Building trauma-informed physical therapists: a mixed-methods evaluation of a multimodal training module in hybrid DPT education.

BACKGROUND: Trauma-informed care (TIC) remains inadequately integrated into health professions education despite its clinical relevance, limiting opportunities for graduates to develop the skills necessary to support individuals with trauma histories. OBJECTIVE: This gap is particularly pronounced in Doctor of Physical Therapy (DPT) education, where hands-on clinical practice creates unique conditions that could evoke trauma-related responses or retraumatization. This study evaluated a multimodal TIC training module embedded in a hybrid DPT curriculum. METHODS: Using a convergent mixed-methods design, this study evaluated a multimodal TIC training module embedded in the third semester of the first year of a hybrid DPT curriculum across two consecutive cohorts (N = 142). Quantitative pre-post surveys measured changes in self-reported TIC-related knowledge, attitudes, and confidence; qualitative data were drawn from post-intervention open-ended survey responses and student self-reflection essays. RESULTS: Significant improvements were observed across all three domains, with large effect sizes replicated across both cohorts (Hedges' g = 1.39 for knowledge familiarity; g = 1.31 for confidence). Qualitative analysis yielded four themes: developing a trauma-informed professional identity, intentional relationship-building as core clinical practice, applying TIC principles in clinical decision-making, and recognizing the role of the clinician's inner experience. Integration of quantitative and qualitative data revealed strong convergence and complementarity across strands, and identified a confidence-complexity paradox; large measured gains in physical examination confidence alongside persistent qualitative uncertainty about managing trauma responses during hands-on care. CONCLUSION: These findings support embedding TIC training in DPT education, with implications for professional identity formation and mitigation of physical therapist burnout.