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应用创伤知情视角应对青少年困境:儿科学者的专业发展课程。

Applying a Trauma-Informed Lens to Challenging Adolescent Encounters: A Faculty Development Session for Pediatricians.

机构信息

Assistant Professor, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences.

Instructor, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences.

出版信息

MedEdPORTAL. 2024 May 31;20:11408. doi: 10.15766/mep_2374-8265.11408. eCollection 2024.

Abstract

INTRODUCTION

Patient encounters perceived to be challenging are common and contribute to both suboptimal patient health outcomes and provider burnout. A trauma-informed care (TIC) approach to these encounters is critical, as many of the characteristics associated with challenging patient encounters can be linked to a history of trauma exposure.

METHODS

Our team created and delivered a 1-hour synchronous virtual session intended to bolster provider knowledge of TIC principles and their application to challenging adolescent encounters. Participants were all faculty and staff engaged in pediatric primary care at an urban academic center, including physicians, nurse practitioners, psychologists, and social workers. The content was rooted in adult learning principles and included didactic components anchored to case-based learning with facilitated group discussions and opportunities for reflection. We used paired pre- and postsession self-assessments of provider knowledge, confidence, and practice related to TIC using Likert-scale and free-text questions. Descriptive statistics and a paired test were used to determine the impact of the session on these metrics.

RESULTS

In 24 paired surveys, there were statistically significant increases ( ≤ .001) in participant perceived knowledge, confidence, and practice, with 100% of participants having a statistically significant improvement in one or more of these domains. There were also strongly positive Likert-scale and free-text responses regarding content relevance and delivery.

DISCUSSION

We demonstrate that a brief session can create improvement in pediatric providers' perceived knowledge about the application of TIC principles to challenging adolescent encounters as well as confidence in their ability to put these into practice.

摘要

简介

患者认为具有挑战性的就诊是常见的,这不仅会导致患者的健康状况不佳,还会导致医护人员的职业倦怠。对于这些就诊,采用创伤知情护理(TIC)方法至关重要,因为许多与挑战性就诊相关的特征都可以与创伤暴露史联系起来。

方法

我们的团队创建并提供了一个 1 小时的同步虚拟会议,旨在增强医护人员对 TIC 原则的了解及其在青少年具有挑战性就诊中的应用。参与者均为城市学术中心从事儿科初级保健的教职员工,包括医生、护士从业者、心理学家和社会工作者。内容基于成人学习原则,包括以案例为基础的学习为基础的教学部分,并辅以小组讨论和反思机会。我们使用配对的会前和会后自我评估,使用李克特量表和自由文本问题来评估提供者在 TIC 方面的知识、信心和实践相关问题。使用描述性统计和配对检验来确定会议对这些指标的影响。

结果

在 24 对配对调查中,参与者感知的知识、信心和实践方面都有统计学意义上的显著提高(≤0.001),100%的参与者在这些领域中的一个或多个方面都有统计学意义上的改善。关于内容相关性和交付方式,也有强烈的正面的李克特量表和自由文本反应。

讨论

我们证明,一个简短的会议可以提高儿科医护人员对 TIC 原则在青少年具有挑战性就诊中的应用的知识理解,并增强他们将这些原则付诸实践的信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5533/11219089/5df7c8cdb3bb/mep_2374-8265.11408-g001.jpg

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