Just in TIME: Trauma-Informed Medical Education
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PERSPECTIVE ARTICLE
Just in TIME: Trauma-Informed Medical Education Aneesah McClinton 1,2,3 & Cato T. Laurencin 1,2,4,5,6,7 Received: 20 July 2020 / Revised: 20 September 2020 / Accepted: 21 September 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract Numerous organizations implement a trauma-informed approach. This model assists institutions in providing care and education that delivers support to members who have undergone traumatic experiences, and many institutions apply the principles as a universal precaution. Student and trainee experiences in medical education reveal a hidden curriculum that may deliver conflicting messages about the values of an institution, in which equity is promoted, but biased and discriminatory practices are commonplace. Implicit racial bias has been identified in the patient-provider interaction and may also extend its impact on the learner experience. Bias and discrimination inflict trauma on its targets via emotional injury. Applying the principles of the trauma-informed approach, we advocate for trauma-informed medical education (TIME). TIME fosters awareness that students and trainees can experience trauma from a biased system and culture and advocates for the establishment of policies and practices that support learners to prevent further re-traumatization. TIME will serve as a means to deliver just and equitable education. Keywords Trauma-informed . Medicine . Education . Implicit bias . Unconscious bias . Racial bias . Racism . Discrimination
The clinical learning environment demands a traumainformed culture. A trauma-informed approach is advocated in the fields of health care [1, 2], education [3], social services [4], law enforcement [5], and many others as a way to understand and attend to individuals affected by traumatic experiences. A critical aspect of the model is to acknowledge that trauma shapes an individual’s experience, and organizations
* Cato T. Laurencin [email protected] 1
Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA
2
Raymond and Beverly Sackler Center for Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA
3
Department of Surgery, University of Connecticut School of Medicine, Farmington, CT 06030, USA
4
Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
5
Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, USA
6
Department of Material Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
7
Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT 06269, USA
that deliver care and provide education must be attuned to these experiences to interact and collaborate in a way that is culturally sensitive, transparent, establishes rapport, and empowers its members. Trauma is defined as an event or a set of circumstances that are physically and emotionally harmful, can be life-threatening, and adversely a
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