Maria is a typical 13 year-old girl-active, social, and friendly. One day, she complains to her mother of "not feeling quite right". A few days later, Maria looks pale and complains of being tired all the time. She begins missing school and after school activities. Maria's mother becomes concerned and takes Maria to her pediatrician, thinking she might have the flu or be anemic. The doctor examines Maria and does some blood tests. The next day, the doctor recommends that Maria and her mother see a specialist at the hospital for further evaluation.


As the specialist, Maria is your patient. How would you approach her diagnosis and treatment? What questions would you ask? How would you react if Maria or her parents either withdraw or act aggressively towards you? What questions would you ask to understand their behaviors?

More and more medical schools are incorporating trauma informed or patient centered care principles into their curriculum to help prepare students to conduct better physician-patient interactions. At the University of Missouri School of Medicine, Kimberly Hoffman, Ph.D, associate dean for curriculum and assessment, and research associate professor of family and community medicine, developed the Patient-centered Care – Objective Structured Clinical Exam (PCC-OSCE) to help train medical students. The test utilizes real life simulations to provide students the opportunity to practice patient-centered care skills, as well as faculty and patient feedback on the skills they implemented well and those that need improvement.

For those already graduated from medical or nursing school, the trauma informed care courses available (with FREE CEUs) on can provide you with the essential skills to assess your patient's distress, provide emotional support and address other family needs.