Landscape analysis of emergency medicine residency education on domestic violence

BACKGROUND: Domestic violence (DV) is a public health problem in the United States. Emergency physicians are often the first providers to see patients needing acute care for injuries sustained secondary to DV and are an important part of the healthcare workforce for underserved populations seeking help. While much has been published about the need for better identification and care of this population, little is known about the current prevalence and characterization of DV curricula in accredited emergency medicine residency programs. 

METHODS: Cross-section survey of program directors sent to 232 Accreditation Council for Graduate Medical Education-accredited emergency medicine residency programs to learn about the presence, content, format, and barriers related to implementation of DV curriculum in their residency programs. The survey was open from May to June 2022. 

RESULTS: A total of 63 programs responded (response rate: 26%). In total, 84% of programs reported having some form of DV curriculum, with the majority of respondents (81%) offering 1-5 h of content. Most programs included content on intimate partner violence (92%), child abuse (91%), and human trafficking (91%), but only 79% of programs had content on elder abuse. The most common modalities of DV curriculum implementation were didactic lectures (98%) and bedside teaching (51%). In total, 20.5% of 3-year programs had no DV curricula, while 44% of programs planned to implement improvements to their curriculum. The most common barriers to implementing additional education or further strengthening DV curriculum were lack of time in curriculum (69%) and lack of expertise in faculty (25%). 

CONCLUSIONS: The majority of residency program respondents offer some formal DV curriculum with variation in the delivery modality and curriculum time dedicated to DV. There are existing solutions to address the barriers faced by the many programs that hope to improve their DV curriculum. Creative solutions, such as incorporating non-emergency medicine lectures or supporting faculty in bedside teaching, could help residencies meet the American College of Emergency Physician recommendation for integrating the DV curriculum into emergency medicine training.