Sexual Assault and Domestic Violence Continuing Education for Massachusetts Clinicians
In August 2014, a comprehensive sexual and domestic violence bill was enacted in Massachusetts. Chapter 260 of the Acts of 2014 provides legal protections for victims, outlines criminal offenses, and mandates training for clinical healthcare professionals including physicians, dentists, nurses, physician assistants, clinical social workers, other clinical healthcare providers, police, and judges.
A note about terminology: A range of definitions and nomenclature is reflected in the peer-reviewed literature associated with most forms of gender and power-mediated violence, abuse, and coercion. As a result, different definitional and descriptive terms can be found, and are often used interchangeably. While this course is written to be specifically responsive to Chapter 260 provisions regarding “Domestic and Sexual Violence Training,” the literature’s variation in terminology is reflected in this course. Specifically, the terms “abuse,” “violence,” “trauma,” and “coercive control” are used interchangeably. In addition, “domestic violence” (DV) and “intimate partner violence” (IPV) are used to describe coercive control in dating or intimate relationships (the broader issue of “family violence” is outside the scope of this course). Similarly, the terms “sexual violence” (SV), “sexual assault” (SA) and “sexual coercion” (SC) are used interchangeably.
This educational offering is presented to physicians and other clinical healthcare professionals in the Commonwealth of Massachusetts in compliance with the Acts of 2014, Massachusetts General Laws Chapter 260, Section 9. This course provides information, clinical guidance, and resources to help physicians and other practicing healthcare professionals identify and respond, in a trauma-informed and culturally responsive manner, to patients and clients:
- Who are experiencing domestic violence (DV) and/or sexual violence (SV);
- Who may be at risk for abuse; or
- Who may have experienced or been exposed to DV or SV at some point in the past, including during childhood.
SV and DV are substantial and often overlapping issues, meriting exploration and response in a manner that is culturally responsive, trauma-informed, and attuned to the range of individual, interpersonal, institutional, societal, and historical influences that can impact each individual and each topic. SV is a frequent component of DV.
This course is intended not only to comply with the legislative mandate described above, but also to serve as a foundation for self-directed lifelong learning. Clinicians who are interested in developing deeper or specialized expertise in any aspect of violence across the lifespan are encouraged to seek out opportunities within their own professional fields or to contact the Massachusetts Medical Society Department of Health Policy, Public Health and Education at dph@mms.org.
Please read this paragraph carefully prior to beginning this continuing education activity: Because DV and SV are so prevalent both within the Commonwealth as well as beyond, some who interact with this material may have had recent or past personal exposure to these forms of abuse, including during childhood, or may be in an ongoing, current abusive relationship as a survivor or as a perpetrator. Additionally, because this material addresses some of the most purposeful and heinous behaviors encountered in clinical practice, learners – including but not limited to those who have had personal exposure – may experience discomfort, triggering, disturbing thoughts, or re-traumatization in the course of these and similar continuing education efforts. Those whose lives have been affected directly by abuse or by interacting with this educational material are urged to seek support from a community-based direct service organization, a confidential hotline, or from a trusted colleague, therapist, or other source.
Course Objectives
Clinicians who complete this online continuing education course will be able to:
- Summarize the incidence, prevalence, and spectrum of domestic violence (DV) and sexual violence (SV);
- Articulate both risk and protective factors associated with DV and SV;
- Describe physical and emotional symptoms and signs associated with experiencing DV and SV;
- Identify immediate, short-term, and long-term health impacts of DV and SV;
- Explain the behavioral dynamics of coercive control most commonly seen in those who perpetrate abuse;
- Demonstrate sensitivity to challenges commonly encountered by individuals who face particular vulnerability related to personal or societal circumstances, including adolescents; elders; disabled individuals; people of color; immigrants; those living in or at risk of poverty, individuals with limited English proficiency, and those with diverse sexual preferences or gender expressions;
- Describe the range of adverse effects seen in children who are exposed to or who witness DV or SV;
- Explain the principles of trauma-informed care;
- Illustrate how to inquire routinely in the clinical setting about DV and SV as components of violence and abuse across the lifespan, and document patient disclosure and relevant physical findings in the medical record in a manner that underscores safety and confidentiality for the patient;
- Respond to patient disclosure in a trauma-informed and culturally responsive manner;
- Refer patients to appropriate practice-based and community-based services, and arrange for appropriate follow-up, including comprehensive primary care;
- Deal effectively with personal feelings and emotions that can arise when caring for traumatized individuals;
- Articulate prevention strategies that can be implemented within clinical practice settings; and know how to pursue further educational and practice opportunities in the field.
Faculty
Elaine J. Alpert, MD, MPH, Author
Elaine J. Alpert, MD, MPH is an internationally respected educator, scholar and consultant in intimate partner violence (IPV), sexual assault (SA), and human trafficking (HT). Beyond these and other content areas that encompass violence across the lifespan (VAL), Dr. Alpert’s expertise spans clinical care; prevention-focused public health; medical education and distance learning; strategic planning; policy; advocacy; and leadership.
Following a 25-year career at Boston University Schools of Medicine and Public Health as a clinician, medical educator, public health faculty member, and assistant dean, Dr. Alpert was awarded a 2009 Fulbright Fellowship to develop and teach courses about the health and public health aspects of VAL and about intervention planning to improve public health at the University of British Columbia (UBC) in Vancouver BC, Canada. She also developed the UBC Interpersonal Violence Prevention Program and launched a web-based Violence Intervention and Prevention (VIP) Connector. She currently teaches communication skills, and several topics related to sensitive interviewing, including about IPV and SA at UBC’s medical school.
Dr. Alpert is the Founding Chair of the Massachusetts Medical Society (MMS) Committee on Violence Intervention and Prevention (CoVIP), a respected committee that remains active 35 years after its inception. As part of her ongoing commitment to CoVIP, she has served as lead author of numerous MMS educational programs, policies, and numerous publications, including The MMS Seminar Series on Domestic Violence, all six editions of Intimate Partner Violence: the Clinician's Guide to Identification, Assessment, Intervention and Prevention (6th ed., 2015), and Human Trafficking: Guidebook on Identification, Assessment, and Response in the Health Care Setting (2014, 2024 in final preparation).
Dr. Alpert served as consultant to the Division of Global Health and Human Rights at Massachusetts General Hospital in Boston, contributing to a multi-country qualitative research study on health and public health responses to sex trafficking; and developing a curriculum, toolkit, and related publications for health providers and organizations on HT identification and response.
Dr. Alpert served on the U.S. Institute of Medicine Committee on the Training Needs of Health Professionals to Respond to Family Violence (1999–2001), which published Confronting Chronic Neglect: the Education and Training of Health Professionals in Family Violence. Dr. Alpert developed a comprehensive curriculum for healthcare providers and co-edited a Supplement to Academic Medicine entitled Educating the Nation's Physicians About Family Violence. She is the lead author of Responding to Domestic Violence: an Interfaith Guide to Prevention and Intervention and an accompanying training curriculum and tool-kit, and developed online continuing education about IPV and SA for the Commonwealth of Massachusetts. More recent presentations and publications include monographs about IPV and substance use coercion and about guidance for suicide prevention hotlines written for the National Center on Domestic Violence, Trauma, and Mental Health, a commentary about trauma-informed responses to sexual assault in emergency medicine settings, and two chapters for a textbook on public health responses to human trafficking.
Dr. Alpert continues to consult globally about health/public health responses to IPV, SA, and HT. Her approach champions collaborative working relationships among diverse stakeholders, including public officials, non-governmental organization staff, scholars, educators, administrators, clergy, caseworkers, advocates, representatives of community-based organizations, and survivors.
Dr. Alpert has received honors and awards throughout her career. Her greatest reward, though, is seeing former students become respected contributors to and leaders in their fields.
Rebecca Lee, MD, Researcher/Reviewer
Dr. Lee is a family medicine physician at Massachusetts General Hospital dedicated to providing comprehensive primary care to patients of all ages with a focus on preventive medicine and health promotion. Her passions within medicine include homeless health, addiction medicine, family planning and global medicine.
Dr. Lee attended Wesleyan University as an undergraduate, studying both chemistry and art. A summer in a Northern India village serving as a teacher and health educator inspired her work in public health and medicine. A graduate of Tufts University School of Medicine, she is deeply interested in community-focused healthcare. She spent one day a week during her first two years of medical school with the Boston Healthcare for the Homeless Street Team where she delved further into how best to care for the homeless population and those struggling with addiction.
She co-founded the Student Coalition on Addiction, an organization focused on improving education on addiction in the health professions, advocating for better services and treatment availability at the city and state level, and promoting student involvement in community activism. Upon earning her medical degree, Dr. Lee received the Tufts University Presidential Award for Civic Life. She completed her residency at the Greater Lawrence Family Health Center.
Accreditation Statement
The Massachusetts Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The Massachusetts Medical Society designates this enduring material for a maximum of 3.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets the criteria for the Massachusetts Board of Registration in Medicine for risk management study.
ABMS MOC Approval Statement
Through the American Board of Medical Specialties ("ABMS") ongoing commitment to increase access to practice relevant Maintenance of Certification ("MOC") Activities through the ABMS Continuing Certification Directory, this activity has met the requirements as an MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
Allergy and Immunology
Anesthesiology
Colon and Rectal Surgery
Family Medicine
Medical Genetics and Genomics
Nuclear Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry and Neurology
Radiology
Thoracic Surgery
Urology
National Commission on Certification of Physicians Assistant (NCCPA)
Physician Assistants may claim a maximum of 3.00 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.
Exam/Assessment
A score of 70% or higher is required to receive AMA PRA Category 1 Credit™.
Course Fees
MMS Member Physician: $120.00
MMS Resident/Student Member: Free
Non-Member Physician: $270.00
Non-Member Resident/Student: $60.00
Allied Health Professional: $96.00
Activity Term
Original Release Date:
Review Date (s): February 4, 2025
Termination Date: February 4, 2026
Format & Estimated Time to Complete: Text & Graphics, 3 hours
System Requirements
Desktops/Laptops
Windows 10
Mac OSX 10.6 higher
Most modern browsers including:
IE 11+
Firefox 18.0+
Chrome latest version
Safari 12+
Mobile/Tablet
iOS devices beginning with OS version 10 or higher (includes, iPhone, iPad and iTouch devices)
Flash player is required for some Online CME courses.
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Contact us at nejmcust@mms.org or (800) 843-6356. Massachusetts Medical Society, 860 Winter Street, Waltham, MA 02451.
