Building trauma-informed physical therapists: a mixed-methods evaluation of a multimodal training module in hybrid...

Trauma-informed care (TIC) remains inadequately integrated into health professions education despite its clinical relevance, limiting opportunities for graduates to develop the skills necessary to support individuals with trauma histories.

This gap is particularly pronounced in Doctor of Physical Therapy (DPT) education, where hands-on clinical practice creates unique conditions that could evoke trauma-related responses or retraumatization. This study evaluated a multimodal TIC training module embedded in a hybrid DPT curriculum.

Using a convergent mixed-methods design, this study evaluated a multimodal TIC training module embedded in the third semester of the first year of a hybrid DPT curriculum across two consecutive cohorts (N = 142). Quantitative pre-post surveys measured changes in self-reported TIC-related knowledge, attitudes, and confidence; qualitative data were drawn from post-intervention open-ended survey responses and student self-reflection essays.

Significant improvements were observed across all three domains, with large effect sizes replicated across both cohorts (Hedges' g = 1.39 for knowledge familiarity; g = 1.31 for confidence). Qualitative analysis yielded four themes: developing a trauma-informed professional identity, intentional relationship-building as core clinical practice, applying TIC principles in clinical decision-making, and recognizing the role of the clinician's inner experience. Integration of quantitative and qualitative data revealed strong convergence and complementarity across strands, and identified a confidence-complexity paradox; large measured gains in physical examination confidence alongside persistent qualitative uncertainty about managing trauma responses during hands-on care.

These findings support embedding TIC training in DPT education, with implications for professional identity formation and mitigation of physical therapist burnout.