Trauma-Informed Care Training in Family Medicine Residency Programs

Dichter, Melissa E.; Teitelman, Anne M.; Klusaritz, Heather; Maurer, Douglas; Cronholm, Peter F.; Doubeni, Chyke A.

doi:10.22454/fammed.2018.505481

Cited by 25 publications

(22 citation statements)

References 5 publications

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“…Wawancara total berlangsung selama 15-20 menit. Empat domain TICS-M yaitu (i) orientasi, (ii) memori jangka pendek dan memori jangka panjang, (iii) atensi dan (iv) memori semantik, pemahaman dan pengulangan (bahasa/konsentrasi) (Dichter et al, 2018). Penilaian TICS-M terdiri dari: (i) nama, (ii) usia, (iii) tanggal, (iv) hari kerja, (v) musim, (vi) nomor telepon (masing-masing 1 poin), (vii) menghitung mundur (2 poin), (viii) latihan mengingat 10 daftar kata, kemudian menyebutkan kata yang di ingat (masing-masing 10 poin), (ix) pengurangan (5 poin); (xxiii) penamaan responsif (4 poin), (xivxv) pengulangan (2 poin), (xvi) presiden saat ini (1 poin) dan (xvii) wakil presiden saat ini (1 poin), (xviii) ketukan jari sebanyak 5 kali (2 poin) dan (xix, xx) kata berlawanan (2 poin).…”

Section: Bagan 2 Kriteria Eksklusiunclassified

Gangguan Kognitif pada Pasien Pasca Sembuh Dari Covid-19

Ratmadewi¹,

Laksono²,

Huwae³

2021

SLJIL

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Pasien yang sembuh dari Covid-19 memiliki beberapa keluhan pada daya ingat. Virus corona dapat menembus ke SSP (Sistem Saraf Pusat) dan cairan serebrospinal dalam waktu kurang dari seminggu. Pemeriksaan histopatologi otak pasien Covid-19 yang meninggal menunjukkan potensi SARS-CoV-2 menginfeksi ke sistem saraf pusat (SSP). Neuro inflamasi juga dapat merusak BBB (Blood Brain Barier). Setelah BBB terganggu, sitokin dapat masuk ke SSP dan menyebabkan aktivasi mikroglial dan stres oksidatif, yang menyebabkan gangguan kognitif. Metode Penelitian dilakukan secara cross sectional random sampling terhadap pasien di Ruang Isolasi Covid-19 Rumah Sakit Tingkat II. Prof. dr. J.A Latumeten Ambon selama periode Maret 2020 sampai dengan Maret 2021 dengan melakukan wawancara menggunakan Telephone Interview for Cognitive Status-M (TICS-M) yang terdiri dari 22 pertanyaan dengan total nilai 50. Dari 167 pasien, terdapat 54 pasien yang bersedia di wawancara dan terdapat 28 pasien yang memiliki kecenderungan gangguan cognitive ringan dengan rentang usia 31-40 tahun. Penelitian ini menemukan bahwa nilai TICS-M pada pasien pasca Covid-19 berhubungan dengan usia, namun tidak berhubungan dengan jenis kelamin dan lamanya pendidikan.

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Section: Bagan 2 Kriteria Eksklusiunclassified

Gangguan Kognitif pada Pasien Pasca Sembuh Dari Covid-19

Ratmadewi¹,

Laksono²,

Huwae³

2021

SLJIL

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“…Clinicians in Pediatrics, Family Medicine, and Obstetrical care report that they lack adequate training and time to manage complex mental health problems and identification and care of trauma in their patients. (Dichter et al, 2018;Horowitz & Cousins, 2006;Horwitz et al, 2015) Mental health providers also report a lack of time and training as barriers to providing TIC. (Sharif et al, 2021) Gaps in trauma-informed care systems include lack of sustainable funding for providers to identify and treat toxic stress, lack of resources to mitigate secondary trauma for staff, and barriers to access to services once trauma exposure has been identified.…”

Section: Introductionmentioning

confidence: 99%

Community ECHO (Extension for Community Healthcare Outcomes) Project Promotes Cross-Sector Collaboration and Evidence-Based Trauma-Informed Care

Buysse

Bentley

Baer

et al. 2021

Preprint

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Background Adverse Childhood Experiences (ACEs) are traumatic events that occur before age 18 years. ACEs, associated with negative health behaviors and chronic health disorders, disproportionately impact people from poor and marginalized communities. Toxic stress from ACEs can be prevented and treated with trauma-informed care. Inadequate training prevents the maternal and child workforce from providing evidence-based trauma-informed care. Cross-sector collaboration between pediatric care sectors is crucial to providing systems-wide trauma-informed care, but significant barriers impede cross sector communication. Training and formal cross-sector communication networks are needed to create strong systems of trauma-informed care in communities. The Stanford ACEs Aware ECHO (Extension for Community Healthcare Outcomes) program was created with 3 workforce development goals: 1) introduce the California Office of Surgeon General-led ACEs Aware Initiative to the maternal and child health workforce in 3 California counties, 2) disseminate trauma-informed evidence-based best practices, 3) bridge community silos to increase collaboration between care sectors to promote trauma-informed care systems. Methods Participants were recruited from Federally Qualified Health Centers, county public health departments, community behavioral health organizations, educational institutions, and agencies that serve low-income children and families. 100 unique participants representing 3 counties and 54 agencies joined sessions. Twelve virtual educational sessions were convened over 6 months using the Project ECHO model via Zoom technology. Sessions consisted of didactic lectures and whole-group case-based discussions. Results After completing the educational series, participants expressed commitment to increased cross-sector collaboration, and reported increased knowledge and confidence in using trauma-informed skills. After participation, a significant number of participants had also completed another recommended California ACEs Aware Initiative online training. Conclusion An ECHO series of virtual workforce development sessions on trauma-informed best practices promoted cross-sector communication and was associated with strong participant engagement and satisfaction. The educational series increased knowledge and confidence in use of evidence-based trauma-informed best practices.

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“…Clinicians in one study felt frustrated working with patients who had trauma histories, sometimes focusing on acute medical issues to avoid initiating a discussion about trauma that they felt ill‐equipped to handle . A recent survey of family medicine residency programmes found most programmes had what was perceived as insufficient training in trauma‐informed care domains, using primarily didactic teaching methods to recognise trauma signs …”

Section: Introductionmentioning

confidence: 99%

“…4 A recent survey of family medicine residency programmes found most programmes had what was perceived as insufficient training in trauma-informed care domains, using primarily didactic teaching methods to recognise trauma signs. 5 One pilot study in a Veterans Affairs (VA) women's primary care clinic involved a health psychology resident observing patient encounters and providing feedback about trauma-related communication. 6 Although this intervention improved medical residents' self-perceived communication skills and comfort responding to trauma disclosure, it was brief in nature during a 2-week rotation, used a small sample (n = 8), and did not include any background teaching about trauma.…”

Section: Introductionmentioning

confidence: 99%

Trauma‐informed primary care for medical residents

Shamaskin-Garroway

McLaughlin

Quinn

et al. 2019

The Clinical Teacher

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Summary Background Psychological trauma can have a significant impact on mental and physical health, and interpersonal relationships. Many physicians report discomfort addressing psychological trauma in the context of health care visits, and few training opportunities exist for health care trainees to learn about the relationship between trauma and health. The aim of this project was to develop and implement an educational curriculum to teach medical and nursing trainees about trauma‐informed primary care. Methods We expanded upon pilot data from a brief interdisciplinary intervention to train medical residents in trauma‐informed primary care at a Veterans Affairs hospital. We generated a trauma‐informed care curriculum involving five 1‐hour didactic sessions, 10‐minute group reflection regarding patient interactions prior to each didactic session, and optional patient care observation and feedback. The curriculum aligned with internal medicine (n = 16) and nurse practitioner (n = 5) interprofessional primary care education sessions during the 2017/18 academic year. Results The curriculum was feasible and associated with increased self‐reported knowledge, attitudes and practice around trauma‐informed care. Free text feedback indicated that residents found the topic important, appreciated a skills‐based approach and valued experiential educational activities. Conclusions Training residents in trauma‐informed care results in improved knowledge, attitudes and practices in caring for patients with psychological trauma. Residents appreciated both experiential and skills‐based exercises. Next steps include continued exploration of using direct observation and feedback, and examining effects of training on patient outcomes (e.g. satisfaction with care).

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Trauma-Informed Care Training in Family Medicine Residency Programs

Abstract: Despite the acknowledged importance of effects of trauma in health care, this study identified insufficient exposure to training in the core TIC domains in family medicine residency programs, underscoring a need for greater integration of TIC training during residency.

Cited by 25 publications

References 5 publications

Gangguan Kognitif pada Pasien Pasca Sembuh Dari Covid-19

Gangguan Kognitif pada Pasien Pasca Sembuh Dari Covid-19

Community ECHO (Extension for Community Healthcare Outcomes) Project Promotes Cross-Sector Collaboration and Evidence-Based Trauma-Informed Care

Trauma‐informed primary care for medical residents

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