Brandt, E.N. (1997) Curricular Principles for Health Professions Education about Family Violence, Academic Medicine, 72, Supplement S51-S58


 

[1] Davis, D., O’Brien, M.A., et al  (1999) Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA, 282 (9), 867-874.


 

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