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A Trauma-Informed Approach to the Medical History: Teaching Trauma-Informed Communication Skills to First-Year Medical and Dental Students

Authors
  • Brown, Taylor1
  • Mehta, Pooja K.2
  • Berman, Sarah3
  • McDaniel, Katherine1
  • Radford, Caitlin1
  • Lewis-O'Connor, Annie4
  • Grossman, Samara5
  • Potter, Jennifer6
  • Hirsh, David A.7
  • Woo, Beverly8
  • Krieger, David9
  • 1 Fourth-Year Medical Student, Harvard Medical School
  • 2 Second-Year Resident, Department of Medicine, Brigham and Women's Hospital
  • 3 First-Year Resident, Department of Psychiatry, Cambridge Health Alliance
  • 4 Nurse Practitioner, Department of Medicine, Division of Women's Health, Brigham and Women's Hospital; Instructor, Harvard Medical School
  • 5 Social Worker, Department of Psychiatry, Brigham and Women's Hospital
  • 6 Professor, Department of Medicine, Harvard Medical School; Physician, Department of General Internal Medicine, Beth Israel Deaconess Medical Center
  • 7 The George E. Thibault Academy Associate Professor, Harvard Medical School; Physician, Department of Internal Medicine, Cambridge Health Alliance
  • 8 Associate Professor of Medicine, Harvard Medical School; Senior Physician, Department of Medicine, Brigham and Women's Hospital
  • 9 Clinical Instructor in Medicine, Harvard Medical School; Physician, Atrius Health
Type
Published Article
Journal
MedEdPORTAL : the Journal of Teaching and Learning Resources
Publisher
Association of American Medical Colleges
Publication Date
Jun 07, 2021
Volume
17
Identifiers
DOI: 10.15766/mep_2374-8265.11160
PMID: 34150993
PMCID: PMC8180538
Source
PubMed Central
Keywords
Disciplines
  • Original Publication
License
Unknown

Abstract

Introduction Trauma is ubiquitous and associated with negative effects on physical and mental health. Trauma-informed care (TIC) is a framework for mitigating these health effects and improving patients’ engagement with medical care. Despite these clinical benefits, TIC is not routinely taught in undergraduate medical education. Methods We designed a session for first-year medical and dental students to introduce TIC principles and their application in patient care. The session focused on screening for and inquiring about trauma and responding to disclosures of trauma. Using live patient interviews, small-group discussions, and case-based role-plays, the session offered expert instruction and hands-on practice. Students completed pre- and postsession surveys and a 5-month follow-up survey. Students reported their comfort with screening for trauma and responding to disclosures of trauma before and after the session and at 5 months following the session. Results Of the 164 student participants, 76% completed surveys during the session, and 50% completed the follow-up survey. More than one-third (34%) of respondents reported having received at least one disclosure of trauma from a patient within the first 5 months of medical school. Students’ comfort with screening for trauma increased from 30% to 56%, and their comfort with responding to disclosure of trauma increased from 35% to 55%. These improvements persisted on reevaluation at 5 months. Discussion We present a model for teaching trauma-informed communication skills to first-year medical and dental students. The intervention significantly increased students’ comfort level and self-reported clinical skills, and benefits persisted at 5 months.

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