BACKGROUND AND OBJECTIVES:Trauma exposure predicts mental disorders, medical morbidity, and health care costs. Yet trauma-related impacts have not received sufficient attention in primary care provider (PCP) training programs. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), and evaluated its efficacy. METHODS: We randomized PCPs to training or wait-list (delay) conditions; wait-list groups were trained after reassessment. The primary outcome assessing newly acquired skills was a patient-centeredness score derived from Roter Interactional Analysis System ratings of 90 taped visits between PCPs and standardized patients (SPs). PCPs were family medicine residents (n=17) and community physicians (n=13, 83% family medicine specialty), from four sites in the Washington, DC metropolitan area. RESULTS: Immediately trained PCPs trended toward a larger increase in patient centeredness than did the delayed PCPs, with a moderate effect size (.66). The combined trained PCP groups showed a significant increase in patient centeredness from before to after training. CONCLUSIONS: This is a promising approach to supporting relationship-based trauma-informed care among PCPs to help promote better patient health and higher compliance with medical treatment plans.
RCT Entities:
BACKGROUND AND OBJECTIVES:Trauma exposure predicts mental disorders, medical morbidity, and health care costs. Yet trauma-related impacts have not received sufficient attention in primary care provider (PCP) training programs. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), and evaluated its efficacy. METHODS: We randomized PCPs to training or wait-list (delay) conditions; wait-list groups were trained after reassessment. The primary outcome assessing newly acquired skills was a patient-centeredness score derived from Roter Interactional Analysis System ratings of 90 taped visits between PCPs and standardized patients (SPs). PCPs were family medicine residents (n=17) and community physicians (n=13, 83% family medicine specialty), from four sites in the Washington, DC metropolitan area. RESULTS: Immediately trained PCPs trended toward a larger increase in patient centeredness than did the delayed PCPs, with a moderate effect size (.66). The combined trained PCP groups showed a significant increase in patient centeredness from before to after training. CONCLUSIONS: This is a promising approach to supporting relationship-based trauma-informed care among PCPs to help promote better patient health and higher compliance with medical treatment plans.
Authors: Debra L Roter; Susan Larson; Harold Shinitzky; Robin Chernoff; Janet R Serwint; Graceanne Adamo; Larry Wissow Journal: Med Educ Date: 2004-02 Impact factor: 6.251
Authors: Martha A Medrano; Robert G Brzyski; David P Bernstein; Jeanette S Ross; Jill M Hyatt-Santos Journal: Menopause Date: 2004 Mar-Apr Impact factor: 2.953
Authors: Bonnie L Green; Pamela A Saunders; Elizabeth Power; Priscilla Dass-Brailsford; Kavitha Bhat Schelbert; Esther Giller; Larry Wissow; Alejandra Hurtado de Mendoza; Mihriye Mete Journal: J Loss Trauma Date: 2015-09-25