Carey Heck

Thomas Jefferson University College of Nursing
USA

Abstract Title: Teaching Difficult Conversations Through a Trauma-Informed Lens

Biography:

Research Interest:

Background/Introduction
Trauma-informed care is increasingly emphasized within advanced nursing practice and education; however, graduate nursing students are frequently required to engage in emotionally charged conversations without formal preparation grounded in trauma-informed principles. Difficult conversations related to care transitions, risk disclosure, death, loss, or clinical failure often occur within contexts of power imbalance and emotional vulnerability. When these interactions are approached without trauma-informed strategies, they may contribute to re-traumatization, emotional distress, compassion fatigue, and burnout among advanced practice nurses and nurse educators.

Purpose
The purpose of this presentation is to describe a practice-driven, trauma-informed approach to teaching difficult conversations within graduate nursing education and to highlight strategies that promote psychological safety, learner development, and professional resilience.

Methods
This educational approach is embedded within a graduate Adult-Gerontology Acute Care Nurse Practitioner program and will be implemented longitudinally across three sequential courses required for program completion. The assignment integrates simulation of high-stakes clinical conversations, guided reflection, and structured debriefing. Trauma-informed care principles including trustworthiness, safety, collaboration, and empowerment are intentionally incorporated into both the communication content and the learning environment. Learners practice emotional regulation and shared decision-making while engaging in realistic clinical communication scenarios. Students participate in trauma-informed simulation experiences using standardized patients to enact high-stakes clinical conversations. Scenarios are developed by acute care faculty to reflect realistic and progressively complex communication challenges aligned with course objectives. Each simulation includes facilitated preparation, guided reflection, and structured debriefing with intentional attention to psychological safety, emotional regulation, and shared decision-making.

Results
Preliminary results are in progress. Initial evaluation during summer session will focus on students’ perceptions of psychological safety, preparedness, and perceived value of the trauma-informed simulation, reflection, and debriefing components. Ongoing data collection across the three-course sequence will inform formal analysis of student feedback and guide future refinement of the assignment.

Limitations
This approach is described within the context of a single graduate nursing program and is based on education practice rather than empirical outcome data. Findings may be influenced by institutional culture, faculty expertise within trauma-informed pedagogy, and learner readiness. Further evaluation is needed to assess long-term outcomes and generalizability across diverse nursing education settings.

Conclusion
Teaching difficult conversations through a trauma-informed lens offers a pragmatic strategy to support graduate nursing students as they develop communication skills. By embedding trauma-informed principles into simulation, reflection, and debriefing, nurse educators can reduce the risk of re-traumatization while fostering resilience and professional growth. This approach has the potential to enhance both learner well-being and the quality of difficult conversations encountered in acute care advanced practice nursing. Improved preparedness of advanced practice nurses to engage in high-stakes clinical conversations, enhanced psychological safety for both clinicians and patients, and the potential to mitigate compassion fatigue and burnout. Integrating trauma-informed communication pedagogy into graduate curricula may strengthen the quality of difficult conversations encountered in the acute care setting for the advanced practice nurse and support sustainable workforce development.