Evaluation of a Clinical Workshop to Improve Students' Readiness to Manage Intimate Partner Violence

Friday, 20 April 2018: 2:05 PM

Jane R. Ierubino, DNP
Joan's Hope, Ivyland, PA, USA

Domestic violence (DV), also called intimate partner violence (IPV), is a major health issue affecting a significant portion of the population. Roughly one in three American women (24.3%) will have experienced physical violence by an intimate partner in her lifetime (De Boinville, 2013). This includes a variety of behaviors from slapping, pushing or shoving to severe acts of violence such as being beaten, raped, burned, or strangled. Recent global prevalence figures indicate that approximately one in three (35%) of women worldwide have experienced either physical and/or sexual violence in their lifetime (World Health Organization [WHO], 2016). In addition to the immediate acute injuries from an assault, violence can have devastating effects on victims’ long-term health (Centers for Disease Control and Prevention [CDC], 2016). Family members and the community are also affected by the violence. Nurses are in a key position to identify victims, provide support and refer victims to appropriate resources (De Boinville, 2013).

Physical and sexual assaults, or threats to commit them, are the most apparent forms of domestic violence. However, perpetrators of DV may use a larger system of abuse, including emotional, economic, social isolation, intimidation, coercion and threats, to maintain power and control over the victim. There are many myths about domestic violence that hinder understanding of the problem. Many believe that the DV is not a problem in their communities, that domestic violence only affects poor women of color, and that drugs and alcohol are the cause of DV. Others believe some people deserve to be hit and that if the situation were that bad, a victim would just leave (Domesticviolence.org, 2015). There is a need to replace these false ideas with the most current and accurate knowledge available.

Despite the enormity of the problem, there is little information in the literature that describes effective educational interventions related to domestic violence for nursing students. Nursing students may not be receiving the educational preparation to correctly assess, provide support and referral, and to document domestic violence interventions. Opportunities for students to engage with victims of violence in the clinical setting are rare. Confidentiality and safety are paramount and limit exposure. Many nurses feel unprepared to deal with DV and do not demonstrate best practices in the clinical setting. Students learn by observing the behaviors of clinicians in the health care setting. Often screening for violence is omitted or is done incorrectly. Many students are graduating from their programs with limited or no domestic violence education. Some students observe inadequate assessment and nursing care of victims of violence, thus reinforcing inappropriate care. The lack of experience or exposure to incorrect care can have a profound effect on students’ ability to provide comprehensive assessment, support and documentation to victims of violence (Bryant & Benson, 2015).

Giving students information to increase their knowledge, experience, and skill, and promote positive attitudes toward victims of violence is essential. The purpose of this research was to determine the effect an evidence-based educational intervention had on baccalaureate nursing students’ ability to care for victims of DV. The educational intervention was a six-hour clinical workshop that included an evidence-based lecture, films, video clips, games, role-play, guest speakers, and hands-on activities that simulate the nursing role related to assessment, support, referral, and documentation of nursing interventions related to DV.

Evaluation of the workshop was done using a quasi-experimental design. Students in the control group experienced traditional clinical, while students in the intervention group experienced traditional clinical with one of their clinical days spent attending the clinical workshop. Nursing students at a four-year, private university in the Northeast were evaluated at the beginning and end of the Women’s Health course using the Provider Readiness to Manage Intimate Partner Violence Survey – Revised (PREMIS-R). The survey measures three constructs, Perceived Preparation, Actual Knowledge, and Opinions. Students who experienced the workshop had improved scores for Perceived Preparation and Opinions. Actual Knowledge scores were unchanged. Students felt better prepared, more confident, and had attitudes that would empower them to provide improved care for victims of violence.