M02 – Trauma Informed Primary Care Training in Graduate Medical Education: The Pearls and the Pitfalls

Summary

Background: Trauma-informed primary care (TIPC) realizes the impact of trauma, recognizes the signs and symptoms of trauma, and responds in a manner to avoid re-traumatization. Screening for adverse childhood experiences (ACEs) is a component of TIPC as interventions can mitigate the development of poor health outcomes. Since 2012, the American Academy of Pediatrics has urged physicians to address toxic stress in primary care. Despite this, as few as four percent of physicians routinely screen and intervene for ACEs. Rational: This presentation highlights resident physicians’ perceptions of TIPC training and identifies how graduate medical educators can improve training and screening processes for ACEs. Method: Thirty-Eight Family Medicine residents completed a survey on TIPC. Survey responses that were quantitative were analyzed using aggregated descriptive statistics (means, standard deviations, frequencies) with SPSS (version 26.0). Open-ended survey responses were analyzed using a thematic analysis approach. Thematic analysis follows an inductive process of becoming familiar with the data, generating initial codes, and then identifying and refining common patterns or themes across qualitative data. Investigators independently coded the open-ended responses and reached a consensus on an agreed coding framework. Based on this framework, the study team then completed the remaining coding and recursively refined a thematic structure through discussion. Patterns of commonality and divergent views were identified. The research team then developed the final themes by consensus. Results: Fifty-percent of participants identified screening for ACEs as useful. However, only 38% were confident in “ability to screen for ACEs”, and only 21% were confident in “following-up with information collected during screening”. Forty-five percent indicated “usually” suggesting a behavioral health referral, and 29% “usually” offered medication to relieve relevant symptoms. Regarding barriers, 93% of participants indicated “lack of time for initial screening”, and 100% identified “lack of time to provide brief intervention”. Nearly 68% noted “discomfort in assessment”, 62% perceived “lack of ability to help”, and 51% perceived “competing primary care recommendations”. Presentation: We will provide an introduction to TIPC (10 min). Second, methods of this study will be shared (15 min). Third, results from the study will be identified (10 min). Fourth, we will discuss limitations, next directions, and conclusions of the study (5 min). Fifth, we will provide time for the audience to discuss their exposure to and experience with TIPC (10 min). We will conclude with Q&A (10 min).