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

Brown, Travis; Berman, Sarah; McDaniel, Katherine; Radford, Caitlin C; Mehta, Pooja; Potter, Jennifer; Hirsh, David

doi:10.1097/acm.0000000000003587

Cited by 62 publications

(71 citation statements)

References 39 publications

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“…The session's design and implementation followed TIME principles of content and context: We codesigned all aspects of the session in collaboration with senior students and multidisciplinary clinicians with expertise in TIC; we empowered senior students to take on a variety of leadership roles; and we incorporated peer supports throughout the session. 14 Groups of two or three student-facilitators and faculty-facilitators coled the small-group discussion and role-play sessions as described below. We assumed neither the student-facilitators nor faculty-facilitators had expertise in TIC.…”

Section: Methodsmentioning

confidence: 99%

“…TIME aims to increase the trauma competency of medical school graduates and improve learner engagement through trauma-informed learning environments. 14 In the curriculum at Harvard Medical School (HMS), medical and dental students interview patients as early as their first month of school and begin practicing physical examination the following month. 15 Given the ubiquity of trauma, students encounter traumatic disclosures early on and need skills to respond to them.…”

Section: Introductionmentioning

confidence: 99%

“… 13 Within UME, trauma-informed medical education (TIME) has been proposed as a way to integrate trauma-informed concepts (i.e., educational content) in a trauma-informed manner (i.e., educational context). 14 For example, TIME advocates introducing topics that some students might find distressing, such as intimate partner violence (IPV) or taking a sexual history (i.e., educational content), in a learning environment that applies the principles of TIC (i.e., educational context), such as offering peer support for students after a session with distressing material. TIME aims to increase the trauma competency of medical school graduates and improve learner engagement through trauma-informed learning environments.…”

Section: Introductionmentioning

confidence: 99%

“…TIME aims to increase the trauma competency of medical school graduates and improve learner engagement through trauma-informed learning environments. 14 …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Introduction: Trauma is ubiquitous and associated with negative effects on physical and mental health. Trauma-informed care (TIC) is a framework for mitigating these health effects and improving patients' engagement with medical care. Despite these clinical benefits, TIC is not routinely taught in undergraduate medical education. Methods: We designed a session for first-year medical and dental students to introduce TIC principles and their application in patient care. The session focused on screening for and inquiring about trauma and responding to disclosures of trauma. Using live patient interviews, small-group discussions, and case-based role-plays, the session offered expert instruction and hands-on practice. Students completed pre-and postsession surveys and a 5-month follow-up survey. Students reported their comfort with screening for trauma and responding to disclosures of trauma before and after the session and at 5 months following the session. Results: Of the 164 student participants, 76% completed surveys during the session, and 50% completed the follow-up survey. More than one-third (34%) of respondents reported having received at least one disclosure of trauma from a patient within the first 5 months of medical school. Students' comfort with screening for trauma increased from 30% to 56%, and their comfort with responding to disclosure of trauma increased from 35% to 55%. These improvements persisted on reevaluation at 5 months. Discussion: We present a model for teaching trauma-informed communication skills to first-year medical and dental students. The intervention significantly increased students' comfort level and self-reported clinical skills, and benefits persisted at 5 months.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…TIME aims to increase the trauma competency of medical school graduates and improve learner engagement through trauma-informed learning environments. 14 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2021

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“…In recognition of the fact that medical students bring experiences of trauma to medical education, a growing movement advocates for a similar application of the TIC principles to medical education (Matta, 2016;Matta et al, 2016). More recent articulations of the theory of "Trauma-Informed Medical Education" (TIME) call for the application of trauma-informed principles both to curricular content -for example, teaching about trauma and trauma-informed care -and educational context -for example, applying the six principles to the development and delivery of trauma-related content and to the learning environment (Brown et al, 2020). Traumainformed medical education has the potential to support learning, professional development, and personal well-being and increase effectiveness of learning and faculty engagement.…”

Section: Trauma-informed Medical Educationmentioning

confidence: 99%

Anatomy as a Model Environment for Acquiring Professional Competencies in Medicine: Experiences at Harvard Medical School

McDaniel

Brown

Radford

et al. 2020

Anatomical Sciences Ed

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Anatomy education provides students with opportunities to learn structure and function of the human body, to acquire professional competencies such as teamwork, interpersonal skills, self‐awareness, and to reflect on and practice medical ethics. The fulfillment of this wide potential can present challenges in courses that are part of an integrated curriculum and shorter than traditional courses. This new reality, together with students' increasing concern about the stresses within medical education, led to efforts at Harvard Medical School to implement practical steps toward an optimal learning environment in anatomy. These were based on core elements of ethical anatomy education and principles of trauma‐informed care. Anatomy is conceptualized here as the “first clinical discipline,” with relational interactions between anatomical educators, medical students, and body donors/patients. Essential prerequisites for the implementation of this work were support by the medical school leadership, open partnership between engaged students and faculty, faculty coordination, and peer‐teaching. Specific interventions included pre‐course faculty development on course philosophy and invitations to students to share their thoughts on anatomy. Student responses were integrated in course introductions, combined with a pre‐dissection laboratory visit, an introductory guide, and a module on the history and ethics of anatomy. During the course, team‐building activities were scheduled, and self‐reflection encouraged, for example, through written exercises, and elective life‐body drawing. Students' responses to the interventions were overall positive, but need further evaluation. This first attempt of a systematic implementation of an optimal learning environment in anatomy led to the identification of areas in need of adjustment.

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The utility of an online discussion board for reflective writing in an emergency medicine rotation

Pandit,

Chu,

Russell

et al. 2023

AEM Education and Training

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BackgroundNarrative analysis and reflection have been found to support professional identity formation (PIF) and resilience among medical students. In the emergency department, students have used reflective practice to process challenging clinical experiences, such as ethical dilemmas or moral distress. An online discussion board, however, has not been described as a curricular component of emergency medicine (EM) rotations. The objective of this educational innovation was to support medical students in an EM clinical rotation via an online discussion board for reflecting on and debriefing clinical experiences with faculty and peers.MethodsFifty‐two medical students enrolled in the pass/fail EM elective between May 13, 2019, and October 30, 2020. Each cohort of six students took part in a cohort‐specific discussion using the Canvas learning management system. Students were encouraged to post about any observations, reflections, or emotions after their shifts. Faculty course directors responded to each post using concepts of debriefing, coaching, and trauma‐informed teaching.ResultsOver 18 months, 49 of 52 (94%) students participated in the discussion board. Of 346 total posts, half were by students, and the other half were faculty responses. Students posted 3.27 times each, on average. Students rarely raised questions about scientific knowledge content, fact‐based aspects of patient care, or specific skills. Rather, they often posted about intensely affective reactions to experiences that left them with complex emotions. Upon review of posts by the course directors, the majority (54%) of students’ posts contained a range of affective responses. Students appreciated faculty responses and supported each other in their written responses to peers.ConclusionsAn online discussion board can be used successfully for asynchronous reflective practice to debrief clinical experiences during an EM rotation, if designed incorporating faculty and peer support using trauma‐informed teaching principles to bolster well‐being and PIF.

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

Abstract: Willingness of medical students to be examined in a physical examination course.

Cited by 62 publications

References 39 publications

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

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

Anatomy as a Model Environment for Acquiring Professional Competencies in Medicine: Experiences at Harvard Medical School

The utility of an online discussion board for reflective writing in an emergency medicine rotation

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