Education at OHSU

Trauma Informed Educational Practices

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The Trauma Informed Educational Practices Mission

Our mission is to transform healthcare education by building a community of educators and scholars engaged in implementing and evaluating equity-centered trauma informed educational practice (TIEP). TIEP grounds nursing in an equitable, inclusive, and culturally responsive pedagogical approach using the six guiding principles of Trauma Informed Care.

This page was last updated Thursday, November 30, 2023

"Trauma informed educational practices is a mindset, an acceptance of diversity, including background, knowledge, skills, and life experiences, and an understanding that some of those life experiences may be varied and include trauma" (Najjar, 2023; Najjar et al., 2022). Adverse childhood experiences like poverty, neglect, and exposure to violence, including discrimination and racism, can induce overwhelming stress. Chronic stress and trauma can impact the brain’s cognitive and memory centers, derailing learning and triggering behaviors such as fight, flight, freeze, or fawn.

Beginning to understand trauma, recognizing it, and responding to it requires a mindset shift focused on providing a structure to support students, faculty, and staff in creating a learning environment free of discrimination and trauma, which fosters resilience. Trauma informed educational practices can be seen as restorative of former and current trauma and/or preparation for the future by building resilience. 

The profound antidote to addressing trauma is human relationships, and if these relationships are positive, they can buffer the effects of stress and trauma. We have the power to decide whether we want our systems and institutions to be a place of trauma and re-trauma or a place of healing.

REFERENCE: Najjar, R., Jacobs, S., Keeney, S., Vidal, G., & Noone, J. (2022). Reflections on the Process of Implementing Trauma-Informed Education Lunch and Learns. Nurse Educator, Publish Ahead of Print.

REFERENCE: Najjar, R. (2023, January 25). Trauma-informed approach provides framework for achieving health equity. Campaign for Action.

Achieving health equity requires a collective effort across and within healthcare disciplines. The 2020-2030 Future of Nursing report outlined the role of nurse educators and the learning environment in addressing social determinants of health, equity, and education. If unaddressed these determinants can undermine our ability to achieve health equity. 

Using a trauma informed approach allows us to examine the influences of historic and systemic racism and discrimination that lead to inequities in the classroom. Students are exposed to racism and discrimination in and outside of the classroom which can be compounded by intergenerational poverty and trauma. A trauma informed approach provides us a framework and centers equity as we adjust to changes to our individual and systemic practices, pedagogy, and policies. 

  • Build a trauma informed lens: this is a journey, not a destination.
  • It is not enough to offer students remediation courses; what is required is a transformation in teaching and grading practices. This requires that we begin to accept that our practices are inequitable and work to change our practices, pedagogy, and policies.
  • Embed safety and trust in all our work: this requires that we build positive relationships with students to facilitate learning and mitigate stress and the impact of current or past trauma. Keep in mind as educators that fear of failure, anxiety, and self-doubt reduce cognitive and learning abilities.
  • Focus on culturally responsive practices: this requires that we are aware of and acknowledge historical and oppressive systems that have disproportionally affected racial, ethnic, and other systemically excluded groups. Our curriculum should be multicultural with positive cultural representations and provide evidence of the resilience of communities. Failing to honor and value students’ backgrounds and experiences in the classroom is another form of violence and can lead to trauma or re-trauma.

This online platform provides information in various forms, including articles, books, podcasts, videos, and websites. A great resource and a collaborative partner for this work is Trauma Informed Oregon (TIO). TIO is a non-profit organization that has helped to train healthcare providers in trauma informed care and serves as a resource for trauma informed efforts across the state. A strong focus for trauma informed efforts is wellness, and TIO dedicates a webpage with multiple resources on this concept of wellness. We encourage you to learn more about viewing wellness through a trauma informed lens.

Click the following tabs to explore and learn more about trauma informed educational practices.

The development of this online platform was funded by the OHSU Racial Equity and Inclusion grant opportunity through the OHSU Center for Diversity and Inclusion in partnership with the OHSU Office of Educational Improvement and Innovation. 

We aim to strengthen healthcare education by supporting faculty and staff with the desire to implement or evaluate trauma informed educational practices. Please contact us if you would like more information about faculty and staff training or changes in your institution.

Rana Najjar_FR

Rana Halabi Najjar, Ph.D., RN, CPNP

Associate Professor

OHSU School of Nursing – Monmouth

Pronouns: she, her, هي

Email Rana
Headshot of Francis Rojina smiling with an ocean background.

Francis Alicia Rojina, M.P.H.

Student Inclusion & Success Coordinator

OHSU School of Nursing – Klamath Falls

Pronouns: she, her, ella

Email Francis

Our Research/Scholarship Interest Group (RIG/SIG) aims to transform healthcare education by building a community of educators and scholars using and evaluating Trauma Informed Educational Practices (TIEP). Individually, we are working on ways to expand our TI practices and pedagogical approaches. Collectively, we explore ways to support and share ideas on implementing TI in the educational environment. If you are interested in attending our educational sessions or collaborating on scholarship and research, please contact us.


RIG/SIG Principle Investigator

Rana Najjar_FR

Rana Halabi Najjar, Ph.D., RN, CPNP

Associate Professor

OHSU School of Nursing – Monmouth

Pronouns: she, her, هي

Email Rana

RIG/SIG Co-Investigator

Headshot of Doria Thiele

Doria K. Thiele, PhD, CNM, IBCLC

Assistant Professor of Clinical Nursing

Pronouns: she/her

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Echo recording of presentation on 'Trauma Informed Pedagogy in Healthcare'

Presented by Doria K. Thiele, PhD, CNM, IBCLC, Rana Halabi Najjar, Ph.D., RN, CPNP, and Holly Villamagna, MD

Equity-Centered Trauma Informed Approach

The following diagram describes the Equity-Centered Trauma Informed Approach to educational practice. The diagram illustrates the four phases of developing a trauma informed lens, which is centered on equity and justice. Remember, this is a journey, not a destination. The ongoing process of developing a trauma informed lens should be reflected in practice, pedagogy, and policy at OHSU to ensure safety, trust, peer support, collaboration, empowerment, and cultural responsiveness among the OHSU community. It takes all these components to light the way toward becoming a trauma informed space.

Equity-Centered Trauma-Informed Approach Diagram
Adapted from Missouri Model: A Developmental Framework for Trauma Informed Approaches, MO Dept. of Mental Health and Partners (2014)

Equity-Centered Trauma-Informed Education

by Alex Shevrin Venet

Image of the front cover of Venet's book, "Equity-Centered Trauma-Informed Education"

In this book, Venet shares a systems approach to resorting to justice and equity in the classrooms, schools, and communities. The book has five parts: bring equity to the center, adopt a universal approach, rethink your role as an educator, move from mindset to systems change, and change the world from the inside your classroom. Venet writes candidly about how our educational systems are inequitable, and cause trauma or re-trauma. Informative concepts and content include:

  • Principles of Equity-Centered Trauma-Informed Education
  • Developing our lens (practice), transforming our classrooms (pedagogy), and shifting the larger systems (policy)
  • Adopt a Universal Approach using the four proactive priorities (predictability, flexibility, connection, and empowerment)
  • Tools to examine current practices
  • Examine the curriculum, disrupt harmful narratives
  • Activism and action as healing

The author includes many resources and references that are valuable to educators and administrators interested in advancing social justice and equity in education.

Venet AS. Equity-Centered Trauma-Informed Education. First edition. W.W. Norton & Company; 2021.

Training for Change: Transforming Systems to Be Trauma-Informed, Culturally Responsive, and Neuroscientifically Focused

by Dr. Alisha Moreland-Capuia

Front cover of Dr. Alicia Moreland-Capuia book on Training for Change: Transforming Systems to Be Trauma-Informed, Culturally Responsive, and Neuroscientifically Focused

Training for Change provides an overview of the neurobiology of fear, brain development, trauma, substance use, bias, racism, and environmental factors that impact healthy brain development. Dr. Alisha Moreland-Capuia shares case studies to elucidate the concepts and provide recommendations to facilitate a trauma informed approach to changing systems. The book includes 12 chapters on topics such as:

  • Developing brain and trauma
  • Intersection of fear, trauma, aggression, and a path to healing
  • Labeling theory: the power of words and implicit bias
  • Restorative justice
  • Self-care
  • Change and hope of systems change

A must-read for any organization moving on the path to being trauma informed.

Moreland-Capuia A. Training for Change: Transforming Systems to Be Trauma-Informed, Culturally Responsive, and Neuroscientifically Focused. Springer Nature Switzerland; 2019.

Examining the Intersections of Equity, Trauma-Informed Pedagogy, and Student Learning
How childhood trauma affects health across a lifetime
How Neuroscience Is Changing What We Know about Learning

Mindful Breaks & Practices

A brief video with simple brain boosting exercises that activate both right and left brain, improve concentration, and strengthen our mind. The exercises also help with decision making, attentiveness, logical thinking, and alertness.
Watch Energizers! author Susan Roser as she leads staff members through the Energizer 'Check My Beat' activity.
This video features an interactive presentation demonstrating 6 of the most successful brain breaks & Zoom games that are ideally suited for online or virtual groups, such as Zoom meetings & classes. They are drawn from playmeo's online database of 100s of ice-breakers, energisers, trust-building exercises & team-building activities.

Grounding Exercises

For these grounding exercises, walk students through the exercises after you watch the videos. You can have students stand facing the walls in the room so they can’t see each other. It helps them be uninhibited in their movements.

Feeling anxious? Grounding exercises can help to calm anxious thoughts and keep you focused and mindful in your environment. The 5-4-3-2-1 method is a grounding exercise that can be done almost anywhere and it doesn't require any equipment or materials- just your brain! Take a few minutes to learn how to complete the exercise and then try it for yourself.
Kim Eng presents a short video practice on the "Shaking Practice".
"Body shaking" to get rid of negative emotions and negative thoughts.
Learn more about the 4-7-8 breathing technique

Standards of Practice for Trauma Informed Care in Educational Settings

Guidelines were developed by Trauma Informed Oregon through the Defending Childhood Initiative to provide educational institutions guidance in implementing trauma informed educational practice. We encourage institutional implementation starting with the development of a strategic plan based on the needs of students, faculty, and staff within the institutions. The language in this document focuses on K-12 programs, but can be adapted for any educational institution.

The Standards of Practice for Trauma Informed Care in Educational Settings Tool

Trauma Informed Care Screening Tool

Trauma Informed Oregon has also developed a screening tool that outlines ways an organization may advance in sequential movement from trauma aware (phase 1) to trauma informed (phase 4).

Using the Trauma Informed Care Screening Tool

Dr. Doria Thiele

Dr. Doria Thiele has been a nurse educator since 2008 and has taught across several programs.  In recent years, Doria’s teaching has been in the Doctor of Nursing Practice program, which includes six nurse practitioner specialties. Doria’s research focuses on student perceptions of different trauma informed teaching strategies.  This includes surveying students regarding belonging, stress, resilience, discrimination, and about specific trauma informed strategies they have experienced. Doria’s research goals are to better understand what is important to students in regard to trauma informed teaching strategies, and to improve experiences for all students, but most importantly students who come from historically excluded groups.   

Dr. Rana Najjar

Dr. Rana Najjar has been teaching in the undergraduate and graduate programs in the School of Nursing since 2008. Her research and scholarship focus on bias, discrimination, and equitable and inclusive practices in healthcare education. She is the principal investigator for a mixed-methods study examining applicants’ experiences of bias during the admission process. Rana is a leader in Trauma Informed Education Practices (TIEP), collaborating with OHSU to design, implement, and evaluate faculty/staff training on TIEP. Rana has led book clubs and other initiatives with various nursing academic institutions to raise awareness of the impact of inequities on nursing education and build a community of trauma informed educators.



  • Research Interest Group: Evaluating Trauma Informed Education Practices in an Online Nursing Course (PI: Thiele)
  • Facilitators & Barriers to Implementing Trauma Informed Educational Practice Training (PI: Najjar)
  • Improving DNP Student Experiences Using Growth Mindset and Trauma Informed Techniques (PI: Thiele)
  • Experiences of Bias in Nursing School Admissions (PI: Najjar)
  • Research Interest Group: Incorporating Trauma Informed Teaching into Doctor of Nursing Practice Courses (PI: Najjar, Co-PI: Thiele)
  • Building a Trauma Informed Education Resource Center: A DEI OHSU collaborative (PI: Najjar, Completed).


Conference Presentations

  • Najjar, R.H. Trauma-Informed Pedagogy: A Just, Equitable, and Inclusive Practice. Podium Presentation at the Western Institute of Nursing Conference, April 2023, Tucson, AZ.
  • Najjar, R.H. Trauma-Informed Educational Practices. The American University of Beirut Nursing Research Day Conference. May 2022. Virtual Presentation
  • Najjar, R.H., Noone, J., & Thiele, D. (2022). Trauma-Informed Educational Practices (TIEP): An Equitable and Inclusive Approach to Nursing Education. Podium Presentation (Professor Rounds) at the National League for Nurses Conference, September, 2022, Las Vegas, NV.
  • Najjar, R.H., Equity-Centered Trauma-Informed Education. Poster and Podium presentation at the AACN Diversity Leadership Institute, June 2022, Virtual.
  • Najjar, R.H., Noone, J., & Thiele, D. Using Trauma-Informed Educational Practices: An Equitable and Inclusive Approach to Nursing Education. Poster Presentation at AACN Diversity Symposium Conference, November 2021, Virtual.
  • Thiele, D.K., Najjar, R.H., & Goranflo, R. Incorporating Trauma-Informed Education Practices into the Doctor of Nursing Practice Program. Poster presentation at the OHSU Education Symposium, May 2022, Portland, OR.
  • Najjar, R.H. Trauma-Informed Approaches Center, Equity, Inclusion, and Culturally Responsive Pedagogy. Webinar for International Network for Doctoral Education in Nursing, November 2023, Virtual.

Invited Lectures

  • Najjar, R.H, & Ackerman-Barger, K. Achieving Health Equity by Leveraging Equity-Centered Trauma – Informed Educational Practice. Podium Presentation. Western Institute of Nursing. April 2023.
  • Najjar, R.H. Equity-Centered Trauma-Informed Approaches in Healthcare Education. University of Washington, Office for Nursing Research: Nurse-Led Community Engaged Scholarship on Social Determinants of Health. November 2022.
  • Najjar, R.H. Equity-Centered Trauma-Informed Education. The University of California Davis: Growing as a Community Education Webcast. September 2022.
  • Najjar, R.H. Equity-Centered Trauma-Informed Educational Practices. The University of California Davis. Faculty Development Workshop. September 2022.
  • Garcia, E., Hassmiller, S.B., Myler, A., Najjar, R.H., & Shirley, J. Trauma-Informed Inclusive Educational Practices. Panel Discussion with Audience Q & A at the Oregon Consortium for Nursing Education Conference, May, 2022, Bend, OR.
  • Najjar, R.H. Equity-Centered Trauma-Informed Education. Digital Lecture Series for OHSU Nursing @ Noon, January 2022.

TIEP Training

  • Najjar, R.H, Fry-Bowers, E., & Downs, A. Bookclub on Equity-Centered Trauma-Informed Educational Practices. An OHSU, University of San Francisco, & University of Portland Collaborative. February 2023 – April 2023
  • Najjar, R.H & Ackerman-Barger, P. Bookclub on Equity-Centered Trauma-Informed Educational Practices. An OHSU & UC Davis Collaborative. October 2022 – March 2023
  • Najjar, R.H & Garcia, E. Equity-Centered Trauma-Informed Educational Practices. OHSU RN/BS Program. Faculty Development sessions. September 2022.
  • Najjar, R.H. Equity-Centered Trauma-Informed Education. The University of California Davis: Learning Culture Committee. September 2022.

Forum Session: February 14th from 12-1 PM

This is open to all internal and external to OHSU, please fill out the following form to receive the link for the session:

2022-2023 Book Club: Discussing Equity-Centered Trauma-Informed Education

Flyer for 2022-2023 Book Club Discussing Equity-Centered Trauma-Informed Education

A joint collaborative activity between OHSU School of Nursing and the Betty Irene Moore School of Nursing. The book club discussions will focus on the book, Equity-Centered Trauma-Informed Education, by Alex Shervin Venet. Learn more about the author and book by visiting

Book Club Session Dates:

  • October 17th
  • November 14th
  • February 13th
  • March 20th (with special guest, author Alex Venet)

All sessions will be held via Zoom from 12:00 - 1:30 pm (PST). More information about registration to come in September 2022.