The Culture of Gun Violence: An Active Learning Exercise

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Abstract Introduction: Effectively addressing and preventing gun violence requires multidisciplinary collaboration between public health and health care providers. Community-level violence prevention cannot be the exclusive responsibility of public health; health care providers have the opportunity to intervene at the point of care, when injury is most acute and the victim or family members may be most at risk of further violence or may be motivated to break the cycle of violence. This active learning exercise utilizes a case discussion about a patient who presents to the Emergency Department with a gunshot wound. Methods: This case study involving a gunshot wound is presented in a PowerPoint presentation. The session typically lasts 60 minutes, with 15-20 minutes devoted to student discussion. Open-ended questions prompt students to think about the personal, social, cultural, and environmental factors that may have contributed to this patient's situation. The exercise then discusses the culture of violence that leads to so many injuries and the role physicians and other health care providers can play in the prevention of gun violence. Results: This resource has been used twice in a psychopathology course for second-year medical students. The mean student evaluation score for this module was 4.44/5.00 in the first year and 4.06/5.00 for the second year. Discussion: Students are highly engaged with this exercise, and seemed surprised to think about how physicians can be involved with efforts to prevent gun violence. After the session, several students have approached the instructors, asking how they can get involved in local initiatives to reduce gun violence. The students are also surprised to learn the patient is Caucasian, which challenges the stereotypes they have about young men who perpetrate urban gun violence. This situation allows for the course instructor to emphasize the need for caution in forming assumptions about patients.