Trauma-informed primary care for medical residents.

Abstract

Psychological trauma can have a significant impact on mental and physical health, and interpersonal relationships. Many physicians report discomfort addressing psychological trauma in the context of health care visits, and few training opportunities exist for health care trainees to learn about the relationship between trauma and health. The aim of this project was to develop and implement an educational curriculum to teach medical and nursing trainees about trauma-informed primary care. We expanded upon pilot data from a brief interdisciplinary intervention to train medical residents in trauma-informed primary care at a Veterans Affairs hospital. We generated a trauma-informed care curriculum involving five 1-hour didactic sessions, 10-minute group reflection regarding patient interactions prior to each didactic session, and optional patient care observation and feedback. The curriculum aligned with internal medicine (n=16) and nurse practitioner (n=5) interprofessional primary care education sessions during the 2017/18 academic year. The curriculum was feasible and associated with increased self-reported knowledge, attitudes and practice around trauma-informed care. Free text feedback indicated that residents found the topic important, appreciated a skills-based approach and valued experiential educational activities. Training residents in trauma-informed care results in improved knowledge, attitudes and practices in caring for patients with psychological trauma. Residents appreciated both experiential and skills-based exercises. Next steps include continued exploration of using direct observation and feedback, and examining effects of training on patient outcomes (e.g. satisfaction with care).