Training dentistry students to recognise and respond to domestic violence

James Cook University (JCU) is training dental students to recognise and respond to signs of domestic violence.

Dentists have traditionally received little training in the area, despite the fact that many domestic violence-related injuries involve damage to teeth.

The College of Medicine and Dentistry, in collaboration with JCU’s Social Work academics and the Cairns Domestic Violence Service, has developed a new program aiming to address this knowledge and skill gap.

The ‘Domestic Violence: recognise, respond and refer’ program is the first of its kind in Australia, and began in 2015 when students completing clinical placements in regional, rural and remote locations reported feeling out of their depth when presented with patients who showed signs of domestic violence.

Said Dr Felicity Croker, a senior lecturer in dentistry at JCU: “It became evident to me that we needed some educational intervention.”

Felicity asked JCU social work Lecturer Dr Ann Carrington to help her develop a program for the dentistry students. The pair approached the CEO of the Cairns Regional Domestic Violence Service Amanda Lee Ross, who has worked in the field for more than 15 years.

The program provides students with tools to discuss domestic violence matters sensitively and skilfully with patients, and to respond and refer them to other services.

Amanda said the program fills an important gap in service provision for people experiencing domestic and family violence.

“I’ve delivered a lot of training to other professionals who may come into contact with people experiencing domestic or family violence – such as doctors and nurses – but the one group of people we’d never had any contact with was dentists. I was very happy to be involved. It makes total sense: we see people experiencing facial injuries, and I’ve lost count of the number of clients who lost teeth because of the violence.”

Over 200 dentistry students now participate in the educational program annually, which includes a series of workshops in preparation for clinical practice.

Sessions cover the prevalence of domestic and family violence; role-play scenarios to help students find the right words to ask patients the right questions, while being mindful of not blaming a victim of violence; and non-verbal cues – such as not sitting behind a patient, or standing over them in the chair – that can help to ease anxieties, and promote honest conversations.

 “Most people don’t like going to the dentist, but these patients may be anxious for a different reason, and that’s to do with what they’ve experienced at the hands of somebody else. I’m really excited by such a program as this: it’s exciting, it’s different and we’re leading the way.”

To evaluate the program, students were surveyed before and after participating about their understanding, perceptions and preparedness for responding appropriately to domestic violence. Students’ knowledge regarding domestic violence increased significantly and they reported feeling enabled to embed awareness of domestic violence into their clinical practice.

Students Casey Townsend, Winson Chan and William Shield, who completed the research project about the program, and have joined JCU staff to present the research at several conferences in Australia and internationally.

Winson said he has found the program useful. “All things come with practise. If I get some hands-on experience, and more preparation for it, I would be more inclined to talk to the patient about it. It’s the same as doing a filling - the first time, it was quite daunting, then after a couple of times, it became normal.”

“We hope to work with the dentistry community to provide practicing dentists with access to this vital knowledge about their role in supporting patients who are experiencing domestic or family violence,” Felicity said.

The program has received considerable interest from the wider dental community. JCU is delivering some professional education to dentists in Cairns on the topic in June 2018, and White Ribbon and the Queensland Domestic and Family Violence Implementation Council have visited the University to find out more about the program.

First published in the ADA News Bulletin, No 473, March 2018 – republished with permission.

For help with domestic or family violence, please call 1800 RESPECT (1800 737 732)