P3A159: Pediatric Approach to Trauma and Resilience

Background: Trauma Informed Care (TIC) is critically important for reducing the impacts of early adversity. The Pediatric Approach to Trauma, Treatment, and Resilience (PATTeR) is a curriculum developed by the American Academy of Pediatrics and partners to introduce healthcare providers to strength-based approaches to TIC. PATTeR uses videos to educate about adverse childhood experiences (ACEs) to identify, respond, and manage consequences of adversity while avoiding re-traumatization. Investigators at Center for Resiliency and Wellbeing (CRW) at Phoenix Children’s (PC) implemented the PATTeR curriculum throughout the first two years of pediatric training with the addition of small group debriefs, case discussions, and direct patient care experiences. Investigators also taught trainees integrative techniques to improve patients’, parents’ and clinical providers’ sense of calm and wellbeing.

Methods: Residents at PC complete the PATTeR curriculum in a small group setting during three interactive workshops across their first two years of residency. One cohort of residents (academic years 2021-22, 2022-23) completed surveys self-reporting knowledge, attitudes, and skills relating to TIC at three different time points: before beginning the PATTeR curriculum (Pre-1), immediately after completing the curriculum in year 1 (Post-1), and immediately after completing the curriculum in year 2 (Post-2). A total composite score was calculated and generalized estimating equations were used to estimate the change in composite scores between time periods. The mean difference between time periods, along with the corresponding 95% confidence interval and p – values were reported (Table 2). Bonferroni’s adjustment was applied and an alpha level of 0.017 used to determine statistical significance.

Results: Composite scores significantly increased by 37.08 points (p < .001) between Pre-1 and Post-1 timeframes. Comparisons between Post-1 and Post-2 saw a significant reduction (-8.36; p < .001) in composite scores. However, there was still a significant increase in scores when comparing Pre-1 and Post-2 scores (28.72; p < .001).

Conclusion: Based on our initial results, the PATTeR curriculum, with local modifications, is highly effective at increasing trainees’ knowledge, attitudes, skills, and confidence in TIC. The decrease in composite score between year 1 post surveys and year 2 post surveys could represent greater metacognition and will be investigated with future cohorts. Next steps include studying additional cohorts and our direct patient care experiences and CRW workshop curriculum for third year. In the future, the PATTeR curriculum could be implemented at additional residency programs to ensure more providers use trauma-informed care approaches with patients and families.