Communication Skills Training Using Simulation for Integrating Adverse Childhood Experiences into Adult Primary Care Visits for Students

Introduction: Adverse childhood experiences (ACEs) can affect health and well-being throughout the lifespan. Trauma-informed care (TIC) integrates trauma understanding and resists retraumatization through fostering a safe and healing environment. This 3-hour workshop taught trainees competency-based TIC skills to identify potential signs of ACEs and other trauma in their adult patients and sensitively incorporate the impact of these experiences into their care. Methods: After completing prereadings, third-year medical students (MS3) and second-year physician assistant students (PA2) attended a lecture about TIC and observed a demonstration of a patient interaction. Students then completed a simulated longitudinal outpatient visit with a simulated patient (SP). The four cases of adult primary care patients presented with (1) depression and knee pain, (2) medically unexplained symptoms, (3) chronic back pain, and (4) substance use issues resulting in chronic disease. No SPs initially disclosed trauma, but all had significant ACEs. A faculty member observed the simulation, giving immediate feedback on performance. Workshops were evaluated by students in pre- and postsurveys measuring self-assessed knowledge about TIC, confidence applying TIC principles, and perceived importance of TIC. Discussion: This simulation training enhanced students' understanding of ACEs' influence on adult health outcomes and strengthened perceived ability to apply TIC principles, including incorporating trauma inquiry into longitudinal care.