Abstract Rationale In the intensive care unit (ICU) internal medicine (IM) residents may experience secondary trauma, defined as emotional responses and behaviors similar to personal trauma following exposure to traumatic stories and experiences of patients. This impacts professional fulfillment, can perpetuate burnout, and ultimately affect patient care. Secondary trauma interventions often focus on self-care rather than addressing the trauma itself. Trauma-informed care (TIC) is an institutional and systematic approach to recognize the prevalence and signs of trauma, resist re-traumatization, and ultimately improve patient- and clinician-centered outcomes. We therefore developed and implemented a novel curriculum on secondary trauma and TIC in the ICU for IM residents. Methods We performed a targeted needs assessment that utilized early-year individual meetings with IM interns and group resilience sessions focused on patient deaths to inform the content and structure of the curriculum. There were three components to the curriculum, delivered in a three-hour session of protected educational time for IM residents: 1) didactics defining secondary trauma and TIC, 2) a multidisciplinary panel of psychiatrists, ICU attendings, fellows, nurses, and social workers to discuss personal experiences of secondary trauma and delivering TIC, and 3) small group breakout sessions where residents identified TIC-based interventions to address secondary trauma in the ICU. Participants completed anonymous pre- and post-curriculum surveys to assess knowledge, attitudes, and skills related to TIC. Results Of the 112 IM residents surveyed, 65% (n = 73) completed the pre-curriculum survey. Fifty three percent of those (n = 39) completed a post-curriculum one month following the session. More than a third of the residents (41%, n = 30) reported receiving prior education on TIC. A third of residents felt comfortable identifying (38%, n = 28) or applying (34%, n = 25) TIC principles pre-curriculum which improved to 92% (n = 37) for both post-curriculum (Figure 1). At one-month post curriculum, most residents (87%, n = 32) believed discussing secondary trauma in residency was valuable or extremely valuable, thought this curriculum should be offered again (95%, n = 35), and desired further training on secondary trauma prevention (81%, n = 30). Conclusions A TIC curriculum for IM residents can improve trainee understanding of and comfort discussing effects of secondary trauma in the ICU. Residents found these topics valuable and were invested in ongoing education on related topics. Future directions will focus on scalability from a single session/site and generalizability to non-ICU settings for IM residents. This abstract is funded by: None
Keating et al. (Fri,) studied this question.