Competency in trauma-informed care: Empowering advanced practice registered nursing students to adopt a trauma-informed approach during routine health assessment

• Published in: Nurse education today 2025-01, Vol.144, p.106477, Article 106477
• Main Authors: Holod, Alicia F., Tornwall, Joni, Teall, Alice M., Overcash, Janine
• Format: Article
• Language: English
• Subjects: Adult; Advanced Practice Nursing - education; Clinical Competence - standards; Competency-based education; Curriculum; Education, Nursing, Graduate - methods; Educational Measurement - methods; Empowerment; Female; Health assessment; Humans; Male; Mental health; Midwestern United States; Physical examination; Rubric; Simulation-based experiences; Students, Nursing - psychology; Students, Nursing - statistics & numerical data; Trauma-informed care; Wounds and Injuries - nursing
• ISSN: 0260-6917; 1532-2793; 1532-2793
• DOI: 10.1016/j.nedt.2024.106477

Nurses need competency in trauma-informed care (TIC) to create supportive environments that encourage patient engagement and treatment adherence. Increased demand for TIC in nursing practice requires improved approaches to competency evaluation. This study aimed to evaluate the competency of advanced practice registered nursing (APRN) students in implementing TIC principles, utilizing a rubric tailored for simulation-based learning within an advanced health assessment course. Employing a non-experimental, observational approach, this project utilized a quantitative, rubric-based assessment to analyze video-recorded simulations and rate competency in implementation of TIC principles. The study included 64 graduate-level APRN students enrolled in a mandatory advanced health assessment course at a large midwestern university in the United States. The study assessed student competency in implementing seven TIC principles within a simulation-based experience (SBE), using a scale ranging from 1 (novice) to 5 (expert). While a few students demonstrated competency at, or above, level 3 in certain TIC principles, the overall average competency rating remained below 3. This outcome aligns with expectations for novice APRN students. Notably, the principles of communication and safety showed the highest average competency levels. Findings revealed that most students were at a novice competency level, struggling with implementation of TIC principles. This highlights the imperative for nurse educators to incorporate a variety of educational activities into the curriculum. Integrating TIC content into didactic lectures, providing formative assessment opportunities, and conducting post-lecture SBEs are recommended strategies to enhance TIC competency among APRN students, thereby equipping them with the essential skills to deliver exemplary care to trauma survivors. •There is a growing demand for trauma-informed clinicians.•Advanced-practice nurses lack training in trauma-informed care.•Competencies in trauma-informed care include assessment for a history of trauma.•Trauma-informed competencies can be evaluated in simulation-based experiences.