754 - Healing starts with hearing: Training pediatric residents to screen immigrant and refugee patients through trauma- and culture-informed care

Publication Number: 3730.754

Youmna Moufarrej, Children's Hospital Los Angeles, Los Angeles, CA, United States; Spandana Induru, Children's Hospital Los Angeles, Los Angeles, CA, United States; Panteha Hayati Rezvan, Children's Hospital Los Angeles, Los Angekes, CA, United States; Devin J. Shah, Children’s Hospital of Los Angeles, Los Angeles, CA, United States; Sarah White, Children's Hospital of Los Angeles, Los Angeles, CA, United States

Background: Immigrant and refugee patients face multiple challenges prior to, during, and following resettlement, placing them at higher risk for mental illness. Trauma-informed care (TIC) and culture-informed care (CIC) are evidence-based tools to building a trusting relationship with immigrant/refugee patients. Inpatient hospitalization may be the first time some refugee and immigrant patients receive health care after arrival, presenting a unique opportunity for mental health screening.

Objective: This project aims to assess if educational didactic sessions increase pediatric residents' abilities to recognize and screen immigrant and refugee patients for mental illness using TIC and CIC in the inpatient setting as demonstrated during Objective Structured Clinical Examinations (OSCEs).

Design/Methods: We recruited first year pediatric residents at a large, safety net children's hospital during the 2025-2026 academic year. The residents were assigned randomly to the control or intervention group (Fig. 1). We administered pre- and post-surveys to assess self-rated knowledge and confidence in refugee/immigrant mental health, TIC, and CIC, compared using Wilcoxon signed-rank tests. We additionally assessed likelihood to incorporate learned concepts after the educational session on the post-surveys. The OSCEs were developed using validated simulation tools. We are in the process of assessing performance using checklist evaluation adapted from a validated checklist.

Results: Twenty-one resident subjects participated in the study; individual participant characteristics are shown in Table 1, including potential confounders considered in the study. 62% of participants were familiar with training related to caring for immigrant/refugee patients with mental illness but had not received dedicated training. Compared to pre-survey responses, post-session medians were higher for: (1) knowledge of refugee/immigrant mental health care, (2) confidence in refugee/immigrant mental health screening, (3) knowledge of TIC, (4) knowledge of CIC, (5) confidence in TIC integration, and (6) confidence in CIC integration (Table 2).

Conclusion(s): Our didactic curriculum improved residents' knowledge and confidence across all surveyed domains regarding refugee mental health care, TIC, and CIC. Further OSCE analysis to assess for incorporation of TIC and CIC is pending. There is currently a significant gap in dedicated training in TIC, CIC, and caring for immigrant and refugee patients. We believe that this study highlights the benefits of providing education around the unique needs of this rapidly growing patient population.

Fig. 1. Study design including two population groups and study question.


Table 1. Study participant characteristics (IMPACT= Improving Medicine: Pediatricians and Communities Together; program integrated in all study participants' residency training).
Data are presented as frequency (%).

Table 2. Changes in self-rated knowledge and confidence following educational sessions (n = 21).
Data are presented as frequency (%), mean (SD), and median [25th, 75th percentiles]. P-values reflect paired t-tests for mean comparisons and Wilcoxon signed-rank tests for medians.