530 - Interactive Case-Based Trauma-informed Care Education for Providers in the Neonatal Intensive Care Unit: A Pilot Study

Parents can experience trauma from having an infant in the Neonatal Intensive Care Unit (NICU). This trauma can compound the impact of prior trauma and lead to toxic stress, thereby affecting parental coping and leading to adverse health outcomes for parent and infant. Trauma-informed care (TIC) is an evidence-based approach to healthcare that is rooted in compassion, collaboration, and trust. While TIC could improve support for NICU parents, there is a lack of case-based TIC curricula for NICU providers.

Objective:

To create and evaluate interactive, case-based electronic modules (e-modules) that discuss the exposure and impact of trauma and toxic stress on NICU parents and introduce a trauma-informed approach to communication for NICU providers. 

Design/Methods:

We created e-modules featuring two cases inspired by communication recommendations from NICU parents. In the interactive cases, participants apply TIC principles by choosing how to interact with fictional parents in common NICU situations and receive feedback on their choices via on-screen text. E-modules were offered to 33 trainees and nurses in a 70-bed level IV NICU. To evaluate effectiveness, we adapted an existing Likert scale-based pre/post-test survey on “Knowledge, Attitudes, and Practices of Trauma-informed Care.” Participants also completed three open-ended questions and a case debrief. We analyzed pre/post-test data using paired t-test. Institutional Review Board considered this study exempt.

Results:

Twenty-six of 33 providers (79%) started the e-modules, including 14 residents, 7 fellows, 3 nurses, and 2 students. Participants thought TIC was important, but initially reported knowledge and practice deficits (Table 1). Average scores from pre to post-test increased significantly (p =0.002, Table 1). The largest increases were in likelihood of practicing TIC and knowledge. Using the Kirkpatrick Model, e-modules were effective on multiple levels (Table 2). However, we noted low sustained engagement with 42% (11/26) of participants completing the cases, and 23% (6/26) completing the post-test. In debrief responses, participants reported specific ways they would try to make their care more compassionate and empathetic after completing the e-modules (Figure 1).    

Conclusion(s):

Thirty-minute interactive, case-based e-modules improved NICU providers’ knowledge and intent to practice TIC. As we expand from this pilot study, we plan to offer educational credit and protected time to promote e-module completion. Next steps will include evaluating for sustained change in behavior and clinical practice.