Jonassen J A, Pugnaire M P, Mazor K, Regan M B, Jacobson E W, Gammon W, Doepel D G, Cohen A J
Department of Physiology, University of Massachusetts Medical School, USA.
Acad Med. 1999 Jul;74(7):821-8. doi: 10.1097/00001888-199907000-00017.
To determine whether participation in an intensive domestic violence interclerkship (DVI) improved the knowledge, attitudes, and skills of two successive cohorts of students at the University of Massachusetts Medical School.
The authors measured the knowledge, attitudes, and skills pertaining to domestic violence of third-year students in the classes of 1997 and 1998 using a validated written examination administered before, immediately after, and six months after participation in a 3.5-day or two-day DVI, respectively; they compared the scores using paired t-tests. Nine months after the DVI, the students' domestic violence screening skills were measured by a performance-based assessment (OSCE); using unpaired t-tests, the authors compared the OSCE scores with those of a previous third-year class that had not participated in a DVI. Immediately after the OSCE, the students reported their levels of confidence in domestic violence screening and their satisfaction with the domestic violence curriculum; using chi-square analysis, those self-reports were compared with those of the class with no DVI.
The students who participated in the DVIs immediately and significantly improved their knowledge, attitudes, and skills (p < .001), and fully or partially sustained those improvements six months later (p < .001). Nine months after the DVI, the students performed domestic violence screening more effectively (p < .001), expressed greater comfort with domestic violence screening (p < .001), and felt better-prepared by the curriculum to address domestic violence issues (p < .001) than did the students with no DVI.
Participation in a short, focused DVI curriculum produced sustainable improvements in knowledge, attitudes, and skills that were successfully applied by third-year medical students to effective domestic violence screening. Interclerkships are an effective way to fit into the clinical curriculum those subjects that transcend the traditional biomedical domain and intersect all areas of medical practice.
确定参与强化家庭暴力实习课程（DVI）是否能提高马萨诸塞大学医学院连续两届学生的知识、态度和技能。
作者分别在1997级和1998级三年级学生参加为期3.5天或两天的DVI课程之前、之后立即以及之后六个月，使用经过验证的书面考试来测量他们与家庭暴力相关的知识、态度和技能；他们使用配对t检验比较分数。在DVI课程九个月后，通过基于表现的评估（OSCE）来测量学生的家庭暴力筛查技能；作者使用非配对t检验将OSCE分数与之前未参加DVI课程的三年级班级的分数进行比较。在OSCE之后，学生们报告了他们对家庭暴力筛查的信心水平以及对家庭暴力课程的满意度；使用卡方分析，将这些自我报告与未参加DVI课程的班级的报告进行比较。
参加DVI课程的学生立即且显著地提高了他们的知识、态度和技能（p < .001），并在六个月后完全或部分保持了这些进步（p < .001）。在DVI课程九个月后，与未参加DVI课程的学生相比，参加课程的学生在家庭暴力筛查方面表现得更有效（p < .001），对家庭暴力筛查表现出更大的舒适度（p < .001），并且感觉课程让他们在处理家庭暴力问题方面准备得更充分（p < .001）。
参与简短且重点突出的DVI课程能在知识、态度和技能方面产生可持续的提高，三年级医学生成功地将这些提高应用于有效的家庭暴力筛查。实习课程是将超越传统生物医学领域且贯穿医疗实践所有领域的学科纳入临床课程的有效方式。
