Impact of a 3-year transformational change project in family violence clinical response: Qualitative evaluation of the depth and breadth of knowledge in hospital clinicians by training level.

Abstract

Objectives: This study aimed to investigate the impact of different levels of training in family violence (no training, some training, clinical champions), on the clinician knowledge of key family violence response skills, using qualitative, survey obtained text-box responses.

Design: A cross-sectional, online, survey of hospital clinicians in a major trauma hospital was conducted.

Methods: The Assisting Patient/Clients Experiencing Family Violence: Royal Melbourne Hospital Clinician Survey tool was utilised and open for clinicians to complete, anonymously over a 6-week period. Free-text survey responses were analysed using an inductive thematic analysis approach.

Results: Five hundred twenty-six clinical staff participated, 30% with no training, 52% with some training and 18% who were trained as clinical champions. A clear pattern was observed across training levels. Those with no training opted to demonstrate their family violence knowledge base less frequently. When they did, answers lacked specific information and details, showed limited knowledge of covert family violence indicators and provided a higher proportion of responses that did not align with best practice guidelines. Staff with some training showed a more sophisticated understanding in these areas. However, the quality of their responses did not match those of the clinical champions, who also provided an ongoing community of practice to further their skills.

Conclusions: Providing some training in family violence yields a higher degree of family violence knowledge in clinicians, relative to no training. However, the extra resourcing required to train and maintain a clinical champions model in family violence provides demonstratable benefits, via a more sophisticated and nuanced understanding of indicators, enquiry and disclosure response skills, that align with best practice guidelines.