Exploring Resilience Factors in Medical Students with Adverse Childhood Experiences: a Pilot Study

Objective The primary purpose of this study was to investigate the factors that medical students consider to have promoted their resilience and are thought to be protective against risks associated with a high number of adverse childhood experience (ACEs). Methods The authors invited medical students in all 4 years of education at a single medical school to complete an online survey (n = 1440). The survey included the 10-item ACE Study Questionnaire and simultaneously added the number of "yes" responses. Participants who reported experiencing four or more ACEs were asked to provide their email address if they consented to a follow-up interview to discuss protective factors and resilience. The authors analyzed survey data using descriptive statistics and used the framework method of thematic analysis to analyze the qualitative data. Results A total of 131 (9%) students completed the ACEs questionnaire. The mean ACE score was 1.69, with 25 students reporting 4 or more ACEs (19%). Five students participated in a follow-up interview (25%) which averaged 1 h in length. Thematic analysis revealed four protective and resilience factors: non-parental support, role models, volunteering, and use of mental health services. Conclusions Medical students reported comparable prevalence of ACEs as the general population and all interviewees with 4 or more ACEs endorsed the use of mental health services in medical school to promote resilience. Medical students with ACEs should be encouraged to use mental health services and have access to mentors and role models to promote resilience and combat risks of ACEs.