to more extensive (e.g., a series of lectures or case discussions during a clinical rotation).

About 95 percent of medical schools report curricular inclusion of material related to child abuse and neglect (Alpert et al., 1998). The curricula generally include content on the identification, reporting, and management of child abuse and neglect and are typically introduced during the pediatric rotation in medical school (Alexander, 1990; Bar-on, 1998). Teaching strategies are both didactic and interactive.

With regard to intimate partner violence, medical schools report an increase in education (AAMC, 2000). Content usually focuses on screening, history taking, and available community resources for victims. Sexual assault appears to receive more attention than other forms of maltreatment. Teaching appears to occur most often in the form of lectures, frequently involving presentations by victims, case discussions, and role-playing exercises. The content is usually integrated into courses on history taking and communication or is offered during emergency medicine and obstetrics-gynecology rotations. With the exception of the few schools that now offer problem-based intimate partner violence cases or clinical electives, most instruction on intimate partner violence and elder abuse still occurs in the preclinical years and is predominantly content focused, lecture based, isolated, and not integrated into the overall educational schema with clinical correlations and cross-disciplinary education (Alpert et al., 1998).

Elder maltreatment appears to be least often included in medical school curricula. When it is, content tends to focus on institutional abuse and abuse between older intimate partners rather than other forms of maltreatment in a family setting. The most common teaching method is case discussion, most likely to occur during patient interviewing courses or during emergency department rotations. Schools with a geriatrics rotation appear most likely to address elder abuse.

Residency Training

Family violence training during residency appears most common among programs whose residents are considered mostly likely to encounter victims: pediatrics, obstetrics-gynecology, emergency medicine, internal medicine (primary care), geriatrics, and psychiatry. The Residency Review Committees of the Accreditation Council for Graduate Medical Education require education on family violence in a number of residency and subspecialty residency programs. Programs in pediatrics, adolescent medicine, pediatric emergency medicine, and forensic psychiatry specifically are required to include training in child abuse or neglect. Obstetrics and gynecology residencies must include training on intimate partner violence. Family practice geriatric medicine and geriatric psychiatry residencies must include training on elder maltreatment. Family practice, internal medicine, and emergency medicine residencies must contain training



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