Resident Physician Education in the Human Trafficking Medical Safe Haven.

INTRODUCTION: Human trafficking is a widespread public health problem across the United States. In recognition of the incredible need among victims and survivors of human trafficking for longitudinal, trauma-informed care, the Medical Safe Haven (MSH) was developed in 2016 through the Dignity Health Family Medicine Residency Program in Sacramento, California, and subsequently expanded to 2 other Dignity Health residency program sites. The MSH program included 3 sessions of trafficking-specific curriculum for resident physicians to prepare them to provide care for MSH patients. The current study aimed to evaluate resident physician learner confidence after participating in the MSH curriculum along with perceptions of the MSH program as a whole upon their graduation. METHODS: The study was a retrospective, preassessment/postassessment design. Resident physicians completed surveys that assessed learner confidence after each of the 3 training sessions, utilizing Likert scale items. Third-year resident physicians also completed a survey that included scaled and open-ended questions. Paired t-tests were used to evaluate the data in addition to content analysis for the open-ended questions. RESULTS: There were significant increases in learner confidence after the training sessions on all items measured, including identifying and caring for victims and survivors of trafficking. Third-year residents responded that the MSH program helped them to more effectively communicate and care for victims and survivors and many planned to take the trauma-informed care model to their future practices. CONCLUSION: While generalizability of the study was limited due to the retrospective design, the MSH program was found to have a meaningful impact on the resident physicians who participated in the training.

Diagnostic terminology, athlete status, and history of concussion affect return to play expectations and anticipated symptoms following mild traumatic brain injury.

"Mild traumatic brain injury" (mTBI) and "concussion" are terms often used interchangeably. However, "mTBI" is frequently seen as representing a broader injury that encompasses the construct of "concussion," which often conveys transience or decreased severity. The present study examined the influence of varying diagnostic terminology on acute injury expectations in an undergraduate population (N = 105). Participants were presented with an mTBI vignette and were randomly assigned to one of two conditions in which the term "mTBI" or "concussion" was used to describe the injury. There were no significant differences between the two conditions on anxiety, symptomatology, timeline, or consequence scales. However, participants in the "mTBI" group allocated more days to return to play than participants in the "concussion" group, suggesting that terminology has an effect on perceptions of the severity of the injury. Varsity athletes allocated fewer days to return to play than nonathletes. Individuals with a history of concussion, both athletes and nonathletes, indicated fewer days to return to play, but greater symptomatology than individuals with no history of concussion. Clinicians should consider the influence of diagnostic terminology, athletic background, and history of concussion on perceptions of the severity of an injury because expectations can influence injury outcomes and compliance in a recovery process.