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Addressing intimate partner violence : implications for medical curricula in Mozambique
Book - Dissertation
Background: There is growing evidence in the literature that most medical doctors do not recognise the impact of Intimate Partner Violence (IPV), as it is considered by many as a social or cultural issue. The available literature shows that IPV elements in medical curricula are not standardized and that medical doctors hardly receive effective or any training at all resulting in a lack of appropriate competencies to deal with IPV. We conducted this study to identify ways to improve curricula on IPV content to enhance prevention and medical care in Mozambique. Methods: The research was conducted adopting mixed methods approaches and consisted of four sub-studies. The research setting builds on five medical schools in Mozambique. The first study tackles a scoping review of the literature published between 1998 and 2018 and helped synthesizing the literature and associated research gaps about key concepts of IPV response training programs as they have been integrated into medical undergraduate and graduate curricula. The second study was built on a survey administered to third and 6th-year medical students (N387), enrolled in five medical schools in Mozambique. The instrument focused on mapping students' perceived mastery of their knowledge, skills, and attitudes related to IPV. A WHO model guided the related IPV competence framework. In the third study, we screened the extent that curricula of Mozambican medical schools focused on IPV and helped developing related competences. The final study adopted a mixed-methods approach. In total, 34 of all fourth-year medical students (59%) from one medical school in Mozambique were involved in a quasi-experimental pre-test/post-test design to study the impact of an innovative intervention to develop critical IPV knowledge, skills, and attitudes, underlying a patient communication script. The quantitative study was complemented with a qualitative analysis of student perceptions. Results: IPV content is hardly and inconsistently addressed when focusing on the related content and instructional strategies being adopted. There is a need for a more comprehensive approach to developing knowledge, skills, and attitudes to deal with the victims of IPV. The limited IPV content tracked in medical school curricula in Mozambique, mainly address violence in general, for instance, as identified in orthopaedics or surgery contexts and forensic Medicine and as sexual violence in gynaecology and obstetrics. Teaching and learning strategies, adopted to deal with IPV competences were restricted. Simulation activities are a potential instructional strategy to be used in a safe environment to develop clinical skills. Conclusion: The results of this study are a promising complement of the analysis of the competencies learned by the medical students in Mozambique with the current curriculum. The research thus provided justification for developing a competency based, interprofessional curriculum to improve communication skills in sensitive topics in medical education. Our research also identified new content that would be appropriately incorporated in education and training to produce these competencies in medical students as well as specific educational approaches that could be used in delivering this content.Keywords: intimate partner violence, knowledge, attitude, and skills, competence, curriculum, medical studentU+2019s competences, role plays intervention, communication skills, Mozambican medical curricula.
Number of pages: 1