Transcript Introducing Violence and Abuse Education into

Introducing Violence and Abuse
Education into Undergraduate
Medical Education
Charles P. Mouton, MD, MS
Howard University College of Medicine
Dept. of Comm. And Family Medicine
AVA Biennial Scientific Assembly
April 24-25, 2009
Objectives
• To Identify the requirements for violence
education
• To identify the “access points” in the
standard medical curriculum
• To discuss innovative strategies for
violence education in the medical
curriculum
Why provide education on
Violence
• Growing problem of violence worldwide
• Health professionals are often the initial
surveillance mechanism
• Increasing understanding of the health
effects of violence
• Increasing appreciation of the costs
associated with violence
LCME Requirement
• ED-20: The curriculum must prepare
students for their role in addressing the
medical consequences of common
societal problems, for example, providing
instruction in the diagnosis, prevention,
appropriate reporting, and treatment of
violence and abuse.
When is violence currently taught
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First year ……...12.7%
Second year …. 34.5%
Third year ……. 48.7%
Fourth year …… 3.8%
•64 Schools reported a domestic violence curriculum
•63 report DV is part of the required curriculum
•1 school reported DV as an elective
Current Curricular “access
points”
• Preclinical Courses
– “Doctoring/Patient care”
– Behavioral Sciences
• Clinical Rotations
Ambulatory Medicine
Emergency Medicine
Family Medicine
Pediatrics
• Electives
Dermatology
Psychiatry
Ob/gyn
Neurology
Surgery
What are other or future
“access points”
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Radiology electives
Pathology electives
Geriatrics electives
Ethics courses
Professionalism courses
What should an Ideal Violence and Abuse
Curriculum in Medical Schools look Like?
HU Healthcare Ethics Course
• Interdisciplinary course with students and
faculty from medicine, dentistry, nursing,
pharmacy, and allied health
• Taught in clinical years using large group
lectures followed by small group
discussion using a structured format
– Designed to mimic ethics committee meeting
• Online supplements: Mastery quizzes and
group blog
• Audience response system used in large
lectures
Innovative violence education
• Similar structure with large group lectures
covering various types and effects of
abuse as well as an appropriate response.
• Small group discussion can mimic Death
Review Panels
• Visual presentations should a part
– Videos, photos, victim presentation, etc.
– Evokes emotional response with its cognitive
effects
• All strategies need to emphasize clinical
competencies
Medical Education needs to
emphasize Competencies
• Basic competencies
– Professional Behavior
– Engage and Communicate
– Apply scientific method and
knowledge to problem solving
• Component competencies
– Take a clinical history
– Perform a mental and
physical exam
– Interpret clinical tests
– Perform basic procedures
– Manage clinical info
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Physician Competencies
- Diagnosis Clinical Problems
- Intervene
- Formulate a prognosis
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Advance Competency
- Care within the practice
context
Other Strategies
• Service Learning
– Work with various DV shelters,
DARTs,CFRTs, etc.
• Student Research
• Student Advocacy
– Women in Medicine, AMSA, SNMA, Specialty
Interest Groups, etc.
Conclusion
• Education on Violence and Abuse should
be a required part of every medical school
curriculum
• Research is needed to determine the best
location in the curriculum to prepare
students to address this problem
• Any new curricula on violence and abuse
should emphasize the core competencies
and provide some experiential learning