and the multidisciplinary expertise of our committee members, the committee drafted proposed core competencies at the basic level within the domains identified in the literature (see Table 6.1). These core competencies reflect the committee’s consensus on best practice, the ideal state of knowledge and skills, published expert opinion, and existing curricula. They were developed to address multidisciplinary care and to be inclusive of family violence across the life span.

Content was specified in accord with the areas of overlap found in the curricula the committee examined and proposals offered in the literature. As such, these proposed competencies build on the collective wisdom of those working in family violence. They are not intended as a definitive set of competencies but are offered as a springboard for research and evaluation. The committee emphasizes the need for research on these competencies, or any set that is chosen, to provide a scientific basis and to determine effectiveness. It is our judgment that current training initiatives and educational development should be suspended awaiting scientific evidence, but the need for such evidence must be addressed in the short term. The review of existing curricula and the literature indicate that much of the curricular development to date has largely been done within schools or particular professional groups or by organizations concerned specifically with one type of violence. Thus it appears that much “reinventing the wheel” occurs. In the committee’s view, the various professions and organizations involved with victims of family violence could benefit greatly from collaboration in developing, testing, and evaluating core competencies on family violence.

Advanced competencies for responding to family violence have yet to be developed, with some notable exceptions. For example, the American Association of Colleges of Nursing (1999, http://www.aacn.nche.edu/publications/positions/violence.htm) recently published nursing education competencies for domestic violence (see Appendix H). To date, neither child abuse and neglect nor elder maltreatment have been addressed. The basic competencies set forth in Table 6.1 and the advance practice competencies of the American Association of Colleges of Nursing may provide all health professions with some helpful material to start to inform their own discussions leading to core competency descriptions and research. In addition, the list may provide a starting point from which collaborative work across professions can begin.

Advanced practice education does exist in other areas. For example, subspecialty residencies have been established for developmental pediatrics and adolescent health. Following increased research and a growing recognition of the need for cross-disciplinary training in these areas, the Maternal and Child Health Bureau of the Health Resources and Services Administration funded advanced-level training programs. The adolescent health program, for example, grew out of research on adolescence that began in the 1950s. In 1967, the Maternal and Child Health Bureau funded adolescent programs at 6 sites that included 14 physicians. In 1976, the bureau funded 9 new sites and extended training to



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement