Table 1, Systematic Digital Content 1
Study Length of
education provided
Design of study Provider or framework
Method of education
Outcome measures
Impact of training Overall strength / weakness of study Crable et al.
(2013)An Examination of a gender specific and trauma- informed training curriculum:
Implications for providers International Journal of Behavioral Consultation and Therapy.
4 hours 8 modules
Time series factorial design.
Quantitative study Randomly selected staff.
20 control group 20 treatment group.
Did not discuss
Didactic, experiential learning using case studies.
Pre and post survey of knowledge Survey of satisfaction.
Follow-up 45 days later with same surveys.
Surveys have no validation or reliability Findings:
Outcomes: reduction in satisfaction and little increase in knowledge Brief follow up period staff found training useful however little impact on clinical skills.
Used recognised software for statistical analysis Selection of staff random, good for research purpose however TIC should be provided to all staff Did not use validated tools for questionnaires Limited time for follow up questionnaire
Did not discuss trainers background or
experience/framework for training
Small sample size Hall et al. (2016)
Educating emergency department nurses about trauma informed care for people presenting with mental health crisis: a pilot study BMC Nursing.
1 day Eight 45 minute modules
Exploratory research Mixed methods design.
Quantitative data – pre and post education questionnaire Qualitative data semi-structured focus groups Participants = n (34) training and questionnaires 14 focus group- themes based on perceived effectives and subsequent changes in practice
Reducing Restrictive interventions Project team
Adult learning styles using variety of modes Slideshows, video viewing, group discussion interactive learning games Co-
facilitated by lived experience facilitator
Pre and post knowledge questionnaire focus group 3 month after training
Increase in knowledge of trauma-informed practice, how to respond to disclosure of family violence, increased confidence.
Little impact on how it is ED nurses role to listen to patients talk about trauma, contribution of ED environment to trauma, confidence in response to patient’s disclosure about trauma
Focus group found attitudinal change in nursing staff and person centred approach with an emphasis on communication and providing reassurance
Used recognised software for statistical analysis Used thematic analysis using a general inductive approach with 2 researchers
Used recognised trainers and framework for education Inclusion of lived experience facilitator Did not include all staff in education
Small sample size
McEvedy et al.
(2017)
1 day train the trainer
Descriptive qualitative
Reducing restrictions team
Adult learning styles using
Post training semi structured interviews focus
Service selection of trainees was poor
Recognised software utilised for coding transcripts, inductive
Sensory Modulation and trauma-informed care knowledge transfer and translation in mental health services in Victoria:
Evaluation of a state-wide train the trainer intervention, Nurse Education in Practice
Eight 45 minute modules TIC 1 day train the trainer six 45 minute modules Sensory modulation
Semi- structured interviews, focus group discussions, one paired in- depth interview Participants (n=170) Semi-structured interviews (n=21) Focus groups (n=10)
In depth interview (n=2)
a variety of modes Slideshows, video viewing, group discussion interactive learning games Co
facilitated by lived experience facilitator
on outcomes of training
Poorly implemented in the wider services
Staff not well supported to rollout training structure not in place to roll out training increased knowledge of trainees
reduction in seclusion within some areas
roll out for TIC (n=6) for all modules and (n=10) adapted training
(n=1) did not roll out and (n=2) did not reply to post interview request
analysis used, two researchers with no part in training to reduce bias No pre training information available
Wide range of services included
Poor selection of trainees Limited numbers of trainees provided
feedback and 2 service did not roll out training
Isobel and Delago (2017)
Safe and collaborative communication skills : a step towards mental health nurses implementing trauma-informed training, Archives in Psychiatric Nursing
1 day 8 hour workshop
Participants (n=73) Post training questionnaire Self-reported knowledge Unstructured field notes recorded
Trauma experts Trauma principles Training provided by senior nurses and managers Consultation with other nurses and peer worker
Didactic role play, variety of modes and reflective feedback
Self-reporting questionnaire post-test knowledge
Supervision groups were initiated by a number of staff (n=8) and increase in self- reported knowledge Increased understanding of TIC into practice
Peer reflection was uncomfortable however staff felt this was useful but not part of everyday practice Nurses felt restrained by policy and medical hierarchy when implementing TIC into practice
No pre-questionnaire Descriptive statistics used Basic content analysis and discussion with wider team Limited participants No follow-up from one day training
Questionnaires provided self-reported knowledge No evidence of knowledge improvement
Field notes were taken unstructured
Williams and Smith (2017), Does training change practice?
A survey of clinicians and managers one year after training in trauma- informed care, Journal of Mental Health Training , Education and Practice
½ day managers (n=110 1 day clinicians (n=153) post training survey questionnaire completed by clinicians (n=
43) managers (n=35)
Naturalistic study Post training online survey quantitative outcomes with open dialogue box for further comments
Trauma experts Trauma- informed care principles
Did not discuss
Post training survey questionnaire one year following training, focus on impact of training in clinical practice
Increase in knowledge and attitude
Both managers and clinicians wished TIC to be embedded in practice however moderate impact on clinical input at a personal level, little impact on practice change in workplace
Low response rate 28%
clinicians responded 32%
managers
Study does not mention how data was analysed and by whom
Layne et al.
(2017), Core curriculum of childhood trauma :
5 days (30hrs) over 2 weeks Participants (n=43)
Questionnaires with open ended qualitative feedback
Core curriculum training on
Problem based learning, didactic
Pre and post self-efficacy scores questionnaire
Increase in self-efficacy in using core curriculum training in practice
Data collection using V strand instruments Descriptive statistics
A tool for training a trauma informed workforce, Psychological Trauma and Research
evaluation questions Focus on self- efficacy
childhood trauma Learning facilitator significant experience
learning, adult learning principles
Post PBL semi structured interviews
Good response for using PBL as a training tool for Trauma-informed care
Use of pre and post-test questionnaires Small number of participants
Baker et al.
(2017), the implementation and effect of trauma-informed care within residential youth services in rural Canada: A mixed methods case study
2-day core 1-day follow- up
2-day train the trainer Participants (n=116) Training for trainer and mentors (n=23)
Explanatory sequential mixed method study and a participatory action research approach Trauma-informed care belief measure measuring staff attitudes to TIC ProQOL measuring vicarious trauma/
compassion satisfaction/
burnout/
secondary trauma Both at pre/post- test and follow-up 8 hours of participant observation In-depth participant interviews (n=10)
Risking connections Restorative approach with a focus on Vicarious trauma
Did not discuss however used train the trainer principles
Trauma- informed core beliefs measure Professional quality of life scale 8 hr participant observation Semi-structured interviews
Increased staff beliefs/attitudes of TIC No change in staff satisfaction. Burnout and traumatic stress scores increased.
Observational data confirmed improved staff attitude and adopted TIC into workplace
Move towards healing Organisationally slow progress
Recognised software used in analysis
Triangulation of data Iterative process used for coding
Pre and post test results Follow up interviews provided
Post training not all participant completed all questionnaires (n=82)
Damian et al.
(2017), Organizational and provider level factors in implementation of trauma-informed care after city- wide training: an explanatory mixed methods study
1 day per month for 9 months
Explanatory mixed methods study Participants (n=90) Pre/post-test survey following training (n=90) Safety attitudes questionnaire ProQoL survey
SAMHSA and trauma experts
Ongoing training with support using feedback
Pre and post surveys Safety attitudes questionnaire Professional quality of life scale
Semi-structured interviews 2 months following training
Increase in compassion fatigue and compassion satisfaction. Increase in job satisfaction. Organisational improvement and change in policy/environment.
Heightened awareness of own trauma and support within the workplace
Good response to surveys (n=88)
Pre/post testing completed follow up with semi structured interviews Recognised software used in data analysis
Thematic analysis conducted with 2 trained coders using constant comparative method
Semi-structured interviews (n=16) after 9 month training Goldstein et al.
(2018) Medical students perspective on trauma-informed care training, Nursing Research and Practice
6 hours in 2- hour modules over 3 days
Feasibility study Convenience sample Qualitative open ended questionnaires (n=20)
Trauma principles with trauma expert
Didactic, experiential learning using a variety of modes
Post education questionnaire with open questions, self- report
Increase in knowledge Increase confidence of how to ask about previous trauma and recognise some signs however little support to implement into the workplace
Recognised software analysis to identify themes Independently coded Post questionnaire only Reliant on self-report