1. 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

2. 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

3. 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

4. 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.

5. When is violence currently taught
First year …… %
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

6. Current Curricular “access points”
Preclinical Courses
“Doctoring/Patient care”
Behavioral Sciences
Clinical Rotations
Ambulatory Medicine Psychiatry
Emergency Medicine Ob/gyn
Family Medicine Neurology
Pediatrics Surgery
Electives
Dermatology

7. What are other or future “access points”
Radiology electives
Pathology electives
Geriatrics electives
Ethics courses
Professionalism courses
What should an Ideal Violence and Abuse Curriculum in Medical Schools look Like?

8. 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

9. 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

10. 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
Physician Competencies
- Diagnosis Clinical Problems
- Intervene
- Formulate a prognosis
Advance Competency
- Care within the practice context

11. Other Strategies Service Learning Student Research Student Advocacy
Work with various DV shelters, DARTs,CFRTs, etc.
Student Research
Student Advocacy
Women in Medicine, AMSA, SNMA, Specialty Interest Groups, etc.

12. 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