Training Physicians to Identify Psychological Trauma Using the T-SBIRT Model and Simulated Patients: A Pilot Study

Date of Award

8-2026

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Amy Naugle, Ph.D.

Second Advisor

Scott Gaynor, Ph.D.

Third Advisor

Jonathan Baker, Ph.D.

Fourth Advisor

Roger Apple, Ph.D.

Keywords

Behavioral skills training, simulation-based learning, trauma-informed care

Abstract

Experiencing a traumatic event can result in the development of post-traumatic stress disorder (PTSD), which can not only lead to debilitating symptoms, but also inappropriate diagnoses, deferral of appropriate treatments, and misuse of resources. Because medical visits are frequently complicated by co-occurring mental health concerns, it is imperative that providers can recognize and respond to trauma-related symptoms.

The Screening, Brief Intervention, and Referral to Treatment (SBIRT) model has been shown to be effective in training physicians in the area of substance abuse, and it can be adapted and applied to address trauma (T-SBIRT). The present study utilized simulation-based learning (SBL) to evaluate changes in resident physicians’ knowledge, confidence, and competence in engaging in the T-SBIRT process over time.

Resident physicians (N range = 7–20) completed measures before, immediately after, and at follow-up following a modified behavioral skills training (BST). Outcomes included knowledge, confidence, and ability to implement screening, brief interventions, and referrals to treatment for simulated standardized patients presenting with symptoms of PTSD using a prepost design with follow up.

Linear mixed effects models were used to evaluate change over time due to attrition and missing data. There was a significant increase in confidence scores (F(2, 22.7) = 25.8, p < .001) and T-SBIRT integrity scores (F(2, 28.3) = 3.45, p < .05) following the training with maintenance at follow-up. Multivariate mixed modeling showed that confidence scores did not predict knowledge scores but that case integrity scores positively predicted T-SBIRT integrity scores immediately following the BST (F(1, 19.7) = 16.3, p < .001, b = .495, p < .05). There were no significant changes in knowledge scores (F(2, 18.8) = 3.03, p = .072) or case planning integrity scores (F(3, 42.6) = 1.30, p = .287) following the training. Overall, physicians rated the training as acceptable, feasible, and appropriate for residency education.

Comments

Fifth Advisor: Neil Hughes, M.D.

Access Setting

Dissertation-Abstract Only

Restricted to Campus until

8-1-2028

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