Trauma-Informed Undergraduate Medical Education: A Pathway to Flourishing with Adversity by Enhancing Psychological Safety

Robert C. Whitaker, Georgia B. Payne, Maeve A. O’Neill, Megan M. Brennan, Allison N. Herman, Tracy Dearth‐Wesley, H. F. Weil
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Abstract

We describe the Life Experiences Curriculum (LEC), which attempts to integrate medical student well-being with trauma-informed medical education. The long-term goal of LEC is to help medical students flourish with adversity and trauma, where flourishing refers to having a sense of purpose that arises from awareness of one’s strengths and limitations, shaped by life experiences. The short-term goal of LEC is to develop students’ relational capacities, such as acceptance and awareness of self and others, while building and maintaining students’ psychological safety. We describe the conceptual rationale for these goals and the curriculum’s development, implementation, evaluation, and limitations. The curriculum extends over four years and involves a preclinical seminar and students’ individual and group reflection sessions with LEC faculty. The seminar addresses the coexistence of trauma and flourishing across life experiences, as well as how safety in relationships is impaired by traumatic experiences and must be restored for healing and growth. The physician faculty have no role in student evaluation and co-lead all LEC activities. LEC is intended to provide students with new language for understanding the process of trauma and flourishing in both individuals and systems and to build and sustain students’ relational capacities. There are ongoing efforts to re-imagine self-care as communal-care in which care and support are given and received in a community of students and faculty. Such a model may help build the relational capacities needed to deliver trauma-informed care and also promote flourishing with adversity in healers and in those seeking to be healed.
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创伤知情本科医学教育:通过加强心理安全,在逆境中成长的途径
我们介绍了 "生命体验课程"(LEC),该课程试图将医学生的福祉与创伤知情医学教育结合起来。生命体验课程的长期目标是帮助医学生在逆境和创伤中茁壮成长,这里的茁壮成长指的是拥有一种目标感,这种目标感源于对自身优势和局限性的认识,并由生命体验所塑造。LEC 的短期目标是培养学生的人际交往能力,如对自我和他人的接纳和认识,同时建立和维护学生的心理安全。我们将介绍这些目标的概念原理,以及课程的开发、实施、评估和局限性。该课程为期四年,包括临床前研讨会以及学生与 LEC 教师的个人和小组反思会。研讨班探讨创伤与人生经历中的繁荣共存问题,以及创伤经历如何损害人际关系的安全,并必须恢复这种安全以促进康复和成长。医生教师不参与学生评估,并共同领导所有 LEC 活动。LEC 旨在为学生提供新的语言,让他们了解创伤的过程以及个人和系统的蓬勃发展,并培养和维持学生的关系能力。目前,人们正在努力将自我保健重新想象为社区保健,即在师生社区中给予和接受保健和支持。这种模式可能有助于建立提供创伤知情护理所需的关系能力,也有助于促进治疗者和寻求治疗者在逆境中蓬勃发展。
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