Defense Date


Graduation Date

Summer 8-13-2022

Submission Type

DNP Manuscript

Degree Name

Doctor of Nursing Practice (DNP)


Doctor of Nursing Practice (DNP) Program


School of Nursing

Faculty Mentor

Mary Kay Loughran

Committee Member

Lori Fales


trauma-sensitive schools, trauma-informed care (TIC), social-emotional learning (SEL), adverse childhood experience (ACE), classroom management



Background: The fundamental ACE study asked more than 17,000 adults about their childhood trauma exposure and how it has impacted their health as an adult. The study found a link between ACE exposure and a higher likelihood of experiencing adverse emotional and physical outcomes (Felitti et al., 1998).

Problem: Educators and staff encounter children affected by trauma and are untrained in trauma-informed care approaches, known as the “Four R’s” (SAMHSA, 2014b).

Purpose: This quality improvement (Q.I.) project aimed to respond to the trauma-informed care (TIC) and social-emotional learning (SEL) gaps among educators and staff at a private elementary school in Maryland.

Method: Using a mixed-methods approach of qualitative and quantitative data gathering, including questionnaires, classroom observations, internet-based focus groups, and unstructured interviews.

Intervention: The intervention strategies included TIC education, low-fidelity simulation, and SEL skill-building training sessions.

Results: Pre-and Post-Test TIC knowledge of the educators and staff increased by 15%, and 86% agreed to a practice readiness for change involving motivation, general school functioning, and intervention-specific approaches. Pre-and-Post of current practice perceptions increased by 4%, and SEL classroom utilization efforts improved by 23%. Theme discussions during the focus group were intervention (characteristics, components, support) and classroom outcomes. The themes of the unstructured interviews were organizational data, teacher outcomes, and relationships between variables.

Conclusions: The TIC and SEL educational sessions supported educators and staff in recognizing and realizing trauma behaviors in elementary school students, and the interventions addressed the educational and training gap to help to respond appropriately and resist re-traumatization.