Outcome measurement in trauma-informed care education across healthcare settings: A scoping review.

As trauma-informed care (TIC) becomes more integrated into healthcare systems, consistent and meaningful evaluation remains limited. Educational interventions are central to implementation, yet outcome measures vary widely. This scoping review systematically mapped outcome measures used to evaluate TIC educational interventions in healthcare settings to identify current practices, methodological gaps and opportunities for more coherent and context-sensitive assessment. The review followed PRISMA-ScR guidelines. Five databases (MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC) were searched from database inception to October 2024. Eligible studies described TIC educational interventions for healthcare providers and reported at least one outcome related to knowledge, attitudes, confidence, competence, or behavior. Two reviewers independently screened and extracted data on study design, participants, intervention characteristics and outcome measures. Outcomes were categorized using Moore's Expanded Outcomes Framework, which includes seven hierarchical levels from participation to patient or community health outcomes. Twenty-eight studies met inclusion criteria, most published after 2020 and conducted in the United States. Outcome measurement was dominated by self-reported data, primarily custom pre-post surveys assessing knowledge, confidence or attitudes. Only eight studies used validated tools, most commonly the ARTIC-35 or ARTIC-45. Few assessed behavioral or system-level change, and none directly measured patient outcomes. Educational formats ranged from brief online modules to multi-session interdisciplinary trainings. A small subset explored relational or equity-oriented outcomes such as empathy or cultural humility, often using qualitative methods. This review highlights the field's reliance on short-term, self-reported outcomes and limited use of validated or standardized measures. Developing accessible, equity-informed tools that capture behavioral and system-level change is essential to advance research, guide policy and sustain trauma-informed transformation across healthcare systems.