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

Resident Physicians’ Perceptions of Trauma Informed Care

Abstract

Introduction. Screening for adverse childhood experiences (ACEs) is a significant component of trauma informed care (TIC), as intervention can mitigate negative health outcomes. The American Academy of Pediatrics has called on physicians to address toxic stress. However, as few as 4% of physicians with pediatric patients screen and intervene for 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 pilot study occurred in a large Midwestern Family Medicine residency and involved a convenience sample of 54 resident physicians. Participants completed a survey questionnaire, 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 were also 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 value TIC. However, lack of confidence, competing primary care recommendations, and concern for receptiveness can deter residents from screening and intervention. Graduate medical education must focus on building systems of training that provide learners with the knowledge, skills, and resources to routinely screen and intervene for ACEs in primary care.