ACEs Educational Interventions for Medical Students and Residents: A Systematic Review

Background and Objectives: Adverse childhood experiences (ACEs) affect nearly two-thirds of the US population and have long-lasting consequences on health and well-being. Integrating ACEs education into medical curricula is vital to equip future physicians to address these effects. This systematic review evaluates the effectiveness of ACEs educational interventions in US medical education on student and resident knowledge, attitudes, or practice. Methods: We conducted a comprehensive literature search in January 2025 using MEDLINE (PubMed), ERIC, and PsycInfo databases for studies published between 2013 and 2025, reported using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were empirical studies evaluating ACEs training in US medical schools and residency programs in the English language. Study selection, data extraction, and quality assessment were performed independently by two authors, with discrepancies resolved by coauthor consensus. Results: A total of 608 unique studies were identified from our search and screened, with 15 studies meeting the inclusion criteria. Most interventions relied on lecture-based formats, though 46.7% included interactive components such as small-group discussions and standardized patient interactions. While most studies reported significant increases in ACEs knowledge postintervention, only 20% evaluated objective knowledge changes, with the majority relying on self-assessment. Confidence in addressing ACEs improved in 46.7% of studies, but only 6.7% objectively measured behavioral changes. Conclusions: ACEs education in medical training is expanding, but current interventions vary and often lack methodological rigor. Most studies show short-term knowledge gains, though few assess lasting behavior change. Future research should prioritize objective and longitudinal outcomes to better prepare physicians to address ACEs in clinical practice.