The impact of trauma-informed training on pediatricians' perceived-competence in treating war-affected children: a pilot study.

Abstract

Background: War and collective trauma significantly affect children's physical and mental well-being. Pediatricians, as frontline healthcare providers, play a critical role in mitigating these impacts. However, many lack the training necessary to effectively address the complex needs of children affected by war. This study assesses the state of pediatricians' training, knowledge, and perceived-competence during the first weeks of the Israeli-Hamas 2023-24 war, and evaluates the effect of a trauma-informed training program on pediatricians' knowledge and perceived-competence in treating children affected by war.

Methods: The research was two-staged: [1] Pediatricians' Survey: 180 Israeli pediatricians completed an online survey, reporting their perceived knowledge, and perceived-competence in treating trauma-related issues; [2] Training Evaluation: 22 pediatricians completed a pre-post questionnaire in order to evaluate the effectiveness of a trauma-informed training conducted six weeks into the war.

Results: The survey indicated that only 21 (12.1%) of pediatricians had any trauma-informed training prior to the war. Five weeks into the war, 129 (71.7%) participated in short professional development activity related to trauma care, but still reported that their knowledge and perceived-competence in treating trauma-related issues were below the midpoint of the scale. The training evaluation showed significantly increased pediatricians' perceived-competence in managing trauma-related issues, guiding parents, and referring on after the training. Practical sessions were associated with enhancing perceived-competence. Post-training responses to clinical vignettes showed a notable change in the thoroughness and professional approach toward real-life scenarios of post-traumatic symptoms.

Discussion: The study underscores the necessity of integrating trauma-informed care into pediatric training, especially in war-affected settings. The training not only improved pediatricians' perceived-competence in addressing trauma, but also enhanced their overall ability to manage emotional and behavioral difficulties in children. Because the training was designed and delivered during the initial weeks of the war, the sample size was relatively small, and the study lacked a control group. Expanding such training is crucial for equipping healthcare providers to address the complex needs of children in conflict zones, in order to promote resilience and recovery.