Can Internet-based education improve physician confidence in dealing with domestic violence?

Department of Medicine, University of Arizona Health Sciences Center, Tucson, USA.
Family medicine (Impact Factor: 1.17). 05/2002; 34(4):287-92.
Source: PubMed


Domestic violence (DV) is a common, under-recognized source of visits to health care professionals. Even when recognized, physicians are reluctant to deal with DV, citing a lack of education and lack of confidence in addressing issues presented by DV patients. Only a small number of DV education programs have been shown to lead to improvements in professional knowledge and confidence, and these are intensive, multi-day courses. We sought to develop an on-line DV education program that could achieve improvements in physician confidence and attitudes in managing DV patients comparable to classroom-based courses.
We created an interactive, case-based DV education program targeted to physicians caring for DV patients. We tested the effectiveness of this program in changing attitudes and beliefs in a randomized, controlled trial of Kansas physicians who volunteered to participate in a study of on-line continuing medical education. We measured program effectiveness with an externally developed and validated pretest/posttest instrument.
Sixty-five physicians completed the pretest/posttest, 28 of whom were assigned to receive the on-line DV program. We found a +17.8% mean change in confidence (self efficacy) for physicians who took the DV program versus a -.6% change for physicians who did not take the program. We also found improvements in other important areas associated with poor management of DV patients. These changes were similar or greater in magnitude to those reported by others who have used the same survey tool to evaluate an intensive, multi-hour classroom approach to DV education. User satisfaction with the on-line program was high.
An interactive, case-based, on-line DV education program that teaches problem-solving skills improves physician confidence and beliefs in managing DV patients as effectively as an intensive classroom-based approach. Such programs may be of benefit to those seeking to improve their personal skills or their health care delivery system's response to DV.

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Available from: Roland Maiuro, Oct 10, 2015
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    • "For example, Moscovic et al. [46] randomized medical students to receive either didactic training alone or didactic training plus experiential community-based training among medical students and found that those with the added "real-world" experience felt much better prepared to provide clinical care in this area. The use of new media to improve access for students and practitioners also shows promise [47,48]. Finally, some countries have implemented national level training and evaluation to ensure that clinicians in both training and practice have access to education in this area [49]. "
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    ABSTRACT: The current project undertook a province-wide survey and environmental scan of educational opportunities available to future health care providers on the topic of intimate partner violence (IPV) against women. A team of experts identified university and college programs in Ontario, Canada as potential providers of IPV education to students in health care professions at the undergraduate and post-graduate levels. A telephone survey with contacts representing these programs was conducted between October 2005 and March 2006. The survey asked whether IPV-specific education was provided to learners, and if so, how and by whom. In total, 222 eligible programs in dentistry, medicine, nursing and other allied health professions were surveyed, and 95% (212/222) of programs responded. Of these, 57% reported offering some form of IPV-specific education, with undergraduate nursing (83%) and allied health (82%) programs having the highest rates. Fewer than half of undergraduate medical (43%) and dentistry (46%) programs offered IPV content. Postgraduate programs ranged from no IPV content provision (dentistry) to 41% offering content (nursing). Significant variability exists across program areas regarding the methods for IPV education, its delivery and evaluation. The results of this project highlight that expectations for an active and consistent response by health care professionals to women experiencing the effects of violence may not match the realities of professional preparation.
    BMC Medical Education 02/2009; 9(1):34. DOI:10.1186/1472-6920-9-34 · 1.22 Impact Factor
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    • "For example, in a randomized, controlled comparison, Davis, et al, found similar improvements in knowledge and attitude about evidence-based medicine for an in-person and computer-based course for postgraduate medical trainees [53]; computer-based learning has also proven effective for patient education, enhancing families' safety behaviors and adolescent physical activity, for example [54-56]. Using video clips, on-line training can improve learners' confidence and skills as well as knowledge [57]. As the next generation, which has grown up with the internet and internet-based learning (including undergraduate on-line courses offered through Blackboard®, and other providers), joins the health care professions, it is likely that on-line training will become even more desirable [58]. "
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    BMC Medical Education 02/2008; 8(1):8. DOI:10.1186/1472-6920-8-8 · 1.22 Impact Factor
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    • "Physicians have come to rely on the Internet for accessing clinical information [42] and for continuing medical education (CME) [43]. Internet-based CME has been shown to improve physician knowledge and change physician behavior [44-48]. However, little data is available on the use of web-based curricular materials by physician educators or the effectiveness of faculty development programs aimed at increasing physician use of the Internet curriculum resources. "
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    BMC Medical Education 02/2008; 8(1):11. DOI:10.1186/1472-6920-8-11 · 1.22 Impact Factor
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