Quality Trauma-Informed Care in nurse practitioner (NP) Students Working With Standardized Patients Presenting With Substance Use Disorder: A Qualitative Multiple-Case Study

Aims: To understand how nurse practitioner students provide trauma-informed care to clients presenting with substance use disorder in the simulation setting. Design: A qualitative, inductive, multiple-case study. Methods: Participants were sampled from a cohort of final-semester MSN nurse practitioner students from a medium-sized university in the Midwest. Data were collected surrounding a simulation during, which students provided care for a standardized patient presenting for initial treatment of substance use disorder. Maximum variation purposive sampling was used to select five representative cases (participants) that demonstrated quality trauma-informed care, following the guidelines of Creswell and Poth. Eight data sources were collected and triangulated both within and across each case, including a demographic survey, the Attitudes Related to Trauma-Informed Care Scale (ARTIC-10) survey, spatial and overhead videos, charting, postsimulation surveys of SPs and participants, rubrics, and semistructured interviews. Inductive analysis for a multiple-case study design was conducted by two researchers using methods described by Merriam, including intensive analysis, category development, and interpretation. Spatial videos were analyzed through an Apple Pro virtual reality headset. Results: Quality trauma-informed care praxis was engendered by five core themes: a nonjudgmental approach, drawing from experience, human connection, holistic assessment, and creating space. Conclusion: Although qualitative studies are not generalizable, this study highlights critical components of nursing care that underlie a trauma-informed approach to caring for patients with substance use disorder, with implications for teaching and practice.