Trauma-Informed Care Across Medical Training: Knowledge, Attitudes, Practices, and Lived Experiences Among Medical Students and Clinical Instructors.

backgroundTrauma is common among patients, learners, and healthcare professionals and has important consequences for health, clinical care, and medical learning environments. Trauma-informed care (TIC) provides a framework for recognizing and responding to trauma while promoting safety, trust, choice, and collaboration.

objectiveTo characterize medical students' and clinical instructors' adverse and benevolent life experiences and knowledge, attitudes, and practices of TIC; assess differences by educational role and training stage; and identify opportunities for curricular and learning-environment improvement.

designCross-sectional survey study.

participantsA 52-item survey was offered to medical students (n = 757) and clinical instructors (n = 150). MAIN MEASURES: Validated measures included knowledge, attitudes, and practices of trauma-informed care (KAP-TIC); conventional and expanded adverse childhood experiences (ACEs); and benevolent childhood experiences (BCEs). KEY

resultsTwo hundred sixteen participants responded, including 102 clinical instructors (68% response) and 114 medical students (15% response). More than 70% reported at least one conventional ACE, and respondents had high levels of BCEs (mean 9.0 out of 10). Composite Knowledge and Attitudes scores did not differ significantly between students and instructors, while instructors reported higher trauma-informed Practice scores (median [IQR], 4.42 [4.00-4.83] vs 4.17 [3.83-4.50]; P < 0.001; r

conclusionsSubstantial lived experiences of adversity and differences in trauma-informed practice, particularly among preclinical students, highlight opportunities to strengthen TIC education throughout medical training.