Introducing ACEs (Adverse Childhood Experiences) and Resilience to First-Year Medical Students

MedEdPORTAL. 2020 Sep 15:16:10964. doi: 10.15766/mep_2374-8265.10964.


Introduction: Adverse childhood experiences (ACEs) are associated with negative mental and physical health outcomes and predictive of higher sociodemographic risk. Introducing ACEs into undergraduate medical education is key to prevention, early recognition, and intervention.

Methods: In a 1-hour lecture, held live and viewed online, we delivered a condensed introduction to ACEs to first-year medical students. Live-classroom participants completed pre-/postsession questionnaires self-assessing their knowledge of 10 content areas on a 5-point Likert scale. We analyzed quantitative data to determine mean scores and differences. We synthesized qualitative data obtained from feedback.

Results: One hundred twenty-four students, including 32 live-classroom attendees and 92 online viewers, participated in this activity. Self-assessment scores increased in all content areas measured, with a mean increase of 1.5 (p < .0001). The most significant increases occurred in identifying household dysfunction as ACEs (increase of 2.3), calculating an ACE score (increase of 2.2), differentiating between child abuse acts of commission and omission (increase of 1.9), describing resilience (increase of 1.7), and recognizing the link between ACEs and chronic medical conditions (increase of 1.4). Participants found the lecture informative, appreciating the use of the case illustrating how ACEs impact health and an interactive slide on the risks conferred by cumulative ACEs. Learners welcomed the positive message of resilience.

Discussion: Introducing ACEs in medical student education is feasible. Educating the next generation of health providers on ACEs while highlighting prevention and resilience and teaching trauma-informed care is crucial. This lecture can be readily incorporated into medical student curricula.

Keywords: ACEs; Adverse Childhood Experiences; Child Abuse; Child Maltreatment; Chronic Medical Conditions; Mental Health; Trauma-Informed Care; Virtual Learning.

MeSH terms

  • Adverse Childhood Experiences*
  • Child
  • Child Abuse*
  • Curriculum
  • Humans
  • Students, Medical*
  • Surveys and Questionnaires