Physician roles in addressing intimate partner violence: Stakeholder perspectives to inform medical education and policy

Abstract

Experiencing intimate partner violence (IPV) is associated with a wide range of mental and physical health conditions that often have profound and enduring consequences in the lives of people, families and communities who are affected. Evidence suggests that many of these health concerns can be mitigated with timely access to medical care which addresses patient safety and needs for support. This has led to health policymakers framing IPV as a “health issue” which physicians are uniquely situated to address. Previous research suggests, however, that many physicians are ill-equipped to respond to patients who have experienced IPV, giving rise to questions about how physicians learn about IPV in the course of their training and how this training might be enhanced in order to improve medical care for people affected by IPV. This dissertation is comprised of three original studies that lie at the nexus of health policy and health professions education scholarship. The first study combines environmental scanning and critical discourse analysis to examine how physicians’ roles related to IPV are represented in training resources created for a Canadian medical audience. The second study uses qualitative description to identify physicians’ perceptions of their own roles in caring for patients affected by IPV and highlights the sites and sources of insight that are impactful in shaping these perceptions. The third study integrates key informant technique and interpretive description to synthesize recommendations from stakeholders outside of medicine about physicians’ roles in addressing IPV, and opportunities to improve medical education and practice in the future. Together, these studies offer a critical perspective on broader implications of constructing IPV as a “health issue” that informs practice for physicians, medical educators, researchers, policymakers, and organizers working to improve health care for people affected by IPV.