Adverse Childhood Experiences: Survey of Resident Practice, Knowledge, and Attitude.
OBJECTIVE
Adverse childhood experiences (ACEs) affect 20%-50% of adults and are associated with considerable adult chronic disease, unhealthy behavior, and early mortality. Physicians seldom identify this history although identification can improve health. Low screening rates are attributed to poor physician knowledge of ACEs and barriers to screening, including a lack of confidence to screen and insufficient training. Female physicians and physicians with personal ACE histories report more confidence to screen and fewer time barriers. Our aims were to identify resident screening practices, ACE knowledge, attitudes, and personal ACE histories and to determine preferred ways to learn more, if required.


METHODS
Family medicine residents were surveyed, using a previously published survey. Items included ACE screening practices, ACE knowledge, attitudes, and personal ACE histories.


RESULTS
The response rate was 97% (112/115), and 58% were female. Two percent of residents screened females and males at the first visit, thereafter residents screened women (6.3%) more than men (0.9%). One third of residents identified the correct prevalence of ACE in women and one tenth male prevalence. Unhealthy behaviors or physical chronic disease were not associated with ACE histories. Sixty-five percent of residents were not confident to screen. Twenty-nine percent of residents reported a trauma history. Eighty percent believed it was their role to screen. Formal medical training to screen was received by 45.5%; only five residents recalled training during residency.


CONCLUSIONS
Resident ACE screening rates were extremely low. Physician educational initiatives are recommended to increase confidence to screen and actual screening prior to graduation.
Department of Family Medicine, University of Calgary.
Wendy
W
Tink
Jessica C
JC
Tink
Tanvir C
TC
Turin
Martina
M
Kelly
D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D004503:Education, Medical, Graduate; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008403:Mass Screening; D001523:Mental Disorders; D010820:Physicians; D011795:Surveys and Questionnaires