Abstract
Considering the frequency of sexual abuse and domestic violence (SA-DV) in the population, the likelihood of a medical student meeting patients with this problem is substantial. However, most students do not consider SA-DV in their differential diagnoses. Since 2014, this team has been working in strengthening undergraduate curriculum in SA-DV. It has been a challenging and slow process. To identify barriers and facilitators perceived by the undergraduate teaching team in order to suggest modifications in the curriculum in relation to the competencies required for screening and early intervention for victims of SA-DV. The conclusions obtained may be useful for other medical schools and universities facing this challenge. Qualitative study using grounded theory method for the analysis of interviews and focus groups. SA-DV are perceived as a problem that is pertinent for physicians. However, there is a common belief that teaching about SA-DV should be limited to only certain specific specialties. The main barriers are the limited curricular time, the need to prioritize contents and the lack of specific training of the teachers. A key facilitator is the fact that gender violence is on the public agenda today. The identified barriers coincide with those reported in the literature; limited curricular time and prioritization of contents. Although this study does not show the perception of SA-DV as 'not a medical issue' nor as a subject that pertains to other health professionals, there is the perception that teaching clinical approach to SA-DV only pertains to specialists who are directly involved in this topic.
Highlights
Considering the frequency of sexual abuse and domestic violence (SA-DV) in the population, the likelihood of a medical student meeting patients with this problem is substantial
Evidentemente esto escapa a los alcances de este estudio, pero abre un punto de reflexión, y a su vez un primer desafío, ¿cómo integrar violencia al interior de las familias (VIF)-AS en las distintas especialidades y áreas de estudio?, pero de modo que se integre como un diagnóstico diferencial más y no sólo como una preocupación social, en un contexto en que el tema moviliza a la sociedad en su conjunto
La necesidad de contar con espacios de capacitación y trabajo guiados por parte de otros especialistas más involucrados en violencia al interior de las familias (VIF)-AS parece clave para los docentes, y es probable que las universidades deban intencionar esta estrategia, al menos en un comienzo
Summary
Considering the frequency of sexual abuse and domestic violence (SA-DV) in the population, the likelihood of a medical student meeting patients with this problem is substantial. En Chile no existe información sistematizada en relación a cuánta formación en violencia intrafamiliar y abuso sexual (VIF-AS) reciben los médicos[6]. Un estudio neozelandés mostró que entre las causas de los médicos para no preguntar por VIF-AS estaban la falta de confianza o experiencia en el abordaje de estas situaciones y una preocupación por empeorar la situación (Miller, 2007)[13]. DeLahunta y Tulsky (1998) identificaron los elementos claves para explicar la resistencia a incorporar VIF-AS en los currículos, destacando el tiempo curricular limitado y cómo este se prioriza; la opinión que la violencia “no es un tema médico”, la ambigüedad en las definiciones de maltrato y la falta de soluciones disponibles[14]. Acceder a esta información permitiría reorientar los esfuerzos realizados y serviría de base para que otras escuelas y universidades se sumen y fortalezcan sus currículos
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