Abstract / Summary
Abstract Background Paramedics work in high-stress environments characterised by recurrent exposure to traumatic events, while health-system resilience depends on a workforce that can maintain safe and effective practice during emergencies. Evidence on the sustained application of trauma-informed care (TIC) training in prehospital services remains limited. This study evaluated the acceptability, perceived professional application, and organisational implications of a structured TIC training programme for paramedics. Methods A mixed-methods longitudinal programme evaluation was conducted with 30 paramedics who completed a 40-hour, five-day TIC training programme. Immediate post-training assessment examined acceptability and perceived applicability. At three months, participants completed a 24-item researcher-developed Trauma-Informed Approach to Emergency Cases Form; responses were summarised descriptively. At six months, an independent psychologist conducted structured interviews with a randomly selected subset of participants. Interview data were analysed thematically using Braun and Clarke's six-phase framework. Results Immediate post-training satisfaction was high (mean 9.85/10, SD 0.2). At three months, median scores were 5.0 across all questionnaire items, with observed minimum scores ranging from 3 to 4, indicating high self-reported endorsement of competencies related to trauma recognition, stress regulation, psychological first aid, burnout prevention, peer support, and professional well-being. At six months, participants described continued use of stress-regulation strategies, more supportive team communication, peer support, boundary-setting, and greater awareness of leadership and organisational support needs. Participants also advocated broader access to TIC training within emergency medical services. Conclusions The findings suggest that structured TIC training is feasible and perceived as applicable to prehospital practice, with reported use of trauma-informed strategies extending to team functioning and professional self-regulation six months later. Because the evaluation lacked a pre-training baseline, comparator group, validated follow-up outcome measures, and objective patient or service outcomes, causal effectiveness cannot be inferred. Multi-site studies using validated and behaviour- or service-level outcomes are needed to determine whether trauma-informed workforce development strengthens health-system preparedness and resilience.