Sample distribution over workplace type.

BackgroundDespite international standards outlining the competence areas to be included in educational programs on trauma-informed care, a Norwegian expert group identified a lack of tools to measure the learning outcomes of such programs adapted to the Norwegian context. In response, they developed the Trauma and Development Education Monitor (TANDEM). This study examines the sensitivity of the instrument.MethodsThe study is based on pre- and post-test survey responses to TANDEM’s 55 items, covering the domains of Readiness, Agency, Reflexivity, Knowledge, Skills, and Work Culture, collected from 370 students across four cohorts enrolled in a three-week trauma course at Oslo Metropolitan University. Confirmatory factor analysis (CFA) with measurement invariance analyses were conducted to evaluate configural, weak, strong, and strict invariance in the reflective dimensions Readiness, Agency, and Reflexivity. Latent growth curve (LGC) models were then applied to analyze changes in outcome scores from pre- to post-program. Finally, LGC levels and changes in outcomes were predicted by participant background variables, i.e., workplace type, target age group, role type, work seniority, and prior trauma training.FindingsTANDEM demonstrated sensitivity in detecting significant increases in scores from before to after the course, both for the instrument as a whole and across all domains, most notably for Knowledge and Skills. Some measurement invariance issues were identified in the Agency and Reflexivity domains, indicating interpretation problems. Significant pre–post changes for the total instrument were observed regardless of students’ workplace type, target age group and work seniority, but with greater improvements among those in non-problem focused role types and with less prior trauma training.ImplicationsOverall, TANDEM shows promise as a tool for supporting the implementation, evaluation, and development of trauma competence programs in health and social care contexts. Future developments should test TANDEM across diverse educational, professional, and cultural groups, increase variance in the Readiness domain, refine and validate the domains, and validate the instrument against independent, performance-based competence measures.背景：尽管已有国际标准明确了创伤知情照护教育项目应涵盖的能力领域，但挪威专家小组发现，适配挪威本土语境的此类项目学习成果测评工具仍存在缺失。为此，他们研发了创伤与发展教育监测工具（Trauma and Development Education Monitor, TANDEM）。本研究旨在检验该测评工具的敏感度。 方法：本研究基于参与奥斯陆城市大学为期三周创伤护理课程的370名学生的前后测问卷数据，所用问卷包含TANDEM的55个条目，覆盖准备度、能动性、反思性、知识、技能与工作文化六大维度。研究采用验证性因子分析（Confirmatory factor analysis, CFA）结合测量不变性分析，对准备度、能动性、反思性这三个反映性维度的构型不变性、弱不变性、强不变性及严格不变性进行评估；随后采用潜增长曲线（Latent growth curve, LGC）模型分析项目实施前后的成果得分变化；最后通过参与者的背景变量（包括工作场所类型、服务目标年龄组、岗位类型、工作年限及既往创伤培训经历）对潜增长曲线的得分水平与成果变化进行预测。 结果：TANDEM能够有效检测出课程前后的得分显著提升，无论是在工具整体维度还是各细分领域，其中知识与技能领域的提升最为显著。但在能动性与反思性领域发现了部分测量不变性问题，提示存在结果解读层面的局限。无论参与者的工作场所类型、服务目标年龄组与工作年限如何，工具整体均能观测到显著的前后测得分变化；但以非问题聚焦为岗位类型、且既往创伤培训经历较少的学生，其得分提升幅度更为明显。 启示：总体而言，TANDEM作为一款测评工具，在健康与社会照护场景下的创伤能力项目的实施、评估与优化方面展现出应用潜力。未来的优化方向包括：在多样化的教育、职业与文化群体中验证TANDEM的适用性，提升准备度领域的得分变异度，细化并验证各细分维度，以及采用独立的基于表现的能力测评工具对TANDEM进行效标关联效度检验。