Systemic factors associated with poor anatomical response to anti-VEGF therapy in patients with diabetic macular edema: evidence from a large clinical cohort.

Trauma-informed care (TIC) is increasingly recognized as a cornerstone of equitable and compassionate healthcare, yet there remains little consensus on how to evaluate its impact in education and practice. To our knowledge, this is the first review to systematically map the outcome measures used to assess TIC educational interventions across healthcare settings. Using Moore’s Expanded Outcomes Framework, the review provides a structured synthesis of how learning, behavioral and system-level outcomes have been defined and measured to date. Findings reveal an overreliance on short-term, self-reported indicators of knowledge and confidence, with limited use of validated or equity-informed tools. Few studies examined sustained changes in provider behavior or organizational transformation, and almost none evaluated patient or community outcomes. These gaps hinder comparability across interventions and limit the ability to assess long-term impact or justify investment in large-scale implementation. By identifying key methodological and conceptual gaps, this review underscores the need for standardized, accessible and context-sensitive outcome measures that reflect the relational and systemic dimensions of TIC. The findings can inform future research design, funding priorities and policy decisions aimed at embedding trauma-informed principles across health systems. The accompanying this review provide a practical reference for educators, evaluators and implementation scientists seeking to strengthen the rigor and relevance of TIC evaluation.