Educating for Empathy: A Simulation-Based Approach to Trauma-Informed Care in Residency Training

Trauma-informed care (TIC) is a critical yet underrepresented component of medical education, particularly in residency training. Despite high rates of trauma exposure in the United States, most physicians lack formal training in how to recognize and sensitively respond to patients with trauma histories. This study evaluates the impact of a hybrid educational intervention-including didactics and standardized patient (SP) scenarios-on internal medicine residents' empathy and attitudes toward TIC.

Second-year internal medicine residents at a single academic institution participated in a structured TIC curriculum consisting of educational sessions followed by 3 Observed Structured Clinical Examinations (OSCEs) using SPs portraying trauma-related scenarios. Faculty provided formative feedback using structured checklists. Residents completed the Jefferson Scale of Empathy (JSE) and the Attitudes Related to Trauma-Informed Care (ARTIC) Scale at baseline, 3 months, and 6 months posttraining.

Among 50 participating residents, survey response rates were 98%, 56%, and 58% at the 3 timepoints, respectively. Baseline scores were relatively high on both the JSE and ARTIC, with trends toward increased empathy and trauma-informed attitudes over time. While changes were not statistically significant, no decline was observed, suggesting a positive trajectory since other studies document a decline in empathy over residency training.

This study demonstrates the feasibility and potential benefit of integrating TIC training into residency education. Even among a cohort with high baseline empathy, participation in structured TIC education and OSCEs may support the maintenance and growth of trauma-informed communication skills. These findings support the inclusion of TIC as a formal component of graduate medical education and warrant further study in larger, longitudinal cohorts.