Domestic abuse training for Nursing and Midwifery students: a quasi-experimental and focus group evaluation
This mixed-method study demonstrates that domestic abuse training significantly improves nursing and midwifery students' knowledge, attitudes, and confidence, while highlighting the critical need for both structured undergraduate education and organizational cultural shifts to overcome workplace barriers and better support victims.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Violence within the home is not merely a private tragedy; it is a profound public health crisis that touches the lives of millions. When a person suffers abuse from a partner or family member, the harm extends far beyond immediate physical injury, often leaving deep emotional and psychological scars that last a lifetime. In many parts of the world, this violence is so common that it is estimated one in three women will experience it, and for some, it escalates to fatal levels. Because nurses and midwives are often the first medical professionals to see these individuals, they stand at a critical frontline. Their role is to recognize the signs of danger, ask the right questions, and connect survivors with safety and support. However, for years, a troubling gap has existed: while these healthcare workers are perfectly positioned to help, many feel they lack the knowledge, skills, and confidence to do so effectively. Without proper training, a survivor might disclose their fear only to be met with confusion or disbelief, causing them to retreat and lose a vital lifeline.
A team of researchers at Queen's University Belfast, working alongside the charity Women's Aid, set out to address this gap by testing a new approach to training nursing and midwifery students. They wanted to see if a focused educational session could transform how future healthcare professionals understand domestic abuse, not just in terms of facts, but in their attitudes and readiness to act. The study took place in Northern Ireland, a region where domestic abuse is reported frequently, yet where societal attitudes can sometimes minimize the problem. The researchers gathered students from both nursing and midwifery programs and provided them with a two-hour interactive workshop. This session was designed to be more than a lecture; it covered the complex nature of controlling behavior, the legal frameworks surrounding abuse, and the specific steps a professional should take when a patient reveals they are unsafe. The goal was to move students from a state of uncertainty to one of preparedness.
To measure the impact of this training, the researchers asked the students to complete surveys before and after the workshop. They tested the students on their knowledge of basic facts, such as how common abuse is and when it is most dangerous, and also asked them about their beliefs regarding who gets abused and what role healthcare workers should play. The results were clear and significant. After the training, the students demonstrated a marked improvement in their factual knowledge. They were better able to identify the signs of abuse, including the often-overlooked reality that abuse can be financial or emotional rather than just physical. More importantly, their attitudes shifted. They became more convinced that it is their professional duty to support survivors and more confident in their ability to ask difficult questions about safety. The training worked, turning vague awareness into concrete understanding.
However, the researchers did not stop at the numbers. They also sat down with small groups of students to hear their stories and concerns in their own words. These conversations revealed a deeper, more human layer to the findings. Many students admitted that before the training, they felt genuinely afraid of what would happen if a patient told them they were being abused. They worried about not knowing what to do next, how to handle a situation where a partner was waiting outside the room, or how to ask sensitive questions without causing offense. The training helped alleviate some of this fear, but the students also pointed out that knowledge alone is not enough. They described a workplace culture where some experienced staff members made assumptions about safety based on how a partner looked or acted, or where the pressure of a busy shift meant there was no time to have a proper conversation. Some students recounted hearing colleagues in break rooms blaming victims, suggesting that a woman "asked for it" or "should have left," which creates a toxic environment that discourages survivors from speaking up.
The students were clear about what they needed to bridge the gap between the classroom and the hospital ward. They expressed a strong desire for more than just a one-off session; they wanted domestic abuse education to be woven into their entire curriculum, repeated over time so the lessons stuck. They asked for practical tools, such as role-playing scenarios where they could practice difficult conversations in a safe space, and simple resources they could keep in their pockets to refresh their memory during a shift. They also highlighted the need for a cultural shift within healthcare institutions themselves. They observed that even with the right training, they could be undermined by a workplace that treats safety questions as a mere formality or a "tick-box" exercise rather than a genuine act of care. The researchers found that for training to truly work, it must challenge not only the students' lack of knowledge but also the harmful myths and assumptions that persist among professionals.
Ultimately, this study confirms that structured education can make a real difference in preparing the next generation of nurses and midwives. It shows that when students are taught the facts, the dynamics of abuse, and the skills to respond with empathy, they become more confident and better equipped to help. Yet, the research also serves as a warning that training cannot exist in a vacuum. If the workplace culture remains one that dismisses abuse or blames the victim, even the best-trained professional may struggle to make a difference. The path forward requires a dual effort: continuing to embed robust, practical education into university courses while simultaneously working to change the attitudes and practices of the healthcare systems where these professionals will eventually work. Only by addressing both the skills of the individual and the culture of the organization can the healthcare system truly become a safe harbor for those fleeing violence.
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