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Training in "Trauma-Informed" Family-Centered Pediatric Care: Design and Implementation of Two Models
Julia Price, PhD, Nancy Kassam-Adams, PhD, Kristen L. Kohser, MSW, LSW and Meghan Marsac, PhD, Nemours/Alfred I duPont Hospital for Children, Wilmington DE

Abstract: Purpose: Healthcare providers have an important role in addressing the psychological impact of pediatric injury and illness. “Trauma-informed pediatric care” addresses risk factors for PTSD, including acute pain, immediate emotional distress, and separation from parents, poor social support, and parental emotional distress. Grounded in this empirical literature, key elements of trauma-informed acute care are summarized in a “DEF” model: Addressing Distress, Emotional support, and Family needs. Our team has operationalized these practices in the development and evaluation of training models for trauma-informed care with healthcare providers and hospital staff. Method: In Model 1, we designed and implemented in-person training sessions to increase staff knowledge of psychological trauma. In Model 2, we designed and implemented four interactive online CE courses for nurses about medical traumatic stress and specific, evidence-based trauma-informed practices, using the DEF model. Results: For in-person training (N=125), pre/post measures suggest significant increases in provider knowledge of trauma-informed care: understanding the concept of trauma-informed care (t(115) = 16.3, p <.001), ability to identify emotional reactions to trauma, (t(115) = 11.2 , p <.001), and self-rated ability to provide trauma-informed care (t(115) = 17.3 , p <.001). For online training, very preliminary data (N=67) from post-course surveys suggest strong provider knowledge and intentions to use trauma-informed practices. Conclusion: Two complementary models for trauma-informed care training have demonstrated feasibility, with impressive increases in knowledge in the in-person training model. The potential reach of online training holds promise for dissemination. Future research will evaluate behavior change and impact on patient care.

Objective: Participants will be able to - Define “trauma-informed” and family-centered pediatric trauma care; Describe the implementation of an in-person training program on trauma-informed care implemented at an urban Level 1 Pediatric Trauma Center; Describe the implementation of an online, CE-granting, training program on trauma-informed care for nurses.

Objective Content: Identify that “trauma-informed” and family-centered pediatric trauma care involve assessment of and interventions for patient distress (pain, fear), emotional support, and family needs (resources, stressors) during the course of medical care. Participants should describe specific ways communicating about medical treatment to minimize distress, bolster emotional support, and optimize family resources. Identify the key elements of an in-person training program on trauma-informed care, including specific knowledge about medical traumatic stress risk factors and symptoms that should be addressed in the training and methods for evaluating effectiveness of the training program. Identify the target audience of an online, CE-granting, training program on trauma-informed care for nurses and explain the progression of the series of courses and how to access these courses. Participants will describe general information about medical traumatic stress and the DEF model for trauma-informed care.


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