Family violence (adult domestic violence, child abuse/neglect, and elder abuse) is endemic. Victims of family violence are seen in every venue of health care, yet physicians do not routinely inquire about abuse, even when patients present with obvious clinical characteristics. Although a comprehensive health care response is key to a coordinated community-wide approach to family violence, most practicing physicians have never received education in any aspect of family violence, including child abuse. This paper reports the results of a survey of family violence instruction in medical schools.A written survey of medical school deans and student representatives of all 126 U.S. medical schools was conducted to (1) determine curriculum content in family violence, (2) assess differences between deans' and students' perceptions of curricular offerings, and (3) compare the results of the current survey with those of an earlier curriculum survey conducted in 1987.The majority of deans reported existing curriculum in all three topic areas of family violence. Compared to the 1987 survey, more deans reported existing curriculum in family violence. However, neither total instructional time nor curriculum during clinical training increased. Moreover, student and dean responses were discrepant regarding awareness of curriculum in domestic violence and elder abuse.Despite an increase in the number of schools reporting curriculum in family violence, there does not appear to be increased attention to this problem, at least as measured by time devoted to teaching. Insights from this descriptive survey can promote ongoing efforts toward comprehensive curriculum development in family violence.
Physicians in every field of practice can expect to be called upon to care for patients whose lives have been affected by interpersonal violence. Although the medical profession has begun to acknowledge the appropriate role of physicians in screening, diagnosis, and treatment of interpersonal violence, these areas have not been fully addressed in the curricula of most medical schools. Competencies in the understanding of violence and its treatment are proposed for medical students, residents, and practicing physicians. By the time of graduation, all medical students should be able to demonstrate appropriate attitudes, core knowledge, and basic skills in assessment and intervention of patients at risk from or experiencing violence. During postgraduate training, residents should amass specialized knowledge and skill concerning the spectrum of injuries and illnesses they may encounter in clinical practice. Faculty development efforts should address the advancement of faculty who are well trained in a scholarly approach to teaching and research in this field. This paper describes methods by which educational efforts in interpersonal violence can be introduced into medical education. Proposed goals and objectives for curriculum development in schools of medicine, along with an implementation plan, are offered.
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