Exploring adverse childhood experiences in healthcare professional students: insights from a mixed-methods pilot study

Adverse childhood experiences (ACEs) are associated with long-term mental and physical health outcomes and may influence vulnerability to stress and burnout. Despite growing attention to clinician well-being, limited empirical research has examined ACE prevalence among healthcare professional (HCP) students or how early adversity may shape training experiences. This mixed-methods pilot study assessed ACE prevalence and demographic associations among HCP students and explored students’ perceptions of how ACEs influence well-being and professional development. One hundred and fifty students from medicine, nursing, occupational therapy, physician assistant, and physical therapy programs at a private research university in the United States participated in the survey. Participants completed an online survey including sociodemographic items and the ACE questionnaire. Descriptive statistics and multiple linear regression were used to examine prevalence and associations of ACE scores. Semi-structured interviews were conducted with eight students and analyzed using reflexive thematic analysis. Overall, 83.3% of participants reported at least one ACE and 32% reported four or more. Mean ACE score was 2.80 (SD = 2.28). Nursing students reported significantly higher ACE scores than medical students (B = 1.19, p = .006). In analyses of race, participants identifying as Black or African American, Asian, or another race were combined because of small subgroup sizes and reported higher ACE scores than White participants (B = 0.92, p = .016). Age and gender were not significant predictors. The most frequently reported ACEs were verbal abuse (53.3%), living with a household member with mental illness (45.3%), and physical abuse (35.3%). Qualitative findings indicated that students perceived personal childhood adversity as shaping responses to stress and professional identity, while describing both potential strengths and vulnerabilities and limited integration of trauma-informed content within their training. ACEs were highly prevalent among HCP students, with significant differences observed by program type and race. Findings highlight the potential value of trauma-informed educational approaches and student supports that recognize the role of lived experience in healthcare professional training.