Department of Behavioral Sciences, Midwestern University, Downers Grove, IL, USA.
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Perm J. 2024 Mar 15;28(1):91-99. doi: 10.7812/TPP/23.108. Epub 2024 Jan 29.
Adverse childhood experiences (ACEs) are traumatic experiences that occur prior to age 18 years and can have a long-term impact on adult physical and mental health. Knowledge of ACEs, including the link between ACEs and health, and trauma-informed care (TIC), is essential for medical professionals to ensure respectful and compassionate care for those with a history of childhood adversity. This study examined medical students' knowledge, attitudes toward, and identification of ACEs and TIC to inform curricular efforts.
Using a cross-sectional design, students were recruited from 2 medical schools, one allopathic (medical degree) and one osteopathic (doctor of osteopathic medicine degree) to complete an electronic needs assessment survey. The survey included a patient vignette to assess students' ability to identify ACEs as contributing factors to patient health. The students were blind to the full purpose of the study to obtain an objective measurement of their ability to identify ACEs as contributors to patient health. Additional questions targeting knowledge and attitudes of ACEs and TIC were devised from previously published surveys with supplemental study-designed questions.
Two hundred forty students completed the survey. Results demonstrated variable ability to identify ACEs; strong general knowledge of ACEs, with less developed practical knowledge; and overall positive attitudes toward ACEs and TIC. No differences were found between the medical degree and doctor of osteopathic medicine degree, or year in program.
Medical students would benefit from curricular efforts that help to increase knowledge of the link between ACEs and health, increase practical application of ACEs and TIC, and improve their ability to identify ACEs in clinical scenarios.
不良的童年经历(ACEs)是指 18 岁之前发生的创伤性经历,可能对成人的身心健康产生长期影响。了解 ACEs,包括 ACEs 与健康之间的联系以及创伤知情护理(TIC),对于医疗专业人员确保对有童年逆境史的人提供尊重和富有同情心的护理至关重要。本研究考察了医学生对 ACEs 和 TIC 的知识、态度和识别能力,以为课程设计提供信息。
采用横断面设计,从 2 所医学院(一所是全科学位,另一所是骨科医学博士学位)招募学生完成电子需求评估调查。调查包括一个患者案例,以评估学生识别 ACEs 作为患者健康影响因素的能力。学生对研究的全部目的一无所知,以客观衡量他们识别 ACEs 作为患者健康影响因素的能力。针对 ACEs 和 TIC 的知识和态度设计了其他问题,并从以前发表的调查中添加了补充研究设计的问题。
共有 240 名学生完成了调查。结果表明,学生识别 ACEs 的能力存在差异;对 ACEs 的普遍了解较强,但实践知识发展较弱;对 ACEs 和 TIC 的整体态度较为积极。在全科学位和骨科医学博士学位之间,或在项目的不同学年之间,没有发现差异。
医学生受益于课程设计,这些课程有助于增加 ACEs 与健康之间联系的知识,增加 ACEs 和 TIC 的实际应用,并提高他们在临床情景中识别 ACEs 的能力。