Pediatrician and Co-Medical Director Healthy Generations, Children's National Hospital; Assistant Professor of Pediatrics, George Washington University School of Medicine and Health Sciences.
Clinical Research Coordinator, Children's National Hospital.
MedEdPORTAL. 2020 Dec 30;16:11061. doi: 10.15766/mep_2374-8265.11061.
A large body of evidence links exposure to childhood trauma with negative health outcomes. Training future physicians to recognize and respond to trauma is paramount, and engaging medical students in the preclinical years affords the opportunity to foster the development of a trauma-informed lens that can then be solidified during clinical clerkships.
We developed and implemented a 4-hour trauma-informed care (TIC) symposium for 179 second-year medical students at the George Washington University School of Medicine and Health Sciences during the Patients, Populations, and Systems course. The symposium included three interactive didactic sessions focusing on the connection between trauma and health and TIC principles. A facilitated small-group discussion allowed students to apply TIC principles to a patient case, followed by reflection and evaluation.
The overall rating of the TIC symposium was 4 out of 5. Strengths included integration of a small-group case with discussion on application of TIC in practice, experience of the lecturers and small-group facilitators, and review of research relating adversity to specific health outcomes. Suggestions for improvement included incorporating role-play and standardized patients. Content analysis of student reflections mapped to the domains of physician competency.
A 4-hour symposium can affect student knowledge and understanding of TIC. Teaching TIC presents an opportunity to prepare medical students for a career in medicine through cultivation of required physician competencies. Next steps include enhanced opportunities to practice TIC and follow-up analysis of participants to determine behavior change during clinical years.
大量证据表明，儿童期创伤暴露与不良健康结果有关。培训未来的医生识别和应对创伤至关重要，让医学生在临床前阶段参与，可以有机会培养一种创伤知情的视角，然后在临床实习期间巩固这种视角。
我们为乔治华盛顿大学医学院和健康科学学院的 179 名二年级医学生在“患者、人群和系统”课程中开发并实施了一个 4 小时的创伤知情护理（TIC）研讨会。研讨会包括三个互动的专题讲座，重点关注创伤与健康以及 TIC 原则之间的联系。一个促进的小组讨论允许学生将 TIC 原则应用于一个患者案例，然后进行反思和评估。
TIC 研讨会的总体评价为 4 分（满分 5 分）。优点包括将小组案例与 TIC 在实践中的应用讨论相结合，讲师和小组促进者的经验，以及对将逆境与特定健康结果联系起来的研究的回顾。改进建议包括角色扮演和标准化患者。学生反思的内容分析与医生能力的领域相对应。
一个 4 小时的研讨会可以影响学生对 TIC 的知识和理解。教授 TIC 为医学生准备医学职业提供了一个机会，通过培养所需的医生能力来实现。下一步包括增加实践 TIC 的机会，并对参与者进行后续分析，以确定在临床期间的行为变化。
