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

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.