Date of Award

January 2020

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

James M. Dodington

Abstract

Abstract. Authors: Bonnie Elizabeth Hawkins, Edouard Coupet, Sidney Saint-Hilaire, James Dodington.

Patients with violence-related injuries presenting to the Emergency Department (ED) have an elevated risk of repeat injury after being discharged from acute care settings and a high rate of unaddressed mental health and social needs. While there is a growing body of evidence-based interventions to address these needs, there are no published medical education interventions for acute care providers. This study comprised two aims. The first aim was to demonstrate the feasibility of community-engaged trauma-informed-care-based training for emergency and surgical residents focused on the care of patients with violence-related injuries. The second aim was to better understand current trauma-informed care practices of resident physicians in order to inform further research and medical education efforts. In this thesis, we developed a pilot community-engaged resident training and conducted five simulation and small group interview sessions with emergency medicine and surgical residents with at least 1 year of residency experience. Pre- and post-surveys demonstrated statistically significant post-training increases in resident self-rated knowledge and comfort. Qualitative data supported that medical education should focus on medico-legal issues relevant to this patient population such as how to address concerns regarding patient privacy and interacting with law enforcement in the ED, engaging families during trauma resuscitations, referring patients to resources addressing post-discharge mental health, legal, and social needs, and inter-professional team-patient communication strategies suitable for an ED context in which time is limited.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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