Abstracts
Abstract
Purpose: Rural emergency department healthcare professionals are well-positioned to serve as a resource to domestic violence victims but may lack the necessary training to effectively screen for and respond to domestic violence victims. A novel, low fidelity simulation-based education provided an opportunity to increase healthcare professionals’ readiness to screen for domestic violence.
Methods: We facilitated 14 simulations with 181 participants at eight rural sites between September 2022 and June 2023. A multi-method program evaluation was used to assess the impact of the simulation-based education on participants' readiness to screen for domestic violence and their clinical practice. Participants of the simulation were invited to complete a pre and post-simulation survey regarding their experience and perceptions related to screening for domestic violence. Participants were invited to participate in follow-up semi-structured interviews to discuss how simulation-based education has influenced their practice three to nine months following the simulation.
Results: Prior to the simulation-based education participants reported several barriers to screening for domestic violence and a lack of training. Following simulation-based education, a statistically significant increase in readiness to screen for domestic violence was observed, t (102) = 19.43, p <.001, d = 1.91 between the pre- and post-simulation survey scores (n = 103). Through semi-structured interviews (n = 6), two themes were identified: (a) influence on education and (b) the power of simulation-based education.
Conclusions: Simulation-based education is an effective education modality to enhance healthcare professionals’ readiness to screen patients for domestic violence and may positively influence their practice through increased awareness and more consistent screening.
Keywords:
- emergency nurse,
- Domestic Violence,
- rural,
- simulation,
- training
Résumé
Objectif : Le personnel de santé des services d’urgence ruraux est en mesure de servir de ressource aux victimes de violence familiale, mais il peut ne pas posséder la formation nécessaire pour dépister efficacement les victimes de violence familiale et y répondre. Une formation novatrice, axée sur une simulation à faible fidélité, a offert la possibilité d’améliorer la préparation des professionnels de la santé au dépistage de la violence familiale.
Méthodes : De septembre 2022 à juin 2023, nous avons animé 14 simulations auxquelles ont participé 181 personnes dans huit sites ruraux. Une évaluation de programme à méthodes multiples a été utilisée pour évaluer l’impact de la formation par simulation sur l’état de préparation des participants au dépistage de la violence familiale et sur leur pratique clinique. Les participants à la simulation ont été invités à remplir unsondage par rapport à leur expérience et à leur perception du dépistage de la violence familiale avant et après la simulation. Ils ont également été invités à participer à des entretiens semi-structurés de suivi pour discuter de l’influence de la formation par simulation sur leur pratique, trois à neuf mois après la simulation.
Résultats : Avant la formation par simulation, les participants ont signalé plusieurs obstacles au dépistage de la violence domestique ainsi qu’un manque de formation. Après la simulation, une augmentation statistiquement significative de la préparation au dépistage de la violence domestique a été observée, t (102) = 19,43, p < .001, d = 1,91, entre les scores des questionnaires pré- et post-simulation (n = 103). À travers les entretiens semi-structurés (n = 6), deux thèmes ont été identifiés : (a) l’influence sur la formation et (b) la puissance de l’apprentissage par simulation.
Conclusions : La formation par simulation s’avère être une modalité pédagogique efficace pour renforcer la préparation des professionnels de la santé au dépistage de la violence domestique chez les patients, et peut influencer positivement leur pratique en favorisant une plus grande sensibilisation et un dépistage plus cohérent.
Mots-clés :
- personnel infirmier d’urgence,
- violence familiale,
- rural,
- simulation,
- formation
Appendices
Bibliography
- Adelman, M., Rosenberg, K. E., & Hobart, M. (2016). Simulations and social empathy: Domestic violence education in the new millennium. Violence Against Women, 22(12),1451-1462. https://doi.org/10.1177/1077801215625850
- Alberta Innovates. (2022). A project ethics community consensus initiative (ARECCI) ethics guideline tool. https://arecci.albertainnovates.ca/
- Alvarez, C., Fedock, G., Grace, K. T., & Campbell, J. (2017). Provider screening and counselling for intimate partner violence: A systematic review of practices and influencing factors. Trauma, Violence, & Abuse, 18(5), 479-495. https://doi.org/10.1177/1524838016637080
- Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. https://doi.org/10.1191/1478088706qp063oa
- Cleak, H., Hunt, G., Hardy, F., Davies, B., & Bell, J. (2021). Health staff responses to domestic and family violence: The case for training to build confidence and skills. Australian Social Work, 74(1), 42-54. https://doi.org/10.1080/0312407X.2020.1808029
- Eppich, W., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, 10(2), 106-115. https://doi.org/10.1097/SIH.0000000000000072
- Jack, S. M., Kimber, M., Davidov, D., Ford-Gilboe, M., Wathen, C. N., McKee, C., Tanaka, M., Boyle, M., Johnston, C., Coben, J., Gasbarro, M., McNaughton, D., O’Brien, R., Olds, D. L., Scribano, P., & MacMillan, H. L. (2021). Nurse-Family Partnership nurses’ attitudes and confidence in identifying and responding to intimate partner violence: An explanatory sequential mixed methods evaluation. Journal of Advanced Nursing, 77(9), 3894-3910. https://doi.org/10.1111/jan.14979
- Jeffrey, N., Johnson, A., Richardson, C., Dawson, M., Campbell, M., Bader, D., Fairbairn, J., Straatman, A.L., Poon, J., Jaffe, P. (2019). Domestic violence and homicide in rural, remote, and northern communities: Understanding risk and keeping women safe. Domestic Homicide (7). Canadian Domestic Homicide Prevention Initiative. ISBN 978-1-988412-34-4. http://cdhpi.ca/sites/cdhpi.ca/files/Brief_7.pdf
- Kalra, N., Hooker, L., Reisenhofer, S., Di Tanna, G. L., & García-Moreno, C. (2021). Training healthcare providers to respond to intimate partner violence against women. Cochrane Database of Systematic Reviews, 5, CD012423. https://doi.org/10.1002/14651858.CD012423.pub2
- Karnitschnig, L., & Bowker, S. (2020). Intimate partner violence screening in the emergency department: A quality improvement project. Journal of Emergency Nursing, 46(3), 345-353. https://doi.org/10.1016/j.jen.2020.02.008
- Northcott, M. (2011). Domestic violence in rural Canada. Victims of Crime Research Digest, 4, 9-14. https://www.justice.gc.ca/eng/rp-pr/cj-jp/victim/rd4-rr4/p2.html
- Polit, D. F., & Beck, C. T. (2021). Nursing research generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
- Sawyer, S., Melvin, G., Williams, A., & Williams, B. (2022). A new scale of readiness for health care students to encounter partner abuse. Journal of Interpersonal Violence, 37(15-16), NPI 4877-NPI4897. https://doi.org/10.1177/0886260520981131
- Statistics Canada. (2022). Victims of police-reported family and intimate partner violence in Canada. https://www150.statcan.gc.ca/n1/daily-quotidien/221019/dq221019c-eng.htm
- Statistics Canada. (2019). Family violence in Canada: A statistical Profile, 2018. Catalogue number 85-002-X. https://www150.statcan.gc.ca/n1/pub/85-002-x/2019001/article/00018-eng.htm
- Turner, W., Broad, J., Drinkwater, J., Firth, A., Hester, M., Stanley, N., Szilassy, E., & Feder, G. (2017). Interventions to improve the response of professionals to children exposed to domestic violence and abuse: A systematic review. Child Abuse Review, 26, 19-39. https://doi.org/10.1002/car.2385
- Woroch, R. A., & McNamara, M. (2023). Intimate partner violence standardized patient simulation for nurse practitioner students. Journal of the American Psychiatric Nurses Association, 29(4), 338-343. https://doi.org/10.1177/10783903211023557
- Wyatt, T., McClelland, M. L., & Spangaro, J. (2019). Readiness of newly licensed associated degree registered nurses to screen for domestic violence. Nurse Education in Practice, 35, 75-82. https://doi.org/10.1016/j.nepr.2018.12.010
- Youngson, N., Saxton, M., Jaffe, P. G., Chiodo, D., Dawson, M., & Straatman, A. (2021). Challenges in risk assessment with rural domestic violence victims: Implications for practice. Journal of Family Violence, 36, 537-550. https://doi.org/10.1007/s10896-021-00248-7
- World Health Organization. (2016). Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children. https://www.who.int/publications/i/item/9789241511537