Does training in trauma informed care change healthcare providers’ and patients’ emotional and cognitive outcomes, or health?

Problem

Trauma is defined as an event or circumstance ‘experienced by an individual as physically or emotionally harmful or life-threatening’ (SAMHSA, 2017). Traumatic experiences increase the risk of a variety of adverse mental and physical health outcomes, and can result in increased contact with and utilisation of healthcare services. In the last two decades, the trauma-informed approach has gained momentum as a solution to address the high prevalence and adverse health impact of violence and trauma on patients and healthcare providers. A trauma informed approach is a system level intervention that changes culture and practice to create environments and relationships that promote recovery and prevent re-traumatisation among patients and staff. Implementing a trauma informed approach relies on training and workforce development. However, there is a current gap in the evidence for mechanisms of training interventions for trauma informed care and their effect on professional behaviour and practice, as well as patient experiences and outcomes.

Approach

We will carry out a mixed methods systematic review with concurrent quantitative and qualitative analysis, followed by results-based convergent synthesis, into training interventions on trauma informed care for healthcare providers in any healthcare setting. The main outcome measure is any change in healthcare provider or patient behaviour or practice indicating their engagement in the provision of trauma-informed care. Additional outcomes are any healthcare provider or patient psychological outcome indicating their engagement in the provision of trauma-informed care. Examples include changes in knowledge, beliefs and attitudes, confidence, or perception of services. Intervention studies and service evaluations of trauma informed care training interventions of any design will be included, to address the research question: does training in trauma informed care change healthcare providers’ and patients’ emotional and cognitive outcomes, or health?

Findings

Work in progress: interim findings demonstrate substantial heterogeneity in design, content and delivery of trauma informed care training interventions for healthcare providers across a wide range of professions. There is no universal curriculum for trauma informed care, giving rise to this wide variety of training formats. Effectiveness of staff training in trauma informed care does not appear to rely on its duration or intensity, but there is an emerging pattern to suggest that involvement of real or simulated patients within the training intervention has a powerful impact on behavioural and psychological outcomes for attendees.

Consequences

Work in progress: findings from this systematic review have the potential to influence the development of a unified, evidence based, and cost-effective curriculum for training healthcare providers to deliver trauma informed care. In turn, this approach to healthcare has the power to engage and support some of the most vulnerable patients we serve.