Preparing medical students to recognize and respond to gender based violence: a mixed method study in SouthWest Nigeria.

Abstract

Background: Medical practitioners are ideally positioned to mitigate the impact of violence on the health of women. Not only are they well placed to educate students but also to screen and treat victims of violence. However, there is a lack of information on the knowledge and skills required of medical students to identify and manage victims of GBV. Aim: This study determined the factors that impact on student’s knowledge and skills in managing victims of GBV. It gathered the perceptions of victims on screening for violence by physicians and health professionals. Lastly, it established consensus amongst inter professional faculty on the content and strategies of a GBV training curriculum. Methodology: The study adopted a mixed method design. The qualitative methods included the review of curriculum documents, interview of departmental heads, three rounds (RDs) of the Delphi technique and interview of victims. The quantitative method analysed the questionnaire survey of final year medical students from three Schools in South West, Nigeria. The study was in 4 phases: - preliminary phase involving medical students (109) and departmental heads (6). Phase 1 involved medical students (388); Phase II the stakeholders of training (51) and Phase III the victims (33). Results: Younger respondents, females and married students were found to be less skilled to manage victims. Respondents with prior training in GBV were four times more likely to be skilled than their peers [AOR = 4.33, 95% CI: 2.37 – 7.90 and AOR 3.53; 95% CI 2.16- 5.78 respectively]. Consensus was reached on the content, methods and faculty for training medical students about GBV. There was agreement on the disciplines best suited and the need to assess the training. Further discussions are needed per institution on the contact hours and, duration of training. Most (n=24/33) victim participants advocated for medical practitioners to enquire of all women about their experience of GBV. Physically, medically and socially vulnerable women were identified as vulnerable women. The majority (n=24/33) indicated a need for medical students to be trained about GBV by a trans-disciplinary team. Conclusion: Formalised skills training on GBV is a necessity, especially for young, female students. The results will inform the design of a GBV curriculum for medical students in the African context.