Chambliss L R, Bay R C, Jones R F
Department of Obstetrics and Gynecology, Maricopa Medical Center, Phoenix, AZ 85008.
Am J Obstet Gynecol. 1995 Mar;172(3):1035-8. doi: 10.1016/0002-9378(95)90039-x.
Domestic violence is the most common cause of injury to women. Obstetrician-gynecologists, who most women consider their primary care physicians, have a unique role in identifying battered women. This study was designed to assess the extent and nature of current training curricula regarding domestic violence education in obstetrics and gynecology residencies.
A survey sent to all obstetrics and gynecology residencies requested demographic data, the curriculum in respect to domestic violence, availability of interested faculty, the prevalence of battering among patients, satisfaction with the current teaching, and knowledge of pending legislation. Respondents were also asked which of 10 common clinical presentations would prompt their faculty to discuss the possibility the patient was being battered.
Eighty-three percent of programs responded. The "typical" program was urban, had five residents per year, and had faculties of full-time academicians and part-time private practitioners. Twenty-eight percent reported having at least one faculty member with expertise in domestic violence. One third reported a prevalence of battering of < or = 1% with 6% estimating fewer than 1 in 1000. Seventy-five percent did not recognize at least one clinical scenario as suggestive of battering. The majority were dissatisfied with their teaching and wanted help in curriculum development. Forty percent were unaware of pending legislation linking federal support of medical education to including domestic violence in curricula.
The results of this survey highlight deficiencies in the education of obstetrics and gynecology residents about domestic violence. Programs report limited faculty interest, underestimate prevalence, fail to recognize common presentations, and are dissatisfied with their current curriculum. We are not preparing obstetrics and gynecology residents to care for patients with a common problem--domestic violence.
家庭暴力是女性受伤的最常见原因。大多数女性将妇产科医生视为其初级保健医生，妇产科医生在识别受虐妇女方面具有独特作用。本研究旨在评估当前妇产科住院医师培训课程中关于家庭暴力教育的程度和性质。
向所有妇产科住院医师培训项目发送了一份调查问卷，询问人口统计学数据、关于家庭暴力的课程、有兴趣的教员情况、患者中受虐的发生率、对当前教学的满意度以及对即将出台的立法的了解情况。还询问了受访者，10种常见临床表现中的哪一种会促使其教员讨论患者是否遭受虐待的可能性。
83%的项目做出了回应。“典型”项目位于城市，每年有5名住院医师，教员包括全职学者和兼职私人执业医生。28%的项目报告称至少有一名教员具有家庭暴力方面的专业知识。三分之一的项目报告受虐发生率≤1%，6%的项目估计每1000人中不到1人受虐。75%的项目至少不能识别一种提示受虐的临床情况。大多数人对教学不满意，并希望在课程开发方面得到帮助。40%的项目不知道即将出台的将联邦对医学教育的支持与将家庭暴力纳入课程相联系的立法。
本次调查结果凸显了妇产科住院医师在家庭暴力教育方面的不足。各项目报告称教员兴趣有限，低估了发生率，未能识别常见表现，且对当前课程不满意。我们没有让妇产科住院医师做好照顾患有常见问题——家庭暴力患者的准备。
