Violently-injured individuals presenting to the emergency department (ED) have an elevated risk of repeat injury after being discharged from acute care settings and a high rate of unaddressed mental health and social needs. While there is a growing body of programmatic interventions to address these needs, including hospital-based violence intervention programs, there is a lack of data regarding physician perspectives of current practice for this patient population. Understanding current practice is critical for integrating new programs into workflow and developing evidence-based medical education to improve care. The aim of this study is to elucidate current trauma-informed care practices of emergency medicine and general surgery trainee physicians to inform future curriculum development surrounding care of violently injured patients. In this study, emergency medicine and surgical trainees with at least one year of residency experience participated in simulation-primed interviews in pairs or small groups. Interviews garnered perspectives on the physician role in treating violently injured youth, using simulation as a priming event focused on previously known patient concerns. Qualitative themes that emerged were participants (1) perceived their role as managing medical/surgical concerns and seek others to build trust and manage psychosocial and legal concerns, (2) had a high level of knowledge of ED stressors and de-escalation strategies, (3) perceived that patient distrust can negatively impact their ability to provide care, and (4) perceived that law enforcement can negatively impact care and are sometimes uncertain about how to interact with law enforcement. These findings support that medical education for providers should focus on medicolegal issues, particularly managing law enforcement presence in the ED, structural and interpersonal causes of distrust of medical providers and the medical system, and addressing postdischarge mental health and social needs.

到急诊科 (ED) 就诊的受暴力伤害的人在从急性护理机构出院后再次受伤的风险较高，并且未解决的心理健康和社会需求的比例很高。虽然有越来越多的方案干预措施来满足这些需求，包括基于医院的暴力干预项目，但缺乏关于医生对这一患者群体当前实践的观点的数据。了解当前实践对于将新项目整合到工作流程和发展循证医学教育以改善护理至关重要。本研究的目的是阐明目前急诊医学和普通外科实习医师的创伤知情护理实践，为未来围绕暴力受伤患者护理的课程开发提供信息。在这项研究中，具有至少一年住院医师经验的急诊医学和外科实习生成对或小组参加了模拟引导式访谈。访谈收集了关于医生在治疗遭受暴力伤害的青年中所扮演角色的观点，使用模拟作为启动事件，重点关注先前已知的患者问题。出现的定性主题是参与者（1）认为他们的角色是管理医疗/手术问题并寻求他人建立信任并管理社会心理和法律问题，（2）对 ED 压力源和降级策略有很高的了解，（ 3) 认为患者的不信任会对他们提供护理的能力产生负面影响，并且 (4) 认为执法会对护理产生负面影响，并且有时不确定如何与执法部门互动。