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Ramírez SI, Partin M, Snyder AH, Ko E, Aruma J, Castaneda MC, Casas RS. A Scoping Review of Obstetrics and Gynecology Curricula in Primary Care Residency Programs. J Gen Intern Med 2024:10.1007/s11606-024-08987-1. [PMID: 39187722 DOI: 10.1007/s11606-024-08987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND While Women's Health (WH) is a priority for primary care, (Family Medicine (FM), Internal Medicine (IM), Pediatrics (Peds), and combined Medicine/Pediatrics (Med/Peds)), residency curricula remain heterogeneous with deficits in graduates' WH expertise and skills. The overall objective of this study was to assess the quality of WH curricula at primary care residency programs in the United States (US), with a focus on topics in obstetrics and gynecology (OBGYN). METHODS PubMed®, ERIC, The Cochrane Library, MedEdPORTAL, and professional organization websites were systematically searched in 2019 and updated in 2021. Included studies described OBGYN educational curricula in US primary care residency programs. Following abstract screening and full-text review, data from eligible studies was abstracted and quality assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS A total of 109 studies met the inclusion criteria. Over a quarter of studies were interdepartmental or interdisciplinary. The most common single-department studies were IM (38%) and FM (26%). Twenty (25%) studies addressed comprehensive OBGYN curricula; the most common individual topics were cervical and breast cancer screening (31%) and contraception (16%). Most studies utilized multiple instructional modalities, most commonly didactics (54%), clinical experiences (41%), and/or simulation (21%). Most studies included self-reported outcomes by residents (70%), with few (11%) reporting higher-level assessments (i.e., patient, or clinical outcomes). Most studies were single-group pre- and post-test (42%) with few randomized controlled trials (4%). The mean MERSQI score for studies with sufficient data (90%) was 9.8 (range 3 to 15.5). DISCUSSION OBGYN educational curricula for primary care trainees in the US was varied with gaps in represented residents, content, assessments, and study quality.
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Affiliation(s)
- Sarah I Ramírez
- Department of Family and Community Medicine, Penn State College of Medicine, 500 University Drive; HP 11, Hershey, PA, 17033, USA.
| | - Michael Partin
- Department of Family and Community Medicine, Penn State College of Medicine, 500 University Drive; HP 11, Hershey, PA, 17033, USA
| | - Ashley H Snyder
- Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Elizabeth Ko
- Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Jane Aruma
- Anesthesiology, Northwestern University, Evanston, IL, USA
| | - Marie C Castaneda
- Harrell Health Sciences Library: Research and Learning Commons, Penn State College of Medicine, Hershey, PA, USA
| | - Rachel S Casas
- Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
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Ragavan MI, Murray A. Supporting Intimate Partner Violence Survivors and Their Children in Pediatric Healthcare Settings. Pediatr Clin North Am 2023; 70:1069-1086. [PMID: 37865431 DOI: 10.1016/j.pcl.2023.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Intimate partner violence (IPV) is a pervasive public health epidemic that influences child health and thriving. In this article, we discuss how pediatric healthcare providers and systems can create healing-centered spaces to support IPV survivors and their children. We review the use of universal education and resource provision to share information about IPV during all clinical encounters as a healing-centered alternative to screening. We also review how to support survivors who may share experiences of IPV, focused on validation, affirmation, and connection to resources. Clinicians are provided key action items to implement in their clinical settings.
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Affiliation(s)
- Maya I Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh and UPMC Children's Hospital of Pittsburgh, 3414 Fifth Avenue, Pittsburgh, PA 15213, USA.
| | - Ashlee Murray
- Division of Pediatric Emergency Medicine, Children's Hospital of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Allison A, Weerahandi A, Johnson T, Koshan J, Bagstad G, Ferreira C, Jenney A, Krut BA, Wollny K. A Scoping Review on the Use of Experiential Learning in Professional Education on Intimate Partner Violence. JOURNAL OF FAMILY VIOLENCE 2023:1-20. [PMID: 37358988 PMCID: PMC10157572 DOI: 10.1007/s10896-023-00552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/28/2023]
Abstract
Purpose Intimate partner violence (IPV) involves any form of emotional, physical, and sexual abuse including controlling behaviors by an intimate partner. Front line service workers such as social workers, nurses, lawyers, and physicians are often the first professionals to come into contact with individuals experiencing IPV but are often inadequately prepared to respond appropriately as IPV education is highly variable. Experiential learning (EL), also known as learning by doing, has gained much attention from educators; however, the extent and type of EL strategies used to teach IPV competencies has not yet been explored. Our aim was to extract what is known from the literature about the use of EL strategies to teach IPV competencies to front line service providers. Methods We conducted a search from May 2021 through November 2021. Reviewers independently screened citations in duplicate using pre-determined eligibility criteria. Data collected included study demographics (publication year, country, etc.), study participants, and information about the IPV EL. Results Of 5216 identified studies, 61 were included. Medicine and nursing represented the majority of learners in the included literature. Graduate students were the targeted learners in 48% of articles. Low fidelity EL was used most frequently in 48% of the articles; and role play was the EL mode most frequently utilized (39%) overall. Conclusions This scoping review provides a comprehensive overview of the limited literature on how EL is used to teach IPV competencies and identifies significant gaps related to the lack of intersectional analysis within educational interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10896-023-00552-4.
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Affiliation(s)
- Aurora Allison
- Faculty of Law, University of Calgary, Calgary, AB Canada
| | - Ambereen Weerahandi
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | - Torri Johnson
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | | | - Georgina Bagstad
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | - Carla Ferreira
- School of Nursing, University of British Columbia, Vancouver, BC Canada
| | - Angelique Jenney
- Faculty of Social Work, University of Calgary, Calgary, AB Canada
| | - Breanne A. Krut
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | - Krista Wollny
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
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Takov V, Harnden A, Rummel K, Burnell M, McMann S, Wargel CE, Seelbach C, McQuiston J, Brannan GD. Evaluation of a Community Hospital-Based Residencies' Intimate Partner Violence Education by a Domestic Violence Shelter Expert. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095685. [PMID: 37174203 PMCID: PMC10178116 DOI: 10.3390/ijerph20095685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Intimate partner violence, or IPV, is estimated to affect an estimated 10 million Americans. From 2015-2017 our community hospital-based residencies trained first-year residents to improve education in recognizing and screening for IPV. This retrospective cohort study's goal was to analyze the longitudinal effectiveness of the educational program. The education was based on a curriculum created by Futures Without and the United States Office on Violence Against Women. The curriculum was taught by Turning Point, the local county provider for victims of domestic and sexual violence, and involved five hours of training. Physician Readiness to Manage Intimate Partner Violence Survey was used as the assessment tool. Residents were measured pre-, post immediate, and one-year post-education. Measures that include perceived knowledge and perceived preparation improved post immediate and one year after the training (p = 0.0001). Actual knowledge increased significantly post immediate but decreased after one year (p = 0.0001). The proportion of residents who screened patients and the proportion of patients who were screened increased post-intervention. The educational training provided by our local shelter improved residents' performance in several of the categories tested, but most importantly, improved IPV practice post immediate and generally one year after.
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Affiliation(s)
| | | | - Kegan Rummel
- Spectrum Health Gerber Memorial Multispecialty Clinic, Fremont, MI 49412, USA
| | | | | | | | | | | | - Grace D Brannan
- McLaren Macomb Hospital, Mt. Clemens, MI 48043, USA
- GDB Research and Statistical Consulting, Athens, OH 45701, USA
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Burns CJ, Borah L, Terrell SM, James LN, Erkkinen E, Owens L. Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:401-409. [PMID: 36538661 DOI: 10.1097/acm.0000000000005046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Trauma-exposed persons often experience difficulties accessing medical care, remaining engaged in treatment plans, and feeling psychologically safe when receiving care. Trauma-informed care (TIC) is an established framework for health care professionals, but best practices for TIC education remain unclear. To remedy this, the authors conducted a multidisciplinary scoping literature review to discern best practices for the design, implementation, and evaluation of TIC curricula for health care professionals. METHOD The research team searched Ovid MEDLINE, Cochrane Library, Elsevier's Scopus, Elsevier's Embase, Web of Science, and the PTSDpubs database from the database inception date until May 14, 2021. Worldwide English language studies on previously implemented TIC curricula for trainees or professionals in health care were included in this review. RESULTS Fifty-five studies met the inclusion criteria, with medicine being the most common discipline represented. The most prevalent learning objectives were cultivating skills in screening for trauma and responding to subsequent disclosures (41 studies [74.5%]), defining trauma (34 studies [61.8%]), and understanding trauma's impact on health (33 studies [60.0%]). Fifty-one of the studies included curricular evaluations, with the most common survey items being confidence in TIC skills (38 studies [74.5%]), training content knowledge assessment (25 studies [49.0%]), participant demographic characteristics (21 studies [41.2%]), and attitudes regarding the importance of TIC (19 studies [37.3%]). CONCLUSIONS Future curricula should be rooted in cultural humility and an understanding of the impacts of marginalization and oppression on individual and collective experiences of trauma. Moreover, curricula are needed for clinicians in more diverse specialties and across different cadres of care teams. Additional considerations include mandated reporting, medical record documentation, and vicarious trauma experienced by health care professionals.
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Affiliation(s)
- Courtney Julia Burns
- C.J. Burns is a medical student, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0002-3216-5921
| | - Luca Borah
- L. Borah is a medical student, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-8975-1051
| | - Stephanie M Terrell
- S.M. Terrell is a medical student, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-7776-4621
| | - LaTeesa N James
- L.N. James is a health sciences informationist, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0002-5955-2876
| | - Elizabeth Erkkinen
- E. Erkkinen is a medical student, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0002-3522-7286
| | - Lauren Owens
- L. Owens is assistant professor, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; ORCID https://orcid.org/0000-0002-8277-2826
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Toh RQE, Koh KK, Lua JK, Wong RSM, Quah ELY, Panda A, Ho CY, Lim NA, Ong YT, Chua KZY, Ng VWW, Wong SLCH, Yeo LYX, See SY, Teo JJY, Renganathan Y, Chin AMC, Krishna LKR. The role of mentoring, supervision, coaching, teaching and instruction on professional identity formation: a systematic scoping review. BMC MEDICAL EDUCATION 2022; 22:531. [PMID: 35804340 PMCID: PMC9270794 DOI: 10.1186/s12909-022-03589-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/23/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Mentoring's pivotal role in nurturing professional identity formation (PIF) owes much to its combined use with supervision, coaching, tutoring, instruction, and teaching. However the effects of this combination called the 'mentoring umbrella' remains poorly understood. This systematic scoping review thus aims to map current understanding. METHODS A Systematic Evidence-Based Approach guided systematic scoping review seeks to map current understanding of the 'mentoring umbrella' and its effects on PIF on medical students and physicians in training. It is hoped that insights provided will guide structuring, support and oversight of the 'mentoring umbrella' in nurturing PIF. Articles published between 2000 and 2021 in PubMed, Scopus, ERIC and the Cochrane databases were scrutinised. The included articles were concurrently summarised and tabulated and concurrently analysed using content and thematic analysis and tabulated. The themes and categories identified were compared with the summaries of the included articles to create accountable and reproducible domains that guide the discussion. RESULTS A total of 12201 abstracts were reviewed, 657 full text articles evaluated, and 207 articles included. The three domains identified were definitions; impact on PIF; and enablers and barriers. The mentoring umbrella shapes PIF in 3 stages and builds a cognitive base of essential knowledge, skills and professional attitudes. The cognitive base informs thinking, conduct and opinions in early supervised clinical exposure in Communities of practice (COP). The COPs' individualised approach to the inculcation of desired professional characteristics, goals, values, principles and beliefs reshapes the individual's identity whilst the socialisation process sees to their integration into current identities. CONCLUSION The mentoring umbrella's provides personalised longitudinal support in the COP and socialisation process. Understanding it is key to addressing difficulties faced and ensuring holistic and timely support.
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Affiliation(s)
- Rachelle Qi En Toh
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Kai Kee Koh
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Jun Kiat Lua
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Ruth Si Man Wong
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Aiswarya Panda
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Chong Yao Ho
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Nicole-Ann Lim
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Victoria Wen Wei Ng
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Sabine Lauren Chyi Hui Wong
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Luke Yu Xuan Yeo
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Sin Yee See
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Jolene Jing Yin Teo
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Yaazhini Renganathan
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore Blk MD6, Centre for Translational Medicine, 14 Medical Dr, #05-01, Singapore, 117599, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 16961, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Steen M, Raynor J, Baldwin CD, Jee SH. Child Adversity and Trauma-Informed Care Teaching Interventions: A Systematic Review. Pediatrics 2022; 149:184788. [PMID: 35165742 DOI: 10.1542/peds.2021-051174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Health professionals need training to provide trauma-informed care (TIC) for children with adverse childhood experiences (ACEs), which can affect short- and long-term health. We summarize and evaluate published curricula for health professionals on ACEs and TIC. METHODS We searched PubMed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, PsychInfo, and MedEdPORTAL through January 2021. Studies meeting the following criteria were included: Described teaching interventions on ACEs, TIC, and child abuse and maltreatment; included health care providers or trainees as learners; were written in English; included an abstract; and described a curriculum and evaluation. We reviewed 2264 abstracts, abstracted data from 79 studies, and selected 51 studies for qualitative synthesis. RESULTS Studies focused on ACEs/TIC (27), child abuse (14), domestic/intimate partner violence (6), and child maltreatment/parental physical punishment (4). Among these 51 studies, 43 were published since 2010. Learners included a mix of health professionals (34) and students (17). Duration, content, and quality of the 51 curricula were highly variable. An analysis of 10 exemplar curricula on ACEs and/or TIC revealed high and very high quality for methods and moderate to very high quality for curriculum evaluation, suggesting that they may be good models for other educational programs. Four of the 10 exemplars used randomized controlled trials to evaluate efficacy. Studies were limited to English language and subject to publication bias. CONCLUSIONS ACEs and TIC are increasingly relevant to teaching health professionals, especially pediatricians, and related teaching curricula offer good examples for other programs.
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Affiliation(s)
| | - Jennifer Raynor
- Edward G. Miner Library, University of Rochester Medical Center, Rochester, New York
| | | | - Sandra H Jee
- Division of General Pediatrics, Department of Pediatrics.,Center for Community Health and Prevention, Rochester, New York
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Darling A, Ullman E, Novak V, Doyle M, Dubosh NM. Design and Evaluation of a Curriculum on Intimate Partner Violence for Medical Students in an Emergency Medicine Clerkship. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1279-1285. [PMID: 36262384 PMCID: PMC9575587 DOI: 10.2147/amep.s365450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/22/2022] [Indexed: 05/16/2023]
Abstract
PURPOSE Intimate partner violence (IPV) is a widespread public health issue that is relevant to all areas of medicine. Patients who suffer from IPV often contact the health care system via the emergency department, making this a particularly important but too often overlooked issue in this setting. Education on IPV varies in medical schools and emergency medicine (EM) educational programs, and evidence suggests that a barrier to assessing for IPV is a lack of adequate training of clinicians. In this study, we sought to design, implement and evaluate the efficacy of a curriculum on IPV geared towards medical students on an EM clerkship. METHODS We assembled a multi-disciplinary team of EM education faculty, a resident content expert on IPV, and social workers to design a two-part curriculum that was administered to medical students on an EM clerkship. The curriculum involved a 20-minute narrated slide presentation viewed asynchronously, followed by a 1-hour case-based discussion session. The curriculum was evaluated using a 13-item self-assessment survey on knowledge, comfort level and skill in managing victims of IPV, administered electronically before and after the curriculum. Survey results were compared pre- and post-curriculum using Wilcoxon signed-rank test. RESULTS Thirty-four students completed the curriculum and 26 completed both the pre and post self-assessment surveys. A statistically significant improvement in knowledge, comfort level and skills was observed in 11 of the 13 survey elements. CONCLUSION Based on the self-assessment survey results, this curriculum was well received and successfully increased participants' comfort, knowledge and skill level regarding assessment of patients for IPV. This is a focused and feasible curriculum that can be easily incorporated into an EM clerkship to provide effective education on a relevant but often overlooked topic.
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Affiliation(s)
- Alanna Darling
- Department of Emergency Medicine, UMass Chan Medical School – Baystate Medical Center, Springfield, MA, USA
- Correspondence: Alanna Darling, UMass Chan Medical School - Baystate Medical Center, Department of Emergency Medicine, 759 Chestnut St., Springfield 5, S5426, Springfield, MA, 01199, USA, Tel +1 508-414-4492, Email ;
| | - Edward Ullman
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Victor Novak
- Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Melissa Doyle
- Center for Violence Prevention and Recovery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Nicole M Dubosh
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
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Peters MJ, Roffey DM, Lefaivre KA. Effect of orthopaedic resident education on screening for intimate partner violence. Inj Epidemiol 2021; 8:62. [PMID: 34715939 PMCID: PMC8554514 DOI: 10.1186/s40621-021-00355-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/30/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Intimate Partner Violence (IPV) is prevalent in women presenting to orthopaedic fracture clinics. Rates of IPV have increased during the COVID-19 global pandemic. Our aim was to determine the effect of educational experiences on IPV knowledge and IPV screening to inform best-practices in resident education. METHODS Cross-sectional online survey of orthopaedic surgery residency programs in Canada. Demographics, IPV educational experiences, IPV knowledge, and frequency of IPV screening were collected via a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS). Descriptive statistics and regression modeling identified predictors of IPV knowledge and frequency of IPV screening. RESULTS Responses were obtained from 105 orthopaedic residents; 84% participated in classroom training, 39% underwent mentorship training, 32% received both classroom training and mentorship, and 10% reported neither. Classroom training had no statistically significant association with IPV knowledge or frequency of IPV screening. Residents who received mentorship were 4.1 times more likely to screen for IPV (95% CI: 1.72-10.05), older residents were more likely to screen for IPV (OR: 8.3, 95% CI: 2.64-29.84), and senior residents were less likely to screen for IPV than junior residents (OR: 0.29, 95% CI: 0.09-0.82). CONCLUSIONS Classroom training was not associated with any effect on IPV knowledge nor the frequency of IPV screening. Educational efforts should be targeted at increasing mentorship opportunities in order to improve IPV screening practices in Canadian orthopaedic residents.
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Affiliation(s)
- Mikaela J. Peters
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia: Diamond Health Care Centre, 11th Floor - 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Darren M. Roffey
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia: Diamond Health Care Centre, 11th Floor - 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal Health: Diamond Health Care Centre, 3rd Floor - 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Kelly A. Lefaivre
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia: Diamond Health Care Centre, 11th Floor - 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal Health: Diamond Health Care Centre, 3rd Floor - 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
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