1.) Evaluate their own personal ACE score and resiliency score and reflect on
how adverse childhood events and resiliency factors have influenced their
lives.
2.) Help one of their continuity patients with a chronic medical condition
complete the ACE and resiliency quizzes during clinic, and analyze the
results to determine possible implications on the future health of the child.
3.) Discuss with the parents and child during continuity clinic the associations
between the scores and risks of future health impairments.
4.) Advise parents during continuity clinic on how they can foster resiliency in
their children.
5.) Reflect on how the results of the ACE study will impact their care for their
patients in the clinic, and 75% of residents will plan to ask their patients
with chronic medical conditions about their adverse childhood events and
resiliency.
Timeline
Topic
Introduction
Pre-Encounter
Patient
Encounter
Details
Review of objectives
Resident will watch
the video
Understanding Toxic
Stress and
Resilience
Resident will read
Dowd, DE. (2014)
Adverse Childhood
Experiences and the
Lifelong
Consequences of
Trauma. Retrieved
from the Trauma
Guide by the
American Academy
of Pediatrics.
Resident personal
evaluation and
reflection
Resident will
download the ACE
score app if they
have an Android,
iTunes or Kindle
Resident will have a
patient complete
Format
Faculty with
resident
meeting
Time
25 minutes
Resident will
complete the
ACE and
resiliency
quizzes in paper
form
Resident will
evaluate their
scores and
reflect on its
influence
Resident will
meet with
faculty to
discuss
reflection
30 minutes
Resident will
meet with a
45 minutes
Post-Encounter
Debrief
patient with a
chronic health
problem during
their continuity
clinic
Resident will
write a
reflection after
clinic
30 minutes
Resident will
meet with
faculty advisor
20 minutes
Strategy
Residents will download the ACE score app if they have an Android, Kindle, or
iTunes. It is available from iTunes at https://itunes.apple.com/us/itunes-u/adversechildhood-experiences/id518635725?mt=10# It is available for Androids and the
Kindle, as described at https://acestoohigh.com/2013/10/18/want-your-ace-scorenow-theres-an-app-for-that/ I anticipate that in the future, more and more devices
will have apps that provide the ACE quiz in the future.
Copyright/Ethical Concerns
In order to prevent concerns regarding copyrights, I will only use open-source
materials. I will make any graphics myself. If there is a plan for publishing results,
IRB approval will be obtained prior to implementation, and all information will be deidentified. The topics discussed during this module are personal, and all personal
information shared by residents will be kept in strict confidence between the
resident and the faculty member.
Artifacts
1. Here is a link to a screencast with an organizer on the ACE study.
2. Please see the link to the Jeopardy game.
3. Please see below for the rubric.
Rubric
Category:
Proficient
Satisfactory
Analysis of
personal ACE and
resiliency scores
Analysis of patient
ACE and resiliency
scores
Advises parents on
implications of ACE
and resiliency
scores, and
provides
anticipatory
guidance on how to
foster resiliency in
the child
Needs
Improvement
Resident completes
the ACE and
resiliency quizzes
but does not
reflect on the
scores.
Resident makes
family aware of the
resources available
to families and
describes what
individuals can do
to foster resiliency
in children, but
does not
personalize the
Resident is unable
to explain the
connection
between the ACE
and resiliency
scores and future
health. Resident is
unable to explain
to families how
they can foster
Reflects on how
the ACE study
informs his/her
patient care.
particular childs
risk for future
health
complication
related to the score
and provides
guidance to family
on how to foster
resilience in the
child. Resident
makes family
aware of
appropriate
resources.
Reflection is based
upon an accurate
understanding of
the ACE study and
implications for
future health;
reflection explains
how the individual
resident applies
this information
into his/her patient
care.
message to the
individual child
based upon the
results of their
quizzes.
resiliency in their
children.
Reflection is
present but the
concepts are not
richly explained or
the resident does
not explain how
(s)he personally
incorporates the
principles from the
ACE study into
patient care. The
reflection may
discuss how the
ACE study informs
care at the
systems-based
level.
Reflection is
cursory, and
resident does not
describe how the
ACE study
influences patient
care either
individually or at
the systems-level.