LETTER
Violence in Intimate Relationships
Pamela Charney, MD, and
Susan Dresdner, MD
1 September 1996 | Volume 125 Issue 5 | Page 426
TO THE EDITOR:
Historically, internal medicine residency programs have not taught about domestic violence and its sequelae [1]. At our institution, teaching on domestic violence is being incorporated into the ambulatory care curriculum for all second- and third-year internal medicine residents at the initiative of the faculty of our General Internal Medicine—Women's Health track. We have developed an educational session dedicated to improving interviewing and communication skills in dealing with victims of domestic violence that has been incorporated into a 4-week course on prevention.
The psychosocial curriculum for our second- and third-year residents includes the use of trained actors and actresses who are interviewed by the housestaff in a group with faculty supervision. The initial curriculum directed attention to the diagnosis and management of depression and anxiety disorders, including panic attacks. For the session on domestic violence, a faculty member developed a new script that was based on the experience of one of her immigrant patients, whose husband is abusing her and their children.
The session on domestic violence will allow residents to practice interviewing and communication skills with direct feedback from the actress and from their colleagues. The importance of supporting the abused person, assessing the patient's safety after leaving the office, and using our experienced social work staff will be stressed. The teaching guide for the faculty supervising residents in the interview session will be supplemented by copies of the article by Dr. Alpert [1] and the essay by Dr. Weinberg [2]. Materials to be distributed to housestaff include a 1-page handout developed by the Office for the Prevention of Domestic Violence, New York State Department of Health, and the Medical Society of the State of New York.
It is important that residency programs and medical schools focus on domestic violence and its sequelae as part of their education activities. The increasing literature about violence in our society can provide ample resources for practitioners and educators [1, 3, 4]. It is essential that teachers and learners advocate for the inclusion of these topics at all levels of medical education.
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Author and Article Information
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Albert Einstein College of Medicine, Bronx, NY 10461
1. Alpert EJ. Violence in intimate relationships and the practicing internist: new "disease" or new agenda? Ann Intern Med. 1995; 123:774-81.
2. Weinberg RB. Communion. Ann Intern Med. 1995; 123:804-5.
3. Fontanarosa PB. The unrelenting epidemic of violence in America: truth and consequences. JAMA. 273:1792-3.
4. Friedman LS, Samet JH, Roberts MS, Hudlin M, Hans P. Inquiry about victimization experiences: a survey of patient preferences and physician practices. Arch Intern Med. 1992; 152:1186-90.
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