Resident Physicians' Perceptions of Trauma Informed Care: Findings from a Small-scale Descriptive Study.

Abstract

Introduction: Screening for adverse childhood experiences (ACEs) is a significant component of trauma informed care (TIC), as intervention can mitigate negative health outcomes. However, as few as 4% of physicians with pediatric patients screen and intervene for all ACEs. The authors of this study sought to: 1) understand resident physicians' perceptions of TIC; 2) identify areas of training needed to improve screening and intervention of ACEs.

Methods: This descriptive study occurred in a large Midwestern Family Medicine residency and involved a convenience sample of 38 resident physicians. Participants completed a survey, which included a total of 22 Likert-scale and open-ended questions. Descriptive frequencies were used to represent Likert-scale responses, and the open-ended questions were analyzed utilizing a thematic analysis approach.

Results: Participants identified screening for ACEs as useful. However, they reported a lack of confidence in their ability to screen and intervene. Barriers to screening and intervention also were noted and included lack of time, discomfort in assessment, perceived inability to help, insufficient knowledge and skills, and competing primary care recommendations.

Conclusions: Family Medicine residents identified the screening and intervention of ACEs to be important. However, lack of confidence, competing primary care recommendations, and concern for receptiveness can deter residents from screening and intervention. Based on this study's findings, the authors recommend that graduate medical education focuses on building systems of training that provide learners with the knowledge, skills, and resources to routinely screen and intervene for ACEs in primary care.