Domestic violence and the trauma surgeon: Results of a study on knowledge and education

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).