|Requirements For Individual Learners|
|K = Knowledge based objective, S = Skill based objective, A = Attitude based objective|
|Individual Learner Competency||Educational Objectives Learners should be able to:|
|A. Demonstrate general knowledge of violence and abuse.||1. Understand the de nitions of abuse and violence. (k) 2. Understand the interpersonal dynamics of violence and abuse, and the varied and changing types of violence and abuse. (k) 3. Know the epidemiology of violence and abuse in the general population and in speci c clinical populations. (k) 4. Distinguish between myths and facts about violence and abuse. (k) 5. Know risk factors for continued abuse, morbidity and mortality including suicide, homicide. (k, s) 6. Understand the acute and chronic physical and behavioral health effects of violence and abuse. (k) 7. Understand the functions of violence and barriers to help- seeking (individual, social, institutional and cultural). (a) 8. Understand the social and cultural context of violence and abuse, including factors such as gender, sexual orientation, social class, ethnicity, religion, developmental stage, immigrant or refugee history, and local, regional and national variations. (k) 9. Understand individual and population based models for intervention and primary prevention of violence and abuse. (k) 10. Acknowledge pre-existing values, attitudes, beliefs and experiences related to abuse among health care professionals and how these affect interaction with patients and clients.|
|B. Demonstrate clinical skills appropriate to one’s profession and specialty including the ability to identify, assess, intervene and prevent violence and abuse.||1. Assess patients/clients via interview, questionnaire, history taking and health examination processes. Use reliable, valid and normed instruments developed for the assessment of abuse, violence and its symptoms where available. (s) 2. Intervene using evidence-based and evidence-informed treatments. (s) 3. Prevent violence using evidence-based and evidence- informed methods of primary, secondary and tertiary prevention. (s) 4. Recognize risk factors for victimization and perpetration of violence. (k) 5. Recognize physical and behavioral presentations and signs of abuse and neglect, including patterns of injury across the life span. (k) 6. Educate patients and clients regarding limits of con dentiality and reporting requirements. 7. Identify and address the problems associated with emotional, physical, and sexual abuse and neglect. (s) 8. Offer continuity of care and appropriate referrals to community resources. (s) 9. Provide thorough documentation of patient’s and client’s statements, clinical observations, and visual documentation of injuries, using body maps and photographs. (s) 10. Be aware of and comply with state reporting laws, collaborating with the victim of violence to make reports whenever appropriate. (s) 11. Organize and prioritize to provide an accurate, profession- speci c assessment of the problem, and safe, ef cient, effective care. (s) 12. Acknowledge that achieving safety is often a long-term goal that is achieved by the patient/client, requires signi cant preparation, and that many successful interventions can be applied during the course of this process (i.e. naming the abuse, offering support, identifying resources, safety planning, etc.). (k, a) 13. Utilize models of health behavior change, advocacy and empowerment to promote harm reduction strategies as part of an intervention. (k, s)|
|C. Communicate effectively with the patient/client and family.||1. Convey concern and support within appropriate professional boundaries. (s, a) 2. When responding to patients/clients exposed to violence or abuse, demonstrate self-awareness of one’s emotional response, beliefs, assumptions and potential biases. 3. Demonstrate appropriate and effective ways of asking about patients’/clients’ exposure to violence or abuse. (s) 4. Communicate appropriate responses to disclosure, non-disclosure and indicators of abuse despite non-disclosure.(s) 5. Acknowledge patients’/clients’ responses in a non-judgmental, supportive way. (s, a) 6. Acknowledge and respect each patient’s/client’s right to self-determination and understand that empowerment is a primary goal of intervention. (s, a, k) 7. Review with patient/client available local resources. (s, k) 8. Discuss legal obligations on disclosure of abuse for protected categories of patients/clients. (s)|
|D. Communicate effectively with the physical and behavioral health care team.||1. Be able to communicate documented injuries and health effects, using forensic guidelines in obtaining and recording evidence (such as recording speci c, concise and objective information utilizing body maps and photographs). (s) 2. Understand and appreciate the role and contribution of other professions in preventing and managing exposure to violence and abuse. (a) 3. Explicitly negotiate roles and responsibilities for the treatment plan. (s) 4. Maintain patient and client con dentiality in communications with health care team.|
|E. Intervene to promote safety and reduce vulnerability.||1. Perform focused assessment of immediate risk/safety including routine inquiry, screening and case- nding. (s) 2. Assess for immediate danger. (s) 3. Promote safety planning with victims and families. (k) 4. Consult with and refer to specialists and community resources for safety, education, caretaking, and support services (such as protective services, social work, shelter, child abuse hotlines, legal, mental health, substance abuse, and criminal justice) as appropriate. (k) 5. Maintain appropriate clinical follow-up. (s)|
|F. Recognize the individual and cultural variation in relationships and distinguish healthy from abusive patterns.||1. Demonstrate awareness of cross-cultural health issues. (a) 2. Recognize that cultural factors in uence the responses communities have to family violence. (k) 3. Provide culturally competent assessment and care to victims and perpetrators of violence and abuse. (s) 4. Recognize potential barriers to providing care and accessing resources that may arise from cultural differences. (a, k) 5. Utilize professional translation services effectively. (s) 6. Know how to assess cultural explanatory models for causation and acceptance/non-acceptance of violence and abuse. (s) 7. Recognize the potential for complex legal and cultural issues related to a refugee’s or immigrant’s exposure to violence in their country of origin. (a)|
|G. Identify and assess relationship health.||1. Explain that a person’s relationship health has a signi cant impact on their physical and mental health. (s) 2. Understand that relationships are dynamic processes that impact people differently. (k) 3. Recognize that healthy relationship dynamics are the standard on which an assessment of the status of relationship health should be based. (a) 4. Demonstrate effective communication strategies with patients and clients regarding elements of healthy and unhealthy relationships in the context of health and wellness. (s) 5. Demonstrate the ability to refer patients and clients to the appropriate resources depending on their relationship health needs. (s)|
|H. Know legal issues in treating and reporting family violence that apply to one’s profession in the jurisdiction of practice.||1. Know state reporting laws and mandates, local and state reporting agencies, and their procedures and regulations, including potential liability for failure to report. (k) 2. Be able to interact effectively with law enforcement and protective services agencies when appropriate. (s) 3. Understand what happens when a report is made to law enforcement and protective services. (k) 4. Understand the need to balance respect for individual autonomy with concerns for safety of vulnerable persons when making reporting decisions. (a) 5. Understand the health professional’s role in working with the legal system including law enforcement and the courts. (k) 6. Be able to effectively introduce evidence-informed, ethically-defensible, expert testimony in courts. 7. Know and utilize appropriate steps for thorough documentation of abuse in patient/client charts. (s, k) 8. Be able to support patient/client safety when making a report. (s, k)|
|I. Know the ethical requirements of one’s profession regarding violence and abuse.||1. Know ethical principles that apply to patient and client con dentiality for patients/clients exposed to violence and abuse as well as the limits of that con dentiality. (k) 2. Be able to explain the limits of con dentiality. (k) 3. Be aware of the formal ethical positions of the learner’s discipline. (k) 4. Incorporate these ethical requirements in the learner’s personal ethical system regarding care. (a)|
|J. Engage in multi-disciplinary collaboration and outreach in response to violence and abuse.||1. Know how to identify resources in a state and local community and build collaborative relationships with these resources. (k) 2. Understand the impact of community outreach programs on the prevention of physical, emotional and sexual abuse and neglect. (a) 3. Understand the principles of prevention of interpersonal violence. (k) 4. Demonstrate the ability to collaborate with other disciplines to create a comprehensive response within a clinic, organization, hospital, or emergency department; including prevention, identi cation, intervention and follow-up. (s, a) 5. Demonstrate understanding and ability to collaborate with individuals, disciplines, professions, and agencies that may be directly and indirectly involved with advocacy to end violence. (a)|
|K. Practice effective self-care.||1. Acknowledge how one’s own experiences with violence and abuse may in uence one’s ability to respond appropriately to situations, to ask for assistance resolving biases, and developing competencies. (k, a) 2. Be aware of the potential effects on providers of caring for patients and clients exposed to violence and abuse. (a, k) 3. Know how to access support for effective self-care. (k)|
|L. Obtain the training and skills necessary to advance the eld.||1. Understand how to acquire additional teaching skills, research and advocacy skills. (k) 2. Take responsibility for personal and professional development and identify appropriate learning activities. (a)|
|M. Apply the concept of systems-based practice.||1. Understand how to develop a patient-centered, systems- based, inter-professional intervention in an outpatient of ce, emergency department, or health care system. (k) 2. Be able to describe the prevention, recognition, treatment and management of exposure to violence and abuse in terms of organized systems of care. (s)|
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