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Medical Student Identification of Maternal Depression and Intimate Partner
Violence During a Standardized Patient Interview Authors: Sarah
E Winters, MD1; Debra Hillman1; Denise LaMarra2;
Judy Shea, PhD2; David Rubin, MD, MSCE 1 1The
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 2University
of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Background:
The use of Standardized Patients (SP) for evaluation of medical students presents
an opportunity to test whether students adequately assess psychosocial concerns.
Objective: 1) To estimate proportions of students who identified maternal
depression and Intimate Partner Violence (IPV) in a SP with failure to thrive
(FTT).2) To identify characteristics of students and SPs that increase identification
of Depression/IPV. Design/Methods: At the end of clinical clerkships
112 students interviewed a SP with a child with FTT. The etiology of the FTT was
inadequate caloric intake secondary to maternal depression and IPV. Adequacy of
student assessment for IPV and maternal depression was based on inquiry about
six related issues, including identification and counseling. Student characteristics
were obtained from medical school admissions data. Results: 53
% of students were female and 17 % were underrepresented minorities. 66% of students
identified depression and 32% identified IPV during the assessment. Analysis of
student/SP characteristics and exam results showed that underrepresented minorities
were more likely to identify ¾2/6 issues related to depression or maternal
IPV than non-minority students (95% vs. 74%, p<0.05). There was a trend for
women to more frequently identify ¾2/6 of these relevant problems (85%
vs. 70%, p=0.058). Conclusions: Despite curricula that address
IPV and depression, there continue to be gaps in student identification of these
problems. Minority students scored higher on parts of the SP exam related to IPV/depression.
This suggests that recruitment of a diverse student body or curricular improvements
may be important in increasing recognition of these issues. |