Taking Aim at the Injury Prevention Curriculum: Educating Residents on Talking to Patients About Firearm Injury

Abstract

The medical community recognizes that firearm injury is a public health problem. Yet we lack both the tools for and the implementation of evidence-based firearm injury screening and counseling techniques. One reason for these deficits is the lack of clinical training related to engaging patients in firearm injury risk reduction. In this issue, Rickert et al describe a pre–post evaluation of a 2-part firearm injury prevention training curriculum for first-year medical residents at a single academic medical center. Their manuscript serves an important, but still preliminary, step forward for the field of postgraduate medical education on firearm injury and its prevention. Important elements of this project and paper consist of the inclusion of multiple medical disciplines and the use of standardized patients to evaluate participants’ learning. This project also points to the need for further growth. We must commit to consistently and conscientiously framing injuries from guns not as “gun violence” but rather as “firearm injuries” to ensure that they are considered squarely in both the public health space and the clinical space. An ideal curriculum would also highlight the importance of trauma-informed care, cultural competency, and antiracist medical practice while countering implicit biases (e.g., toward gun owners, victims of firearm violence, perpetrators of violence). It should address barriers, as well as facilitators, to change. And most importantly, future educational work must evaluate the effect of these trainings on actual clinical practice—and, even better, the efficacy of education in changing behavior and patient-level outcomes.

Studying the Feasibility and Acceptability of an Interactive Web-based Lethal Means Safety Decision Aid for Hospitalized Adults With Suicide Risk (Lock to Live)

“…Efforts are also underway to enhance the education on lethal means counseling that medical students and residents receive 13–15 . The authors of a recent paper stressed the importance of being mindful of the language used to develop lethal means counseling curricula for medical students and residents, highlighting how some firearm owners do not view providers as trustworthy sources of information 16 . Medical schools and residency programs could adopt the L2L decision aid, either using it as a guide while developing effective lethal means counseling curricula or, perhaps, applying it as a supplement to already formulated lessons.…”