teaching about violence in higher education elaine j. alpert, md, mph mincava april 12, 1999

Teaching About Violence in Higher Education

Elaine J. Alpert, MD, MPH

MINCAVA

April 12, 1999

Topics

• Why teach about violence?• Opportunities and impediments• Approaches and strategies• Quality teaching - a precious resource• Integrating campus and community• Integrating science and advocacy• Two examples• Troubleshooting• Collaboration to achieve a common goal

Why Teach About Violence?

• Prevalent in all stages and contexts– Child abuse and neglect– Child sexual abuse– Intimate partner abuse– Elder mistreatment– Homicide– Suicide– Rape


• Important issue in society– Affects everyone’s sense of well-being– Impedes optimum development of children– Adverse effects on physical and mental health– Adverse effects on society

• Deflects and distorts society’s goals

• Criminal justice costs

• Health care expenditure

• Social service costs

• Indirect costs


• Germane to students’ future careers– Opportunity to make a difference in society– Intellectually challenging– Multidisciplinary– Competitive edge in job market

Why Teach about Violence?

• Germane to students’ personal lives– Common topic of discussion on campus– News and entertainment media exposure– Video games, music videos

• Many students are personally affected– Witness (child, family member, friend)– Victim– Perpetrator

Topics


Opportunities and Impediments

• Opportunities– Faculty pioneers– Student activism, initiative– Visionary leader (dean, department chair)– Incident or event (on or off campus)– Funding availability

Opportunities and Impediments

• Impediments– Faculty opponents– Lack of student initiative– Presence of student initiative– Not perceived as a “priority”– Resistance by administration– Lack of funding– Few women, minorities in leadership positions

Topics


Approaches and Strategies

• Subject-based approach– Content of entire course or segment

• opportunities, challenges

– Integrated through several segments• opportunities, challenges


• Subject-based approach– Ex: MMS Seminar Series on DV– Ex: SB750 - Fam. Viol. and Public Health


• Whole campus approach– Ex, freshman orientation

• opportunities, challenges

– Ex, “Take Back the Night” week• opportunities, challenges

Topics


What Makes a Great Teacher?*

• Engages minds and curiosity of every student, not just those going into the field

• Opens avenues of exploration• Available• Accountable• Affable

(Thanks to Mort Hoffman, Ph.D)

Which is Better?

• in class teaching?

• field / clinical teaching?

Answer: both, and it depends!

In Class Teaching

•Cost effective

•Efficient

•One expert, many students

•Easy to communicate expectations

Field / Clinical Teaching

• Skill-based

• Effective

• One-to-one attention

• Feedback on performance

Classroom Presentations

• Should not be boring

• Active process

• Questions can guide presenter

• Clarify, emphasize important points

• Persuasive

• Empathic

Teaching - live, improvisational performance in real time

• Paying audience

• Well-honed script with improvisation

• Set, props, special effects

• Blocking (how you use your space)

• Dramatic (pregnant) pause

Teaching - live, improvisational performance in real time

• Verbal language (how you use your words)

• Body language (how you use your body)

• Feedback from audience

• Real time performance modification

• Stage fright!

How to be Effective in the Classroom

• Emphasize important points, but don’t repeat yourself• Neither too loud nor too soft• Neither too fast nor too slow• Enunciate clearly (but don’t be ridiculous)• Use pauses but don’t fill up with vocalizers• Don’t hide behind furniture!• Make eye contact• Look alive - use facial expression!

Use a Predictable Structure

• Introduce what you are going to do

• Do what you said you would do

• Summarize what you did

Additional Teaching Strategies

• Break up the lecture into segments

• Use directed group discussion

• Repeat each question before answering

• Manage your time

• Lead the discussion

Other Useful Teaching Strategies

• Survivor presentations

• Panel presentations

• Theater presentations

• Video segments

More Useful Teaching Strategies

• Kelly box

• Utilize technology but don’t get crazy

• Be prepared - make sure everything works!

Less is More

• Don’t need to “cover” everything

• Session is a departure point, not a terminus

• Encourage independent learning

• Knowledge is built, not just passed on

Teaching about Violence

• Students may know more than teachers• Teachers may not appreciate scope of problem • Teachers may not value others’ expertise in field• Some students may be victims, perpetrators or

witnesses• Some teachers…• Knowledge isn’t enough. Specific practical skills

are necessary

Topics


Integrating Campus and Community

• Involve others in curriculum planning– colleagues– students– security– health services– theater groups– survivors– advocates– others


• Involve others in teaching– within and outside of class– advisory group– seek (and be alert to) diversity– guest faculty from university– guest faculty from community (inc. survivors)– collaborate on each others’ projects– work together towards a common goal


• Join in coordinated community-based response– community roundtable– grass roots violence prevention efforts– involve young people - energy and creativity– involve business - money and influence– involve faith community– others

Topics


Integrating Science and Advocacy

• Effective teaching is science-based

• Effective teaching is advocacy-based

• Tension between science and advocacy

Topics

• Why teach about violence?• Opportunities and impediments• Approaches and strategies• Quality teaching - a precious resource• Integrating campus with community• Integrating science with advocacy• Two examples• Troubleshooting• Collaboration to achieve a common goal

Example 1

Massachusetts Medical Society

Seminar Series on

Domestic Violence

Seminar Series on DV

• Self-contained

• 4 sessions

• Skills-focused

• Interactive

• Multimedia

•Seminar Series Intent

• Non-expert medical faculty can teach effectively about DV

• Target audience - physicians in training and in practice (primary care doctors)

• Non-MD clinicians, others (segments of curriculum)

Seminar Series - Goal

• Enable learners to master skills of:– routine inquiry– assessment– referral– advocacy

Seminar Series Contents

• facilitator notes for 4 sessions• handouts • slides• physician pocket reminder (RADAR) cards• teaching goal cards• 15- minute instructional video• 3-disc interactive CD-ROM• baseline, follow-up evaluation instruments

Seminar Series Components

• Seminar 1 - Background and Dynamics of DV– definition– spectrum– high risk indicators– obstacles to leaving– patient, system barriers to receiving care– physician barriers to providing care


• Seminar 2 - RADAR - a Clinical Model for Screening, Diagnosis and Intervention– interviewing techniques– physical examination– documentation– danger assessment– safety planning


• Videotape - “Diagnosis: Domestic Violence”– summarizes first 2 seminars– learner can “see” model of care


• CD-ROM - “Understanding Partner Abuse”– Disc 1 - 3 model, in-depth virtual interviews– Discs 2,3 - 4-visit scripted virtual “case”


• Seminar 3 - Skills Development for Clinical Practice– 3 role plays– modeled after FUND role plays– learners break into groups of 3 (triads)– 3 roles - physician, patient, observer

Value of Role PlaysValue of Role Plays

• Awareness of personal barriers• Safety to practice and explore• Awareness of non-verbal cues• Identification with “victim”• Opportunity to develop new skills• Group learning and modeling• Increased confidence• Gets everyone actively engaged in learning

Adapted from Carole Warshaw, M.D.Adapted from Carole Warshaw, M.D.


• Seminar 4 - a Team Approach to Violence Prevention and Intervention– cofacilitated with a community-based “expert”– reinforces team concept of care– de-emphasizes role of doctor– introduces learners to real referral experts– strengthens relationship with community

agencies

SB750 - Family Violence and the Practice of Public Health

• Catalog Description:

Prereq: SPH SB 721 Behavioral Sciences and Public Health (recommended). This course provides an overview, from a public health/prevention perspective, of the problem of family violence, focusing on child abuse and neglect, child sexual abuse, domestic or intimate partner abuse, and elder abuse...

SB750 - Catalog Description, cont

The “Spectrum of Prevention” model, developed by Dr. Marshall Swift of Hahnemann College, will be utilized to provide a conceptual framework for primary and secondary prevention. Students who have completed this course will be prepared to approach meaningful community-based or investigative work in the field...

SB750 - Catalog Description, cont

Small group discussion, case analyses, and interviews with providers whose daily work is in the field, will foster the examination of issues related to epidemiology, behavioral dynamics, prevention, intervention, public policy, and research in family violence.

SB750 - Goals and Objectives

• Knowledge

• Attitudes

• Skills

SB750 - Assignments

• In- class participation

• Extensive course reader

• Case analyses

• Interviews

• Agency assessment, or

• Research paper

SB750 - Topics Covered, Spring 1999

Week 1. Introduction; Overview and Definitions, Social and Behavioral Factors in Family Violence; The Spectrum of Prevention

Week 2. Violence Against Women – I

Week 3. Violence Against Women - II, Introduction to child abuse and neglectpresentation by survivor of child abuse


Week 4. Research in Family Violence

Week 5. Children Who Witness Violence

Week 6. Child Sexual Abuse Investigation and Victim-Witness Assistance Program Development

Week 7. Partner Violence in the Gay, Lesbian, Bisexual, and Transgender Community


Week 8. Elder Mistreatment

Week 9. Teen Dating Violence - Recognition, Intervention and Prevention

Week 10. The Perpetrators of Family Violence

Week 11. Violence in the Entertainment and News Media


Week 12. Law Enforcement Issues in Family Violence - Ipanel presentation - Judge, Asst. DA, Detective

Week 13. Law Enforcement Issues in Family Violence – II panel presentation - attorney, victim-witness advocate,

survivor

Week 14. Impact of Intimate Violence and Poverty on the Lives of WomenStudent Presentations – I


Week 15. Violence Against Women as an International Human Rights IssueStudent Presentations – II

Course evaluation

Week 16. Building a Coordinated Community Response to DV (The primary prevention of family violence)Student Presentations – III

End of Semester Celebration

SB750 - Opportunities

• First course of its kind in public health

• Will likely lead to additional courses

• Potential for further development

• Good for image of school

• Content useful, worthwhile for students

• “Club 750”

SB750 - Challenges

• Difficult to get through curriculum committee

• Emotionally challenging for students

• Emotionally challenging for teachers

• Large time committment in and out of class

• Boundary fortification

• Funding

SB750 Mid-course feedback

• Content

• Work load

• Other

Topics


Troubleshooting

• Personal issues - faculty, student

• Institutional issues

Troubleshooting

• Personal issues - gender and culture– Gender socialization - how you were raised– Familial, religious, cultural values– Being male or female in a society or culture that

tolerates abuse


Troubleshooting

• Personal issues - power and control– Identification with victim or perpetrator– Personal power and control issues– Power by virtue of “position” (within or outside

of class)


Troubleshooting

• Personal issues - addressing difficult issues– Magnitude of problem– Assumptions about human decency– Assumptions about love and family– Dealing with stereotypes– Dealing with feelings


Troubleshooting

• Institutional issues

– Curricular time constraints

– Administrative structure of institution

– Departmental structure of institution

– Faculty role definition - boundaries

– Faculty role definition - advocacy for change

Topics


Collaboration

• Defining the “team”

• Prerequisites for effective collaboration– listen– respect– communicate– be honest

Summary


teaching about violence in higher education elaine j. alpert, md, mph mincava april 12, 1999

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