Abstract:

Interpersonal violence (IPV) against women is globally a major public health problem and foundational violation of human rights [1]. However, the sub-group of pregnant women experiencing IPV represent the most significant risks for battering, injury and death [2]. This is particularly true for pregnant adolescents [3]. Alarmingly, homicide has been consistently cited as one of the leading causes of death in all pregnant women [4]. IPV during pregnancy is a focused attack that puts not just one, but two lives at risk and, unlike other incidents of IPV, where the head is usually attacked, battering of pregnant women tends to be directed at breasts, abdomen or genitals and can include further sexual assaults and attacks with various weapons [5]. In spite of the identified risks for IPV during pregnancy, the Centers for Disease Control and Prevention (CDC) [6] have noted that health care providers are not comfortable assessing or intervening with these clients, identifying barriers to screening as discomfort with the topic, fear of offending the patient or partner with questioning, and perceived powerlessness to change the problem. These factors are congruent with other contemporary study findings that reflect a significantly low number of pregnant women routinely assessed for abuse by their health care provider [7, 8] . Nursing education related to IPV historically has typically encompassed the goals of promoting an increased awareness of the prevalence and identification of at risk clients and encouraging non-judgmental attitudes; however, screening specific to abuse during pregnancy is clearly lacking [8]. Meeting the objectives of the World Health Organization’s [WHO] ‘‘Global Campaign on Violence Prevention’’ [9] will involve concerted efforts from many organizations and institutions including the health care community. Educating future nurses worldwide about IPV during pregnancy does, however, present challenges, as most lack awareness of this pervasive public health problem, have limited knowledge and erroneous beliefs about IPV [including transcultural variations], and are inexperienced in caring for survivors of IPV. Thus, providing formal education and training in a supportive environment will enhance knowledge and skills about IPV [10]. In direct response to these issues, we will demonstrate how the standardized patient experience can be utilized in the healthcare educational setting to expand awareness, enhance sensitive and comprehensive risk assessment, and subsequently guide safety promotion and intervention. Specifically, a standardized patient is an individual who has been trained to present a clinical scenario by assuming the characteristics of a patient in that situation. Video recording and playback of the interaction additionally provides a valuable opportunity the student to critique her/his assessment and communication skills, while also providing an opportunity to reflect and refine standardized patient scenarios for IPV during pregnancy [10]. This clinical teaching method enables learners to develop skills in conducting bio-psycho-social assessments, while also helping to refine interpersonal communication skills through interaction with a person that is simulating someone who is pregnant and experiencing IPV [11].

Keywords:

standardized patient, maternal homicide, healthcare, assessment, pedagogy.