Abstract
A simulation-based training model, the Professional ACEs-Informed Training for Health Professionals, was evaluated using a pre–post design. The model emphasizes trauma-informed care and simulation to educate students. The study evaluated students' levels of self-efficacy and knowledge. The results support brief didactics combined with simulation to train OT students on adverse childhood experiences and trauma-informed care, supporting American Occupational Therapy Association research priorities.
Primary Author and Speaker: Mary Isaacson
Additional Authors and Speakers: Julie Cribbs
Contributing Authors: Jedediah E. Bragg, Frances Wen, Kristin Rodriguez, Martina Jelley, and Kim Coon
Current American Occupational Therapy Association (AOTA) research priorities focus on health behaviors to prevent and manage chronic conditions. The relationship between Adverse Childhood Experiences (ACEs) and adult adoption of high-risk health behaviors and negative health outcomes are highly correlated. Occupational therapists provide intervention for conditions strongly linked to ACEs. It is necessary to consider training models that educate occupational therapy students about the relevance of ACEs and to empower them with the skills needed to help their patients. The present study examines the effects of the Professional ACE-Informed Training for Healthcare Professionals (PATH) model on the knowledge and self-efficacy of OT students. The training model includes a didactic lecture followed by a simulation. Informed by best practices in trauma informed care, the PATH lecture focuses on information about ACEs, trauma and the brain. It also includes a presentation of specific skills for working with ACEs-impacted patients including: assessment of patient history of ACEs, patient education on ACEs and connection to health outcomes, evaluation of patient health behavior risks, and collaboration with patients on intervention planning and future steps. Post lecture, the trainees engage in a social simulation with a trained, simulated patient (SP). Students participate in the educational assessment by completing a pre and post-test that assesses: (1) knowledge and attitudes toward the importance of ACEs and Trauma Informed Care (TIC) and the (2) General Self-Efficacy Scale (GSEC). The sample included graduate occupational therapy students over two academic years (N = 41). Two repeated measures ANOVAs were conducted to determine if there were statistically significant differences in KAI and GSES scores between years over a short course on ACEs and TIC utilizing a high-fidelity simulation. Results suggest that overall KAI and self-efficacy scores significantly increased from pre-administration to post-administration. Results indicate that the training resulted in an increase in students' knowledge, self-reported belief in the importance of ACEs and TIC, and self-efficacy. An examination of between-subjects effects illustrated no statistically significant difference between the years F(1, 39) = .228, p = .636; η2 = .006. Results suggest that overall KAI and self-efficacy scores significantly increased from pre-administration to post-administration, indicating an increase in students' knowledge and self-reported belief in the importance of ACEs and TIC. Results reveal a statistically significant increase in overall general self-efficacy from pre-administration to post-administration. For two sequential academic years, evaluation indicates that the PATH model provided occupational therapy students with the knowledge and skills to help them begin to address childhood trauma suggesting the PATH model as a standard, replicable training for occupational therapy students. The results support AOTA research priorities and the structure of simulations and brief didactic sessions are useful in educating occupational therapy students on the impacts of ACEs and the importance of TIC.
Miller-Cribbs, J. E., Wen, F., Coon, K. A., Jelley, M. J., Foulks-Rodriguez, K., & Stearns, J. (2016). Adverse childhood experiences and inequities in adult health care access. International Public Health Journal, 8(2), 257–270.
Bragg, J. E., Miller-Cribbs, J., Gordon, J., Gaudet, J., Hellman, C., & Munoz, R. T. (2017). Increasing self-efficacy and building hope through simulation based education. International Journal of Arts & Sciences; Cumberland, 10(2), 549–557.
Scott, K. M., Von Korff, M., Angermeyer, M. C., Benjet, C., Bruffaerts, R., de Girolamo, G., Kessler, R. C. (2011). Association of childhood adversities and early onset mental disorders with adult onset chronic physical conditions. Archives of General Psychiatry, 68(8), 838–844. https://doi.org/10.1001/archgenpsychiatry.2011.77
Wen, F. K., Miller-Cribbs, J. E., Coon, K. A., Jelley, M. J., & Foulks-Rodriguez, K. A. (2017). A simulation and video-based training program to address adverse childhood experiences. The International Journal of Psychiatry in Medicine, 52(3), 255–264. https://doi.org/10.1177/0091217417730289