Citation

Varjavand N, Cohen DG, Novack DH. J. Gen. Intern Med. 2002; 17(6): 465-468.

Affiliation

MCP Hahnemann University School of Medicine, Philadelphia, PA 19129, USA. nielufar.varjavand@drexel.edu

Copyright

(Copyright © 2002, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1046/j.1525-1497.2002.10404.x

PMID

12133162

PMCID

PMC1495067

Abstract

Despite increased awareness of domestic violence (DV), little is known about residents' preparedness to diagnose and respond appropriately to abuse victims. We designed a pilot study to examine this. Seventy-one internal medicine residents participated in a 10-station standardized patient-based Clinical Skills Assessment. Forty (56%) were male and 31 (44%) were female; 46 (65%) were PGY I; 63 (89%) were trained internationally. One station presented a woman with headaches, whose underlying issue was DV. Forty (56%) residents correctly diagnosed DV. Thirty referred the patient for DV counseling. Eighteen addressed immediate safety concerns, and 23 asked about child abuse. Forty-eight (68%) made 1 or more incorrect recommendations. Thirty-six (51%) ordered unnecessary tests. Residents who did not diagnose DV spent nearly twice as much per patient on work-up (mean, $942.00), compared to those who diagnosed DV (mean, $421.00). Use of certain interviewing skills appeared to promote elicitation of DV. Assessment-driven educational interventions could help trainees improve their recognition of DV and make appropriate and cost-effective management choices.

Language: en