Presence 5 for trauma informed care: teaching tangible practices towards bidirectional healing in undergraduate medical education.

introductionTrauma impacts health; the adverse health effects of trauma are well-understood and trauma-informed care is recommended to mitigate these effects. There is an opportunity to leverage evidence-based frameworks to add to the growing body of literature on teaching trauma-informed care within undergraduate medical education. To address this, we developed, implemented, and evaluated the Presence 5 for Trauma Informed Care Workshop (P5 TIC), a discussion-based workshop, informed by evidence and guided by a clinical case, to teach tangible trauma-informed care practices in undergraduate medical education.

methodsP5 TIC was developed by abstracting practices from a narrative literature review and mapping them to the Presence 5 framework. Evidence-based practices informed the development of a 1-hour, in-person workshop comprising didactics followed by a case-based discussion. P5 TIC was implemented with undergraduate medical students (n = 144) through the Practice of Medicine Course. Participants completed a pre- and post-workshop survey to evaluate confidence and attitudes related to trauma informed care.

resultsLiterature review resulted in the following P5 TIC practices: (1) Prepare with Intention (e.g., chart review mindfully) (2), Listen Intently and Completely (e.g., listen for signs and impacts of trauma when your patient is ready to share) (3) , Agree on What Matters Most (e.g., prioritize your patient's trauma-related medical needs) (4), Connect with the Patient's Story (e.g., reflect on how trauma intersects with healthcare) (5), Explore Emotional Cues (e.g., tune into body language and non-verbal cues), and (6)Care for Yourself (e.g., practice compassionate detachment). Learner confidence and attitudes related to trauma informed care increased after participation in P5 TIC.

conclusionP5 TIC is a structured, evidence-based approach to teaching trauma informed care and adds to the literature in providing tangible practices as well as addressing self-care. Further medical education research should be conducted to explore the impact of P5 TIC on learner and patient outcomes.