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以创伤知情为导向的病史采集方法:向医学生和牙科学员教授创伤知情沟通技巧。

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

机构信息

Fourth-Year Medical Student, Harvard Medical School.

Second-Year Resident, Department of Medicine, Brigham and Women's Hospital.

出版信息

MedEdPORTAL. 2021 Jun 7;17:11160. doi: 10.15766/mep_2374-8265.11160.

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.

摘要

简介

创伤普遍存在,并与身心健康的负面后果相关。创伤知情护理(TIC)是减轻这些健康影响并提高患者对医疗保健的参与度的一种框架。尽管有这些临床益处,但 TIC 在本科医学教育中并未常规教授。

方法

我们为医学生和牙科学员设计了一个课程,介绍 TIC 原则及其在患者护理中的应用。该课程侧重于筛查和询问创伤以及对创伤披露的反应。通过现场患者访谈、小组讨论和基于案例的角色扮演,该课程提供了专家指导和实践机会。学生在课程前后和 5 个月后完成了调查。学生报告了他们在课程前后以及在医学院的前 5 个月内对筛查创伤和对创伤披露做出反应的舒适度。

结果

在 164 名学生参与者中,76%的学生在课程期间完成了调查,50%的学生完成了随访调查。超过三分之一(34%)的受访者报告在医学院的前 5 个月内至少收到过一次患者的创伤披露。学生筛查创伤的舒适度从 30%增加到 56%,对披露创伤做出反应的舒适度从 35%增加到 55%。这些改善在 5 个月后的重新评估中仍然存在。

讨论

我们提出了一种向医学生和牙科学员教授创伤知情沟通技巧的模型。该干预措施显著提高了学生的舒适度和自我报告的临床技能,并且在 5 个月后仍有收益。

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