Medical College of Wisconsin, Milwaukee, Wisconsin.
Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin.
West J Emerg Med. 2024 May;25(3):423-430. doi: 10.5811/westjem.18394.
Greater lifetime exposure to psychological trauma correlates with a higher number of health comorbidities and negative health outcomes. However, physicians often are not specifically trained in how to care for patients with trauma, especially in acute care settings. Our objective was to identify implemented trauma-informed care (TIC) training protocols for emergency and/or trauma service physicians that have both sufficient detail that they can be adapted and outcome data indicating positive impact.
We conducted a comprehensive literature search in MEDLINE (Ovid), Scopus, PsycInfo, Web of Science, Cochrane Library, Ebsco's Academic Search Premier, and MedEdPORTAL. Inclusion criteria were EM and trauma service clinicians (medical doctors, physician assistants and nurse practitioners, residents), adult and/or pediatric patients, and training evaluation. Evaluation was based on the Kirkpatrick Model.
We screened 2,280 unique articles and identified two different training protocols. Results demonstrated the training included patient-centered communication and interprofessional collaboration. One curriculum demonstrated that targeted outcomes were due to the training (Level 4). Both curricula received overall positive reactions (Level 1) and illustrated behavioral change (Level 3). Neither were found to specifically illustrate learning due to the training (Level 2).
Study findings from our review show a paucity of published TIC training protocols that demonstrate positive impact and are described sufficiently to be adopted broadly. Current training protocols demonstrated an increasing comfort level with the TIC approach, integration into current practices, and referrals to trauma intervention specialists.
一生中暴露于心理创伤的时间越长，与更多的健康合并症和负面健康结果相关。然而，医生通常没有接受过如何照顾创伤患者的专门培训，尤其是在急性护理环境中。我们的目的是确定已实施的创伤知情护理（TIC）培训方案，这些方案适用于急诊和/或创伤服务医生，并且具有足够的细节可以进行调整，并且有数据表明其产生了积极的影响。
我们在 MEDLINE（Ovid）、Scopus、PsycInfo、Web of Science、Cochrane 图书馆、Ebsco 的 Academic Search Premier 和 MedEdPORTAL 中进行了全面的文献检索。纳入标准为急诊和/或创伤服务的临床医生（医生、医生助理和护士从业者、住院医师）、成人和/或儿科患者以及培训评估。评估基于 Kirkpatrick 模型。
我们筛选了 2280 篇独特的文章，确定了两种不同的培训方案。结果表明，培训包括以患者为中心的沟通和跨专业合作。一个课程表明，目标结果是由于培训（第 4 级）。两个课程都收到了总体积极的反应（第 1 级）并说明了行为改变（第 3 级）。都没有发现具体的学习归因于培训（第 2 级）。
我们的综述研究结果表明，发表的 TIC 培训方案很少，这些方案显示出积极的影响，并且描述得足够广泛采用。当前的培训方案表明，对 TIC 方法的接受程度越来越高，将其融入当前的实践中，并向创伤干预专家转介。
