Assessment of a Cross‐Disciplinary Domestic Violence Training for Emergency Medicine Residents and Law Students

Abstract

Objectives: Domestic violence (DV) patients often have complex medical, social and legal issues that challenge assessment, treatment and referral. We designed a brief cross‐disciplinary training for emergency medicine residents and upper level law students to determine the baseline level of resident and law student competence in assessment and management of patients with a history of domestic violence.Methods: The study included 23 emergency medicine residents and 28 upper level law students at an urban university. The design included pretest, intervention, and retest with 4 standardized patient assessments. The intervention included for each 2 hours of cross‐disciplinary lectures on DV and one joint case‐based 2 hour learning session with the medical and legal learners. Communication skills (CSs) were assessed using a validated criterion standard. History taking competence (HX) was assessed with a prespecified checklist of critical elements designed to elicit key medico‐legal factors relevant to each case. Data were compared with t tests.Results: 18 (78%) residents and 26 (93%) law students completed the study. Pre‐intervention, residents scored 63% (8% standard deviation (SD)) on CS and gathered 71% (13%) of critical HX elements. Law students scored 62% (8%) on CS and gathered 66% (8%) of critical HX elements. Residents (64% (6%)) and law students (63% (6%) showed similar post‐intervention CS scores. Both residents (77% (10%), improvement 6%, p = 0.13) and law students (71% (14%), improvement 8%, p = .15) showed modest but non‐significant improvement in critical HX gathering.Conclusions: A brief cross‐disciplinary training between medical and legal learners demonstrated low baseline scores in DV assessment for both learning groups with modest, but non‐significant improvements in gathering of critical HX elements following intervention. Longer didactic training or more focused skill building might improve skills.