P3.B032: Implementation of Trauma and Violence Informed Care Elective to Supplement Early Medical Education

Background: Interpersonal violence (IPV) is a significant public health issue in the United States, with at least 3 million children witnessing IPV at home annually, and up to 75% of these children experiencing violence themselves. Witnessing and experiencing IPV can have long-term negative physical and mental consequences on children. In a 2021 policy statement, the American Academy of Pediatrics highlights the importance of providing trauma-informed care to prevent and mitigate these damaging effects. Studies have shown that repeated exposure to trauma-informed care practices in undergraduate medical education (UME) training increases IPV knowledge, screening, and recognition. Previous educational efforts have incorporated IPV and trauma-informed care into UME, but no semester-long elective exists.

Methods: We created and implemented a Trauma and Violence Informed Care (TVIC) elective for first-year medical students. This 13-week elective was offered to all first-year medical students at the University of Colorado School of Medicine during the Fall of 2022. Seventeen students enrolled. Curricula were created in collaboration with staff and students from the campus’ sexual assault center and community partners from Denver. The curriculum included lectures, group discussions, and role-playing activities. Learning objectives covered topics including IPV, intersectionality, child abuse and impact of adverse childhood experiences, mandatory reporting, survivors' rights and resources, and vicarious trauma. To assess the impact of the course, pre- and post-course surveys, consisting of Likert scale and free-response questions, were distributed. Survey responses were analyzed using paired T-tests and content analysis for qualitative free-response questions.

Results: All students (n=17) filled out the pre- and post-course surveys. There was a significant difference (p < 0.05) in student comfort and knowledge for the following topics: Skills & Abilities, Intersectionality, Resources, System Based Processes, and Course Logistics. Content analysis revealed that six students valued patient autonomy, validation, and empowerment as future career skills gained from this elective. Five valued IPV recognition and communication skills.

Conclusion: This TVIC elective positively impacted first-year medical student comfort and skills around providing trauma-informed patient care. Increasing UME exposure to trauma-informed care practices is critical to fostering a trauma-informed culture in pediatrics. This elective serves as an example of how TVIC can be introduced into UME curricula.