Is academic medicine prepared to teach about the intersection of childhood experiences and health across the life course? An exploratory survey of faculty

Abstract

Purpose Childhood experiences affect health across the lifespan. Evidence-based prevention and treatment strategies targeting early-life stress are emerging. Nevertheless, faculty physicians' preparation to incorporate this science into practice has not been well studied. The purpose of this study was to explore medical faculty knowledge and beliefs, timing and route of knowledge acquisition, perceived relevance and application of topics, and any associated faculty characteristics. Method The research team developed and administered a 39-question survey to faculty from six departments at the University of Illinois College of Medicine and Rush Medical College in Chicago. The team employed quantitative and qualitative methods to analyze responses. Results Eighty-one (8.8%) eligible faculty completed the survey. Of respondents, 53 (65.4%) achieved a high score on knowledge questions, 34 (42.0%) on beliefs questions, and 42 (59.1%) described high concept exposure, but only six (7.4%) through a formal route. Although 78 (96.8%) respondents indicated that survey concepts are relevant, only 18 (22.2%) reported fully incorporating them in their work. Respondents reporting full incorporation of concepts were significantly more likely to attain high concept exposure scores than those not fully incorporating concepts (17 respondents, 94.4%, vs. 25 respondents, 39.7 %, P < .001), whether reporting formal or informal exposure. Both quantitative and qualitative analysis highlighted limited awareness among respondents of trauma prevalence among healthcare workers, lack of familiarity with interventions, and challenges in addressing childhood experiences given time and resource constraints. Conclusions Most respondents had some familiarity with the impact of childhood experiences on health and perceived the relevance of this science. Nonetheless, many identified the need for additional coaching. Because results suggest that exposure supports full application of concepts, intentional faculty development and establishment of medical education competencies is pivotal to prepare faculty to include these crucial topics in patient care and teaching.