Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Elizabeth Gabzdyl


Sakisha Delves


Purpose: This project is designed to improve knowledge and use of trauma-informed care in the midwifery setting.

Background: Research has shown that medical procedures and treatments can be distressing and trigger post-traumatic stress disorder symptoms in those with trauma histories. Obstetric and gynecological evaluations and procedures are intimate and invasive, putting the patient in a vulnerable situation. Midwifery facilities are in a unique position to provide support through trauma-informed care. However, despite evidence showing the benefit of trauma-informed care provision, training and implementation in the women’s healthcare setting are limited.

Design: A validated pre- and post-survey was utilized to assess changes in knowledge, attitude, and practice of trauma-informed care at a small, rural clinic in Montana following a traumainformed care training.

Results: A statistically significant increase between the pre- and post-survey scores for the questions measuring attitude (MD = 0.167, p < 0.05) and the overall score (MD = 0.198, p < 0.05) was identified. A statistically significant difference in mean scores for questions measuring practice of trauma-informed care between job roles was identified, with those with an administrative support job role having a statistically lower mean scores for questions measuring practice of trauma-informed care, than participants with a healthcare support job role (MD=1.375, p<0.05).

Implications: The results suggest not all job roles practice trauma-informed care equally. Further investigation should focus on looking at the differences in knowledge, attitude, and practice between job roles and how those gaps can be closed to improve the overall provision of trauma-informed care and to focus training efforts.