Original ResearchIntimate partner violence education for medical students in the USA, Vietnam and China
Introduction
Intimate partner violence (IPV) is a significant public health threat that causes injury, and acute and chronic physical and mental health problems.1, 2, 3 IPV includes physical, sexual and/or psychological harm inflicted by a current or former intimate partner.4 Violence by an intimate partner is a common experience for women throughout the world, with global lifetime rates ranging from 15% to 71%.5
Women and children who have experienced IPV suffer from a wide range of health problems, and use healthcare services more often than women and children who have never experienced IPV.6, 7, 8 To ensure the health and safety of women who have experienced IPV, future physicians and healthcare professionals need training regarding identification and interventions for these patients.9 In the USA, efforts to improve IPV education of medical students and residents have been implemented.10 Active learning strategies are commonly used in family medicine residency curricula to teach residents how to manage IPV cases.11 For medical students to develop the clinical skills necessary to address IPV victimization in the healthcare setting, training should: occur during preclinical and clinical rotations; include outreach experiences with victims and community agencies; include education regarding the regulatory standards for addressing IPV in health care; and provide knowledge about culturally appropriate interventions.12 However, there are a number of barriers to implementing an IPV curriculum in medical schools, including lack of funding, limited curriculum time, discomfort in discussing IPV with patients, perception of relevance, training opportunities and resources.13
While IPV is a global health concern, particularly for women,14 few comparative studies of IPV education in medical schools have been undertaken. The purpose of this study was to investigate medical students' knowledge of, and training in, IPV in the USA, Vietnam and China through a cross-national comparative study in order to improve IPV education of future doctors. Comparing these countries helps to elucidate the potential sociocontextual effects of IPV training for medical students. The selection of the countries in this study was not random. Rather, the authors worked with collaborators who were interested in the issue of violence against women in the USA, Vietnam and China.
Women in the USA, Vietnam and China have similar lifetime prevalence rates of IPV of 35.6%, 32.7% and 34%, respectively.15, 16, 17 While medical schools in the USA often include IPV education,18 to the best of the authors' knowledge, there are no formal IPV curricula at medical schools in Vietnam and China. Studies in Vietnam,16 China19 and the USA15, 20, 21 have shown that IPV victims are more likely to be diagnosed with injuries, chronic pain syndromes, mental health problems, reproductive health issues, cardiovascular disease and poorer health overall than individuals who have never experienced IPV. Educating future physicians about the health effects of IPV is essential to improve their skills in addressing this important healthcare issue for women.
Section snippets
Study participants and data collection
The cross-sectional data were collected from July to September 2013 at three public medical schools in the USA, Vietnam and China. The US medical school included in this study is the only medical school in a western state with a population of approximately three million people. The Vietnamese medical school included in this study is one of two medical schools in a city with a population of approximately nine million people. The Chinese medical school included in this study is one of 10 medical
Results
The response rate was 37.5% (60/160) for the USA, 80% (240/300) for Vietnam and 62.6% (174/278) for China. Table 1 summarizes the demographic characteristics of participants, as well as information regarding their experience. Approximately half of the participants were women. While the percentage of female participants was very similar to that of female students in the survey populations in Vietnam and China, female participants were oversampled in the USA (the percentage of female students was
Discussion
This study examined opinions, knowledge and training about IPV among medical students in the USA, Vietnam and China. US participants reported significantly higher levels of knowledge of IPV, were more likely to believe that IPV was a serious problem, and more likely to consider IPV as a healthcare problem compared with Vietnamese and Chinese participants. The Chinese participants, in particular, did not appear to appreciate the importance of addressing IPV. Differences were found between the
Acknowledgements
The authors wish to thank the study participants, and would like to acknowledge the contributions of Adam Stevenson, Evelyn Gopez, Wei Xiao, Jinpeng Wu, Yuan Wang, and Ha Thanh Dat. The authors also thank Lenora Olson for her insightful input on the manuscript.
Ethical approval
This study was approved as an exempt protocol by the Institutional Review Board of the University of Utah, Salt Lake City, USA.
Funding
This work was partially supported by the Asia Center, University of Utah.
Competing interests
None declared.
References (28)
- et al.
WHO multi-country study on Women's Health and Domestic Violence against Women Study Team. IPV and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study
Lancet
(2008) - et al.
Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence
Lancet
(2006) - et al.
Healthcare utilization and costs for women with a history of intimate partner violence
Am J Prev Med
(2007) - et al.
Quality of life of victims of intimate partner violence
Int J Gynaecol Obstet
(2005) - et al.
Physical and mental health effects of intimate partner violence for men and women
Am J Prev Med
(2002) - et al.
Chronic physical symptoms in survivors of intimate partner violence
- et al.
Mental health consequences of IPV
Intimate partner violence: definitions
(2013)- et al.
Barriers to domestic violence help seeking – implications for intervention
Violence Against Women
(2005) - et al.
Physical partner violence and medicaid utilization and expenditures
Public Health Rep
(2004)
Confronting chronic neglect: the education and training of health professionals on family violence
Improving identification and management of partner violence: examining the process of academic detailing: a qualitative study
BMC Med Educ
Trends in violence education in family medicine residency curricula
Fam Med
Intimate partner violence in the medical school curriculum: approaches and lessons learned
Virtual Mentor
Cited by (16)
Impact of a Training Program on Gender-Based Violence of Medical Students: A Quasi-Experimental Simulation Study
2023, Clinical Simulation in NursingVariables associated with a higher awareness of gender-based violence by students of the health sciences and social work
2022, Gaceta SanitariaCitation Excerpt :This has been confirmed by recent studies, which while comparing opinions, knowledge and training on gender-based violence in students from other countries, found that the participants, who received more education related to this topic, knew more about the issue and considered it to be a major problem. Findings such as these seem to suggest that this training could improve not only the students’ knowledge, but also their level of sensitization and awareness.16 Regarding the gender-based violence education received by nursing students, different studies have concluded that, the more training received in this sense, the more willing they are to identify cases of gender-based violence.17
Tolerance of intimate partner violence and sexist attitudes among health sciences students from three Spanish universities
2020, Gaceta SanitariaCitation Excerpt :The analysis of the evolution of the prevalence of IPV-tolerance and sexist attitudes in each degree suggests that only medicine students underwent a consistent and positive change throughout their studies, male students in sexist attitudes and female students in IPV-tolerance. It is difficult to offer a tentative hypothesis to explain this phenomenon because, in all three degrees, IPV is addressed at some point, and professors seem to be sufficiently committed to this formation.20,30 In addition, the psychology degree has the most curricular content about violence, but if we were seeking a student sensitized toward suffering, we would probably choose a nursing student.
Nurses' preparedness, opinions, barriers, and facilitators in responding to intimate partner violence: A mixed-methods study
2024, Journal of Nursing ScholarshipChinese nurses' preparedness and opinions in responding to intimate partner violence: An adaptation and validation study
2022, Journal of Advanced NursingEvaluating the Relationship Between Intimate Partner Violence-Related Training and Mental Health Professionals’ Assessment of Relationship Problems
2022, Journal of Interpersonal Violence