Teaching preventive medicine
A Tool for Measuring Physician Readiness to Manage Intimate Partner Violence

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Background

Intimate partner (domestic) violence (IPV) is a common problem in medical practice that is associated with adverse health outcomes. There are widespread calls to improve IPV education for physicians, but there are few valid, reliable, easily available, and comprehensive measures of physician IPV knowledge, attitudes, and practices that can be used to assess training effectiveness.

Methods

In 2002, expert consensus and previous surveys were used to develop a new survey-based IPV self-assessment tool that included more information on current IPV knowledge and practices than previous tools. The draft tool was evaluated using standard psychometric techniques in a group of 166 physicians in 2002, revised, and then retested in a second group of 67 physicians on three occasions in 2003 and 2004. Analyses were conducted in 2005.

Results

The draft IPV survey tool demonstrated good internal consistency reliability, with Cronbach’s alpha ≥0.65 for ten final scales. The developed scales were closely correlated with theoretical constructs and predictive of self-reported behaviors. On repeat testing, a revised version of the tool was found to have good stability of psychometric properties in a different physician population (Cronbach’s α≥0.65, and internal correlations as predicted), good correlation with measured office IPV practices, and stable results in this population over 12 months.

Conclusions

The final version of this instrument, named the PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) tool, is a 15-minute survey that is a comprehensive and reliable measure of physician preparedness to manage IPV patients. This tool is publicly available and can be used to measure the effectiveness of IPV educational programs.

Section snippets

Background

Intimate partner (domestic) violence, IPV, is a common problem in medical practice that is associated with a number of adverse health outcomes.1, 2, 3, 4, 5 Many believe that these poor outcomes could be improved with better physician education,6, 7, 8, 9 but, despite ongoing educational efforts, field studies continue to show that physicians rarely screen for IPV, are not aware of community resources, and are not confident in their abilities to manage IPV patients.10, 11, 12 Importantly,

Item Development

Existing IPV physician survey tools were reviewed and initial survey items were adapted from previous work, particularly items from scales developed for the CDC (LMS) and the Massachusetts Medical Society (EA). To establish content validity, the proposed survey items were reviewed by an outside group of IPV educators (see acknowledgments). These reviewers were charged with selecting existing items or developing new ones that reflected key theoretical constructs and measured important IPV

Item Development

The draft instrument developed in conjunction with the expert reviewers contained an 11-question respondent profile (used for tracking and group demographics) and 90 proposed survey questions, some of which had multiple components. Survey questions were grouped into four major sections: (1) background (four items/scales dealing with type of previous IPV training, amount in hours of previous IPV training, perceived [felt] IPV knowledge, and perceived [felt] IPV preparation); (2) actual knowledge

Discussion

This IPV survey has been named the PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) tool. In its final form (minus the constraints and victim autonomy scales), it comprises 67 individual items and requires approximately 15 minutes to complete. The PREMIS tool has a high level of consistency with constructs that theoretically contribute to effective healthcare provider response to victims of IPV and a high level of consistency with earlier instruments. PREMIS is more

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