Return to Diagnosis ListShow Learning Points most relevant to Phase 1:

Intimate Partner Violence

Clinical Discipline(s)/Organ System(s)
Emergency Medicine, General Practice
Progress Test Topic(s)
A 30 year old woman is brought in by ambulance to the emergency department at 0200. On arrival, she is short of breath. She states she has run out of ‘Ventolin’ (salbutamol). She is pale, speaking short sentences. This is her third presentation this year. She recovers with salbutamol treatment and the emergency doctor goes to speak with her before discharge home.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Understand the importance of family violence as a health issue, including child abuse and neglect, elder abuse and neglect, and intimate partner violence
   - Understand that family violence is a power and control issue
   - Understand the concept of "toxic stress"
Clinical and Communication Skills 
   - List and explain barriers to identification of intimate partner violence
   - Be aware of the method of routine enquiry for intimate partner violence during clinical assessment
   - Consider intimate partner violence as a possible reason for change in health condition
   - Describe how you would set up and conduct the health assessment (including routine enquiry) in such a way that you create an environment that would allow for safe disclosure by a person who is experiencing intimate partner violence
   - List some validation statements that could be made to adults who disclose intimate partner violence
   - When intimate partner violence is disclosed describe how you would conduct a health and risk assessment in a culturally sensitive and empathic manner; and what key content you would include (e.g. lethality; mental health assessment and risk to any children in the home)
   - Describe how to perform an examination of an adult who you suspect is experiencing intimate partner violence
   - Describe the options for safety planning and referral including identifying key referral agencies that would be appropriate to contact during the health intervention e.g. DHB social workers, community based family violence advocate (i.e. Shine), Police, and Oranga Tamariki (formerly Child Youth and Family)
   - Approach to documentation in clinical notes of intimate partner violence intervention (history, examination including measurement of any injuries described, safety planning and referral)
   - List resources available to health professionals to support them to include intimate partner violence intervention into practice, e.g. local DHB policy, MoH Guideline, DHB Violence Intervention Programme core training
Personal and Professional Skills 
   - Discuss your role as a doctor in routine enquiry and intervention upon disclosure (i.e. assessment, safety plan, referral, documentation)
   - Importance of working within a multi-disciplinary team to determine appropriate support and referral options/pathways for individuals who disclose intimate partner violence
   - Opportunity for self-reflection – what does intimate partner violence mean to me? What experience have I had so far in my clinical training with routine enquiry for, and disclosure of, intimate partner violence?
   - Develop an understanding of the dynamics of intimate partner violence and barriers to seeking help
Hauora Māori 
   - Understand that Māori are significantly overrepresented both as victims and perpetrators of family violence
   - List some factors that have contributed to the occurrence of violence within whanau
   - Understand that solutions to family violence which are based on tikanga and which involve the wider whanau may be more likely to achieve the best outcomes
   - List some ways health practitioners can put into practice the principles of the Treaty of Waitangi in the context of family violence
Population Health 
   - Definition and scope of intimate partner violence (MoH Guideline, NZ Family Violence Clearinghouse)
   - Prevalence of intimate partner violence in NZ
   - Short- and long-term health consequences of family violence, including physical, sexual and reproductive, and psychological and behavioural
   - Co-occurrence of intimate partner violence and child abuse and neglect
   - Sequelae for children exposed of intimate partner violence, even in absence of physical or sexual child abuse
   - Understand key policy and legislation relevant to responding to family violence in NZ, for example, Domestic Violence Act, Oranga Tamariki Act (1989) and Vulnerable Children’s Act
   - Be aware of NZ Family Violence Clearinghouse as source of research expertise and current information:
   - Be aware of The University of Auckland Family Violence Project that addresses resources for students and staff:
Conditions to be considered relating to this scenario
intimate partner violence, asthma