354 - Enhancing Pediatric Resident Trauma Informed Communication with Human Trafficking Victims

Publication Number: 354.4684

Naomi Warnick, University of Louisville School of Medicine, Louisville, KY, United States; Olivia Mittel, University of Louisville SOM, Louisville, KY, United States; Dominique Elmore, University of Louisville School of Medicine, Louisville, KY, United States; Theresa M. Frey, Norton Children’s Hospital, Louisville, KY, United States; Francesca Kingery, University of Louisville School of Medicine, Louisville, KY, United States; Elizabeth Lehto, University of Louisville School of Medicine, Louisville, KY, United States; Robin M. Lund, Norton Children’s Hospital, Louisville, KY, United States; Aaron W.. Calhoun, University of Louisville, Louisville, KY, United States

Background: Human trafficking (HT) survivors often face numerous physical and mental health challenges. Approximately 80% of trafficked youth seek medical care within a year of identification. Trauma-informed communication (TIC) in healthcare settings has been shown to improve short- and long-term health outcomes for this population. Rapid cycle deliberate practice (RCDP) is a teaching method that uses immediate, direct feedback, allowing learners to repeat and improve skills during rather than after simulation, which aids in skill retention. While RCDP has proven effective in healthcare training, its impact on teaching TIC skills remains underexplored.

Objective: This study aimed to determine whether an RCDP-based simulation program designed to teach TIC in the context of human trafficking enhances resident skills compared to a video-based curriculum.

Design/Methods: Pediatric residents were assigned to either a control group (video-based learning) or an intervention group (RCDP). All participants watched an introductory video and completed an initial simulation (Sim 1) with a standardized patient acting as an HT victim. The control group then watched a video focusing on TIC using patient experiences, while the intervention group engaged in an RCDP session using a standardized scenario targeting similar skills. Both groups subsequently completed a second simulation (Sim 2). Simulations were recorded and rated by trained evaluators using the Gap-Kalamazoo Communication Skills Assessment Form-Trauma Informed Care (GKCSAF-TIC). Evaluators were blinded to group assignments and simulation sequence (Sim 1 vs. Sim 2). Sim 2 scores for each group were compared using analysis of covariance (ANCOVA), with Sim 1 scores used as covariates to control for initial skill level. Inter-rater reliability was measured using intra-class correlations (ICC).

Results: Thirty-four residents participated. After adjusting for initial scores, Sim 2 ratings showed no statistically significant difference between the video group (Median [IQR] = 3.5 [3.25-3.8]) and the RCDP group (Median [IQR] = 3.6 [2.9-3.7]) (p = 0.46). Inter-rater reliability was excellent, with a single-rater ICC of 0.93 and an average-rater ICC of 0.96 based on a two-way random-effects model.

Conclusion(s): This pilot study found no significant difference in TIC skill improvement between the RCDP-based simulation and a video-based curriculum for pediatric residents. Further research is needed to identify the most effective methods for teaching TIC, particularly in the context of human trafficking.