Palnati Medha, Martinez Ashley E, Audil Aliyah, Tovar Emily, Macfarlane Paul, Gerber Megan, Wagner Katherine
Third-Year Medical Student, Albany Medical College.
Software Developer, Jahnel Group, Inc.
MedEdPORTAL. 2024 Dec 13;20:11475. doi: 10.15766/mep_2374-8265.11475. eCollection 2024.
Refugee and migrant communities carry histories wrought with trauma. These traumas and trauma-related responses often contribute to feelings of mistrust towards Western health care systems and can additionally foster negative clinician biases (conscious or unconscious) and attitudes towards these communities. Consequently, clinicians often fail to uncover underlying causes of poor health and distress for their refugee and migrant patients.
To dismantle biases and cultivate empathy towards refugee and migrant patients, we developed a 1-hour simulation-based educational workshop to train clinicians to think critically about incorporating trauma-informed care (TIC) for these patients' unique needs. We introduced this tool to the GME curricula at Texas Tech University ( = 36) and to the UME curricula at Albany Medical College ( = 43). Using pre- and postquestionnaires, we analyzed the impact of this workshop on participants' knowledge, attitudes, and practices regarding TIC for migrant and refugee populations ( = 44).
This tool positively influenced students' and residents' knowledge and attitudes regarding TIC and displaced peoples, and learners expressed greater willingness to incorporate TIC into clinical practice ( < .001). Additionally, residents self-reported percentage increases in behaviors that promote equitable care for refugee and migrant patients 6 months postintervention.
This training enhanced clinicians' trauma-informed practices towards refugee and migrant patients, with learners qualitatively expressing a greater sense of empathy towards this community. While measuring the impact on learners' empathy requires further assessment, this educational innovation's preliminary success provides a foundation for the role of simulation-based learning in medical education.
难民和移民群体背负着充满创伤的历史。这些创伤及与创伤相关的反应往往导致对西方医疗系统的不信任感，还可能滋生临床医生对这些群体的负面偏见（有意识或无意识的）及态度。因此，临床医生常常无法找出难民和移民患者健康状况不佳及痛苦的潜在原因。
为消除对难民和移民患者的偏见并培养同理心，我们开发了一个为期1小时的基于模拟的教育工作坊，以培训临床医生批判性地思考如何根据这些患者的独特需求纳入创伤知情护理（TIC）。我们将此工具引入德克萨斯理工大学的研究生医学教育课程（n = 36）以及奥尔巴尼医学院的本科医学教育课程（n = 43）。通过前后问卷调查，我们分析了该工作坊对参与者关于针对移民和难民群体的创伤知情护理的知识、态度和实践的影响（n = 44）。
该工具对学生和住院医生关于创伤知情护理及流离失所人群的知识和态度产生了积极影响，学习者表示更愿意将创伤知情护理纳入临床实践（P < .001）。此外，住院医生在干预后6个月自我报告了在促进为难民和移民患者提供公平护理行为方面的百分比增加情况。
该培训增强了临床医生对难民和移民患者的创伤知情实践，学习者定性地表达了对这个群体更强的同理心。虽然衡量对学习者同理心的影响需要进一步评估，但这项教育创新的初步成功为基于模拟的学习在医学教育中的作用奠定了基础。
