PRP184: Trauma Informed Care Training for a Family Medicine Residency

Kari Nilsen, PhD; Mary Boyce, MD


Context: Psychological trauma refers to an experience that creates a sense of fear, helplessness, or horror that overwhelms a person’s coping resources. Some have minimal symptoms or recover quickly, while others develop more significant, longer-lasting problems. Many primary health care providers feel uncomfortable discussing these types of trauma and may also feel unprepared to deal with the effects of trauma in their patients. As a result, patients with a history of trauma report feeling more stigmatized by health care providers. This is detrimental to care because patients with any form of trauma need more help accessing resources than those who have not. Physician communication predicts patient outcomes, and the way physicians communicate with patients who have experienced trauma can directly impact their lives. This is called “Trauma Informed Care.” Objective: Provide training to family medicine and faculty physicians regarding trauma informed care. Study Design and Analysis: Participating resident and faculty physicians will be given a baseline questionnaire regarding comfort and competence of using trauma-informed care principles with patients. Following this baseline questionnaire, a didactic education session will be held. Following this, participants will participate in standardized patient (SP) encounters focusing on trauma informed care cases. These cases have been developed with help from an area crisis center and the hosting university SP program. Following the SP encounter, participants will be evaluated using a formal matrix. Following the SP encounter and a debriefing, participants will be given the same questionnaire to evaluate comfort and confidence. Pre and post-didactic session questionnaires will be compared to determine amount of change on self-reported competence regarding trauma informed care. Setting: A family medicine residency program. Population Studied: Resident and faculty physicians. Intervention: The intervention included didactic sessions, SP encounters, and a knowledge/comfort survey. Outcome Measures: The change in knowledge and comfort on the questionnaire from before and after the educational session is one measure of outcome. The second outcome is the matrix evaluation on the SP encounter. Results: Data collection is currently ongoing. Expected Outcomes: It is hypothesized that as a result of this training, participants will feel more comfortable and competent helping patients who have experienced trauma.
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Tim Riley 11/23/2020

This is such an important topic, and SP experiences provide a safe playground for learners to explore these skills.  Another benefit is that they can be reproduced at other clinics.  Great job!  I wonder if there are trauma-sensitive behaviors which could be observed during SP interactions or with real-life patients?  That would be useful to see if the experience truly changes behavior.  Thanks so much for this work, and keep it up!

Nadine Parkes 1/6/2021

I observed it very difficult to cognizance at the more than one lifelong traumas I've been thru it is too many various things and so I simply felt devastated and misplaced and commenced crying, however then I simply stopped studying a lot and peeled all of it off at the beach, and stepped into the forgiving calming water and from there my frame eventually launched all tensions and anger and I became eventually loose from all burdens this frame carries. Amazing. I wasn't capable of sleep however the tears stopped, my pulse eventually calmed down.

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