Promoting Health Equity Through Trauma-Informed Care

Levy‐Carrick, Nomi; Lewis‐O’Connor, Annie; Rittenberg, Eve; Manosalvas, Kiara; Stoklosa, Hanni; Silbersweig, David

doi:10.1097/fch.0000000000000214

Cited by 25 publications

(9 citation statements)

References 17 publications

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“…TIC has been proposed in recent years as an important clinical tool in medicine and as a framework to promote health care engagement and health equity. [11][12][13] Despite these clinical benefits, UME has yet to develop, adopt, and advocate for trauma-related curricular content. Published trauma and TIC competencies exist for entry-level psychologists, for all levels of nursing education, and for general health care providers; yet our literature review uncovered no current nationally accepted TIC competencies for UME.…”

Section: Trauma-informed Curricular Contentmentioning

confidence: 99%

Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context

et al. 2020

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Section: Trauma-informed Curricular Contentmentioning

confidence: 99%

Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context

et al. 2020

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“…Given the disproportionate burden of trauma in these groups, practicing trauma-informed care (TIC)—a person-centered approach to interpersonal interactions related to trauma and healing—may promote health equity and effective health service delivery. 15,16 The Substance Abuse and Mental Health Services Administration describes TIC through the 4 R’s: realizing the widespread impact of trauma, recognizing signs of trauma, responding to trauma in a compassionate and efficacious manner, and actively resisting retraumatization. 17 Studies have found that TIC improves primary health care engagement among vulnerable populations, decreases the burden of trauma-related symptoms, and improves patient–practitioner communication.…”

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confidence: 99%

Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation

et al. 2022

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Purpose Trauma-exposed persons often experience difficulties accessing medical care, remaining engaged in treatment plans, and feeling psychologically safe when receiving care. Trauma-informed care (TIC) is an established framework for health care professionals, but best practices for TIC education remain unclear. To remedy this, the authors conducted a multidisciplinary scoping literature review to discern best practices for the design, implementation, and evaluation of TIC curricula for health care professionals. Method The research team searched Ovid MEDLINE, Cochrane Library, Elsevier’s Scopus, Elsevier’s Embase, Web of Science, and the PTSDpubs database from the database inception date until May 14, 2021. Worldwide English language studies on previously implemented TIC curricula for trainees or professionals in health care were included in this review. Results Fifty-five studies met the inclusion criteria, with medicine being the most common discipline represented. The most prevalent learning objectives were cultivating skills in screening for trauma and responding to subsequent disclosures (41 studies [74.5%]), defining trauma (34 studies [61.8%]), and understanding trauma’s impact on health (33 studies [60.0%]). Fifty-one of the studies included curricular evaluations, with the most common survey items being confidence in TIC skills (38 studies [74.5%]), training content knowledge assessment (25 studies [49.0%]), participant demographic characteristics (21 studies [41.2%]), and attitudes regarding the importance of TIC (19 studies [37.3%]). Conclusions Future curricula should be rooted in cultural humility and an understanding of the impacts of marginalization and oppression on individual and collective experiences of trauma. Moreover, curricula are needed for clinicians in more diverse specialties and across different cadres of care teams. Additional considerations include mandated reporting, medical record documentation, and vicarious trauma experienced by health care professionals.

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“…37 Congruence between curricular content and context is essential to catalyze the transformation of medical education and clinical care environments into spaces that use trauma-informed practices that promote health, resilience, equity, and cost-effectiveness. 38 The task force focused on UME so that all physicians would be taught these foundational concepts and skills from the outset of training, recognizing that faculty development is needed to achieve this goal. Given its unifying list of common learner expectations used in training physicians, the task force selected the Physician Competency Reference Set 39 as the overarching framework and followed the process delineated by the AAMC Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development.…”

Section: Development Of Tic Competencies For Umementioning

confidence: 99%

Roadmap for Trauma-Informed Medical Education: Introducing an Essential Competency Set

et al. 2023

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Research has established that trauma is nearly universal and a root cause of numerous health and social problems, including 6 of the 10 leading causes of death, with devastating consequences across the life course. Scientific evidence now recognizes the complex injurious nature of structural and historical trauma (i.e., racism, discrimination, sexism, poverty, and community violence). Meanwhile, many physicians and trainees grapple with their own trauma histories and face direct and secondary traumatization on the job. These findings substantiate the profound impact of trauma on the brain and body and why trauma training is critical to the education and practice of physicians. However, a critical lag remains in translating essential research insights into clinical teaching and care. Recognizing this gap, the National Collaborative on Trauma-Informed Health Care Education and Research (TIHCER) formed a task force charged with developing and validating a summary of core trauma-related knowledge and skills for physicians. In 2022, TIHCER released the first-ever validated set of trauma-informed care competencies for undergraduate medical education. The task force focused on undergraduate medical education so that all physicians would be taught these foundational concepts and skills from the outset of training, recognizing that faculty development is needed to achieve this goal. In this Scholarly Perspective, the authors offer a roadmap for implementation of trauma-informed care competencies starting with medical school leadership, a faculty–student advisory committee, and sample resources. Medical schools can use the trauma-informed care competencies as a scaffold to customize integration of curricular content (what is taught) and efforts to transform the learning and clinical environments (how it is taught). Using the lens of trauma will ground undergraduate medical training in the latest science about the pathophysiology of disease and provide a framework to address many of our greatest challenges, including health disparities and professional burnout.

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Promoting Health Equity Through Trauma-Informed Care

Cited by 25 publications

References 17 publications

Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context

Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context

Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation

Roadmap for Trauma-Informed Medical Education: Introducing an Essential Competency Set

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