(58) Identifying Adverse Childhood Events and Implementing Trauma Informed Care: A Pilot Curriculum for Medical Students

Background: Physicians must recognize the manifestations of trauma and establish interventions in their practice to manage its well studied sequelae. However, medical students rarely receive training pertaining to this subject.

Objectives: This report includes preliminary data from a novel course developed for medical students to identify adverse childhood experiences (ACEs) and implement trauma informed care (TIC).

Design/Methods: An elective rotation was created for 4th year medical students at the University of South Dakota, Sanford School of Medicine. The curriculum included 10 hours of didactic work followed by 10 half day experiences at community entities who serve traumatized individuals. Students completed a pre- and post-test to evaluate knowledge, attitudes, and practices related to ACEs and use of TIC. Average summative test scores and individual responses were calculated and comparisons were made using Student’s T-test. At the conclusion of the course participants wrote a reflection paper outlining the impact of the experience. The papers were evaluated by 6 blinded reviewers who used qualitative thematic analysis to identify common themes within the reflections.

Results: Preliminary results from n=7 medical students were positive. 100% of participants responded to the pre- and post-test and completed reflective papers. The results of the 21 question test indicated 4 areas of significant change. After the course, students felt well informed about ACEs and TIC (p=0.005), felt competent in trauma informed practices (p=0.033), planned to empower patients (p=0.025), planned to inform patients about actions prior to performance (p=0.025), and planned to tailor interactions to each patients’ needs (p=0.013). The reflective papers identified 5 emerging common themes. Students 1) strengthened understanding of trauma, 2) realized the importance of interdisciplinary collaboration, 3) gained exposure and experience navigating community resources, 4) learned implementation of TIC, and 5) experienced emotional impacts from the encounters.

Conclusion: Medical education must equip future providers with knowledge and skills to best care for patients who have experienced trauma. Preliminary results from a novel ACEs and TIC elective course are favorable. Specifically, participants had an improvement in comprehension and competency relating to ACEs and TIC. This curriculum serves as a model for medical education by preparing future physicians to effectively respond to and treat the consequences of trauma.