Enhancing Emergency Medicine Training Through Trauma-Informed Pelvic Exam Education

Cureus. 2025 Nov 20;17(11):e97363. doi: 10.7759/cureus.97363. eCollection 2025 Nov.

ABSTRACT

Objectives Refugee and immigrant women are at high risk for gender-based violence (GBV) and frequently present to the emergency department (ED) as their first interaction with the healthcare system. Trauma-informed care (TIC) is essential to providing sensitive, safe care to these populations, particularly during pelvic examinations. Despite this need, formal TIC training for emergency medicine (EM) residents remains limited. This study evaluated the effectiveness of a TIC-focused workshop aimed at improving confidence and competence in performing pelvic exams on patients with a history of GBV. Methods A single-session workshop was delivered to 34 learners (EM residents and senior medical students) at an urban training site. The session included a didactic overview of TIC principles, followed by role-play scenarios and hands-on pelvic exam skills practice. Participants completed pre- and post-session surveys assessing familiarity, confidence, and anticipated use of TIC maneuvers and language. Descriptive statistics were analyzed using Microsoft Excel (Microsoft Corporation, Redmond, Washington). Results All 34 participants (11 PGY-1, 11 PGY-2, 5 PGY-3, 7 MS4) completed both surveys. Prior to the session, the majority reported being only slightly familiar with TIC (53%) and trauma-sensitive exam components (59%). Most (76.5%) reported low confidence in using trauma-informed maneuvers. Only 9% reported always using such techniques during pelvic exams. Following the workshop, confidence markedly improved: 65% felt somewhat confident, 24% moderately confident, and 9% extremely confident in using trauma-informed maneuvers and language. The session was rated as excellent or very good by 85-88% of participants. Nearly all (91%) indicated they would always or often apply the skills in future clinical practice. Conclusion A brief, focused workshop significantly improved EM learners’ confidence and intent to apply trauma-informed approaches during pelvic exams. Scaling similar training across EM residencies may enhance patient safety, reduce re-traumatization, and promote culturally responsive, compassionate care. Continued integration of TIC into EM education is essential to improving outcomes for trauma-affected populations.

PMID:41426777 | PMC:PMC12718096 | DOI:10.7759/cureus.97363