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

Abstract

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.

U.S. Physicians’ Training and Experience in Providing Trauma-Informed Care in Clinical Settings

“…Medical education curricula could be updated to incorporate TIC. This will deepen the understanding of future and current providers on the acute and long-term effects of trauma across the lifespan [69,70]. At the practice level, peer TIC mentoring, modeling, and support can increase the adoption and implementation of TIC in clinical settings.…”

Trauma-Informed Undergraduate Medical Education: A Pathway to Flourishing with Adversity by Enhancing Psychological Safety

“…There is emerging consensus that patients would benefit if physicians and healthcare systems had greater sensitivity about how adverse life experiences may affect patients’ health and responses to care [ 1 ]. As a result, medical educators are developing curricula for trauma-informed medical education [ 2 3 4 ]. Concurrently, there is concern about the prevalence of burnout, suicide, and poor mental health among physicians, including those in training [ 5 6 ].…”

Integrating Psychological Care Training in Trauma Care for Medical Students: the Need and the Strategies

“…1,3,4 Once medical students are trained in psychological care, their competence to make sound decisions (evidence-based decisions) in high-stress trauma situations shows a significant improvement. 7,8 This improvement in decision-making can also be attributed to there being better dynamics and communication in the healthcare team and more collaboration between professionals from different disciplines. 3,4 Further, these trained medical students can not only advocate for the psychological well-being of trauma patients as an integral aspect of healthcare but even extend their contribution to break down the stigma that has been often reported in seeking mental health support.…”

“…[3][4][5] In addition, once students learn this, they realize the importance of maintaining ethical principles even while dealing with trauma patients by respecting their autonomy, informing them about the available treatment options and obtaining informed consent, etc. [7][8][9] If medical students learn about psychological care pertaining to trauma, they will be well equipped to handle sudden traumatic events by being more adaptable and resilient. 1,3 In short, medical students learning about psychological care can result in better long-term outcomes for trauma patients and also ensure that students offer culturally sensitive and effective care in different scenarios.…”