Confronting Chronic Neglect:: The Education and Training of Health Professionals on Family Violence

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National Academies Press, Apr 4, 2002 - Social Science - 368 pages
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As many as 20 to 25 percent of American adults-or one in every four people-have been victimized by, witnesses of, or perpetrators of family violence in their lifetimes. Family violence affects more people than cancer, yet it's an issue that receives far less attention. Surprisingly, many assume that health professionals are deliberately turning a blind eye to this traumatic social problem.

The fact is, very little is being done to educate health professionals about family violence. Health professionals are often the first to encounter victims of abuse and neglect, and therefore they play a critical role in ensuring that victims-as well as perpetrators-get the help they need. Yet, despite their critical role, studies continue to describe a lack of education for health professionals about how to identify and treat family violence. And those that have been trained often say that, despite their education, they feel ill-equipped or lack support from by their employers to deal with a family violence victim, sometimes resulting in a failure to screen for abuse during a clinical encounter.

Equally problematic, the few curricula in existence often lack systematic and rigorous evaluation. This makes it difficult to say whether or not the existing curricula even works.

Confronting Chronic Neglect offers recommendations, such as creating education and research centers, that would help raise awareness of the problem on all levels. In addition, it recommends ways to involve health care professionals in taking some responsibility for responding to this difficult and devastating issue.

Perhaps even more importantly, Confronting Chronic Neglect encourages society as a whole to share responsibility. Health professionals alone cannot solve this complex problem. Responding to victims of family violence and ultimately preventing its occurrence is a societal responsibility

  

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Contents

Introduction
13
THE CHARGE TO THE COMMITTEE
15
DEFINITIONAL ISSUES
17
ORGANIZATION OF THE REPORT
20
Defining the Problem
21
HEALTH PROFESSIONALS ROLES
27
CONCLUSIONS
33
Current Educational Activities in the Health Professions
35
TRAINING OUTCOMES AND EFFECTIVENESS
97
QUALITY OF THE EVIDENCE BASE
105
CONCLUSIONS
107
Training Beyond the State of the Art
108
CORE COMPETENCIES
109
ACHIEVING COMPETENCY THROUGH EDUCATION AND TRAINING
122
INFLUENCING FAMILY VIOLENCE EDUCATION IN THE FUTURE
134
CONCLUSIONS
138

PHYSICIAN ASSISTANTS
38
NURSING
39
PSYCHOLOGY
40
SOCIAL WORK
42
CONCLUSIONS
43
Forces Influencing Health Professionals Education
45
INTRINSIC INFLUENCES ON THE TRAINING ENVIRONMENT
46
ACCREDITATION LICENSURE AND CERTIFICATION REQUIREMENTS
54
PROFESSIONAL AND PERSONAL FACTORS
56
PROFESSIONAL ORGANIZATIONS AND STAKEHOLDER GROUPS
60
LAWS MANDATING REPORTING AND EDUCATION
68
RESOURCE ISSUES
74
CONCLUSIONS
81
Evaluation of Training Efforts
84
SEARCH STRATEGY
85
TYPES OF TRAINING EFFORTS EVALUATED
88
ASSESSING THE AVAILABLE EVIDENCE
90
CHARACTERISTICS OF THE EVALUATION AND RESEARCH BASE
92
Priorities for Health Professional Training on Family Violence
141
CONCLUSIONS
145
RECOMMENDATIONS
152
FINAL THOUGHTS
160
References
161
Appendixes
191
Accreditation Requirements
193
Policy Statements of Health Professional Organizations
197
Mandatory Reporting Laws for Family Violence
205
Mandatory Education Laws for Family Violence
229
Existing Curricula on Family Violence
233
Summary of Evaluation Studies on Training of Health Care Professionals on Intimate Partner Violence
269
Summary of Evaluation Studies on Training of Health Care Professionals on Child Abuse and Neglect
317
Core Competencies for Family Violence
327
Biographical Sketches of Committee Members and Staff
331
Index
337
Copyright

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About the author (2002)

Cohn is a program officer with the Board on Children, Youth, and Families of the Institue of Medicine and National Research Council. She teaches health professional students. She has a MA and PhD in religious ethics.

Salmon is dean and chief executive officer of the Nell Hodgson Woodruff School of Nursing and Emory University. She has a B.S. and a B.S.N. from the University of Porland and an Sc.D. from John Hopkins University.

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