Exploring Adverse Childhood Experiences in Healthcare Professional Students: Insights from a Mixed-Methods Pilot Study

Background 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 predictors among HCP students and explored students’ perceptions of how ACEs influence well-being and professional development. Methods 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 predictors of ACE scores. Semi-structured interviews were conducted with eight students and analyzed using reflexive thematic analysis. Results 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), and non-White students reported higher scores than White students (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 ACEs as influencing stress vulnerability, professional identity formation, and burnout risk, while also noting limited formal integration of trauma-informed content within training programs. Conclusions ACEs were highly prevalent among HCP students, with significant differences observed by program type and race/ethnicity. Findings highlight the importance of integrating trauma-informed educational approaches and targeted student supports to promote resilience and well-being among future healthcare professionals.