Incorporating Adverse Childhood Experiences in Medical Student Trauma-Informed Training

One of the emerging fields in public health has become how behavior and personal experiences shape the health experience. Particularly, there is interest in understanding how the environment that one lives in changes one’s biology, causing disease, and how interventions can combat this change. A 1998 study conducted by the CDC and Kaiser Health first characterized negative household environments that suffered from dysfunction or abuse and showed how this could be a leading cause of death in adults (Vincent, et al., 1998). Researchers termed these Adverse Childhood Experiences (ACEs). Since that time, additional studies have found that those who suffered from one or more ACEs had increased chronic health issues, mental illness, and substance misuse (CDC, 2020). Studies have also shown that patients who suffer from trauma who visit a doctor with training in ACE and trauma-informed care are more likely to have fewer ER visits, hospitalizations, and repeat physician visits to manage chronic issues. (Felitti & Anda, 2014). Physicians must have knowledge and training surrounding ACEs and trauma to increase trust in the physician-patient relationship, increasing communication. (Stewart, 1995). Since the idea of ACEs is relatively new, research shows physicians are less likely to be exposed to this concept, and additional studies have found that physicians were less likely to have experienced an ACE themselves (Stork, Akselberg, Qin, & Miller, 2020). While education and training around this topic should occur at all medical education levels, medical students must be exposed to this early on in their careers. Additional research around physician communication has shown that medical students who participated in programs centered around these skills had greater communication and empathy later in training than their counterparts who did not participate (Joekes, Noble, Kubaki, Potts, & Llyod, 2011). Similar ACE programs are beginning to be implemented in various forms around the country. Early qualitative measures show that students appreciate knowledge around this topic and have some increase in knowledge around the topic. A professional development program could increase knowledge around this area, increasing trust in the physician-patient relationship and reducing ACE-related health complications