Trauma-informed medical care: Cme communication training for primary care providers

Bonnie L. Green, Pamela A. Saunders, Elizabeth Power, Priscilla Dass-Brailsford, Kavitha Bhat Schelbert, Esther Giller, Larry Wissow, Alejandra Hurtado-De-Mendoza, Mihriye Mete

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalFamily medicine
Issue number1
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Family Practice


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