Patient involvement in trauma-informed care education for healthcare professionals - a scoping review

Background Trauma-informed care (TIC) recognises and responds to trauma impacts and promotes recovery for individuals by transforming healthcare services. Core principles of TIC include “collaboration and mutuality”, which advocates for partnership working between healthcare providers and patients. “Empowerment, voice and choice” recognises how patients have traditionally been disempowered and seeks to restore autonomy. These principles are strongly congruent with various approaches to “patient involvement” in healthcare and healthcare professions education (HPE). Inclusion of TIC in HPE is relatively recent. TIC education should include collaboration and empowerment, ensuring that patient perspectives inform professionals’ development. Evidence-based guidance for patient involvement in TIC education in wide-ranging specialties is lacking, and approaches have not been systematically synthesized. Methods We undertook a scoping review to identify evidence for patient involvement in TIC education for healthcare learners at all levels. Key databases were systematically searched for terms relating to TIC, HPE, and wide-ranging terms relating to patient involvement. Handsearching of key sources was undertaken. Key data were extracted and analysed qualitatively (thematic analysis) and quantitatively. Results After deduplication, 1256 studies were screened, with 22 eligible for inclusion. Disciplines represented included mental health, primary care, emergency medicine, gastroenterology and clinical skills. Qualitative themes included: 1. Diverse approaches to patient involvement in TIC education 2. Patient involvement redistributes power to highlight trauma impacts 3. Patients’ alternative perspectives promote authentic and impactful learning regarding TIC 4. TIC principles are variably applied in enabling patient involvement in TIC education Discussion Wide-ranging approaches and novel educational interventions were identified. TIC was relevant in diverse clinical disciplines and particularly necessary for marginalised groups. However, descriptions of approaches to patient involvement and related outcomes varied, with some studies providing limited reflection on these issues. Intentional approaches to patient involvement allowed alternative perspectives to be prioritised in education, providing richer authentic insights into trauma impacts, beyond medicalised models. Wide-ranging approaches to patient involvement offer diverse, creative options for embedding patient voice, while upholding patient safety and should be explored by educators. Reflection on rationale and application of TIC principles, and theoretical underpinnings of learning, alongside robust patient-centred evaluation of involvement may enhance evidence for future practice.