Trauma-Informed Care for Intimate Partner Violence and Sexual Assault: Simulated Participant Cases for Emergency Medicine Learners.

Abstract

Introduction: Emergency medicine (EM) providers often care for patients who present with concerns related to sexual assault (SA) or intimate partner violence (IPV). However, many providers feel uncomfortable discussing SA and IPV with patients. We aimed to design a curriculum using trauma-informed care principles to improve self-assessed competency in caring for this patient population.

Methods: EM learners, including residents, EM physician assistant fellows, and medical students, attended a 25-minute didactic session introducing the concept of trauma-informed care and important questions to ask in IPV and SA cases. Learners then participated in a 15-minute simulated single-patient encounter during which they practiced collecting a trauma-informed history identifying features of IPV or SA and appropriately responding to such disclosures. The encounters were observed by a trained SA medical forensic examiner or a victim advocate. The learners next participated in a 10-minute individual and 15-minute group debrief.

Results: Sixteen pre- and 17 postcurriculum self-assessments were completed. There was a statistically significant increase in self-perceived confidence in the learners' ability to collect information (p < .01), use strategies to help patients feel physically and psychologically safe (p < .001), recognize how bias influences patient encounters (p < .05), and provide counseling (p < .05). Learners overall found the learning exercise valuable.

Discussion: The exercise introduced learners to trauma-informed care, improved learner confidence, and was well received. Many EM residency programs incorporate simulation into their curriculum; this simulation exercise can be adapted to other programs' educational needs.