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

Date of Review: May, 2023

This resource from MedEdPORTAL is a 3.5 hour session teaches first-year medical and dental students how to screen for experiences of trauma during the medical interview and how to respond to disclosures of trauma using a Trauma-informed care (TIC) framework. The first hour of the session includes a short didactic lecture followed by a live interview demonstration between a patient and clinician. This portion of the session would need to be delivered by someone with expertise in TIC. The patient interviewed had a previous relationship with the faculty member and had expressed interest in teaching medical students about trauma. For institutions seeking to adapt this curriculum, if a similar patient isn’t available, standardized patients could be used instead or the interview could be replaced with a panel of individuals with expertise in TIC. The remainder of the session is designed to be conducted in interactive small groups with a focus on discussion, reflection, and role-play. As described by the co-authors, role-play exercises may be distressing by causing students to embody a patient with lived experience of trauma, and should be made optional. Ideally, students could practice these skills with standardized patients or faculty/senior students instead. The resource follows a flipped classroom model, requiring students to complete 75 minutes of preparatory work including didactic videos and simulated patient interview videos. These preparatory videos are included in the appendices and offer a clear, concise, engaging approach to teaching the principles of TIC. The content was originally designed for groups of 6-8 students who had been working together already for 5 months within the school’s clinical and communication skills curriculum. Given the potentially distressing nature of this topic, other institutions should consider similarly adapting this curriculum within existing small groups where students have already formed relationships with one another. The resource materials include a thorough guide with teaching points, discussion topics related to TIC content, and clear strategies for reviewing this content in a manner that reflects the principles of TIC. The session has a clear emphasis throughout on how to move through the material in a trauma-informed manner that prioritizes the well-being of participants. While the facilitation guide could be used by those without prior knowledge of TIC, the session was designed to be taught by faculty and student facilitators with expertise in TIC. Other institutions should strongly consider recruiting individuals with expertise in this area to lead this curriculum. Student co-facilitators played an especially important role in this curriculum by providing peer support throughout the session and afterwards. —Emma Anselin, MD, NCEAS

Corresponding Author’s Email:

taylor_brown@hms.harvard.edu

Institution:

Harvard Medical School

Where was the Curriculum Implemented:

Boston, MA

Outcomes that Have Been Reported for the Curriculum:

Learner Satisfaction or reaction

Self-reported learner attitude

Self-reported learner behavior in a real patient setting

Outcome and Study Design:

Pre/Post

Level of Learner Assessment

Appreciation of content/attitude assessment (self-reflection, blogging with rubric)