Background: Despite the frequency of domestic violence in trauma patients,
little emphasis has been placed on this subject in the education of surgeon
s and emergency medicine physicians. The 1997 Advanced Trauma Life Support
(ATLS) course included, for the first time, education about domestic violen
ce. This study was done to test the hypothesis that baseline knowledge abou
t domestic violence in trauma care providers is poor and is not improved by
the 1997 ATLS course.
Study Design: A study on domestic violence was designed using attending gen
eral surgeons, general surgery and emergency medicine residents, and medica
l students as test subjects. An educational lecture and pre- and post-tests
were developed using the Eastern Association for the Surgery of Trauma pos
ition paper on domestic violence and other peer-reviewed literature as info
rmation sources. Data collected included level of training, date ATLS cours
e was taken, and pre- and post-test scores. Statistical analysis was perfor
med with ANOVA, with significance attributed to p < 0.05.
Results: Ninety-two subjects attended the lecture and completed the pre- an
d post-tests. The overall mean pre-test score was 54 +/- 1. There was no di
fference in scores for the 1997 ATLS cohort (with domestic violence materia
l) versus the group with earlier ATLS courses (52 +/- 2 versus 51 +/- 1). T
he group that had never taken ATLS scored significantly better on the pre-t
est than the other groups (58 +/- 2, p < 0.05). All groups had significantl
y increased scores on the posttest (mean 77 < 1, p < 0.001 versus pre-test)
.
Conclusions: Baseline knowledge about domestic violence among surgeons and
emergency medicine physicians was poor and was not improved by participatio
n in the 1997 ATLS course. This study strongly supports the need for expand
ed domestic violence education for trauma care providers. (J Am Coll Surg 2
000;191:347-353, (C) 2000 by the American College of Surgeons).