مقاله انگلیسی رایگان در مورد ادغام تجربیات نامطلوب دوران کودکی در سراسر برنامه درسی پرستاری – الزویر ۲۰۱۸

ACEs education in health professions

ACE awareness spawned from medicine has gained widespread interest in multiple settings like school systems, higher education, criminal justice and policy arenas (Felitti, 2017). Nevertheless, health professionals practicing at the frontline of care have been slow to detect clients at high risk for health problems associated with ACEs. Educating health professionals including nursing students about ACEs is pertinent to ascertain the harmful effects of ACEs on health. Current literature has documented time-limited and/or graded variations of ACEs education/ training. For example, a Child Advocacy Studies Training program was studied to examine the effect of educating first-year medical students about child abuse prevention and intervention by taking a two-semester elective course. The study found that first-year medical students felt prepared to identify and report signs of child maltreatment and recommend services for abused children (Knox, Pelletier, & Vieth, 2014). Another study found that graduate students from nine health professional programs at two campuses reported being more familiar with clinical and scientific findings of ACEs and trauma-informed care after they completed a three-week training (Strait & Bolman, 2017). Finally, another example of ACEs education in health professions is a continuing education article written for pediatric nurse practitioners regarding childhood trauma, toxic stress, resilience and use of screening checklists to identify abuse and neglect (Hornor, 2015). The above-mentioned training and educational offerings have made efforts to educate health professionals about ACEs; yet, no systematic integration of ACEs curriculum in an educational program has been documented. ACEs need to be an integral component of nursing curriculum to equip graduates with essential ACEs knowledge and skills in clinical prevention, population health, health promotion and disease prevention to create a culture of health for diverse groups and communities (American Association of Colleges of Nursing, 2011; Robert Wood Johnson Foundation, 2017). To prepare the nursing workforce with necessary knowledge for promoting health for children and families, LCON designed and initiated a systematical integration of ACEs across BSN curriculum. The project involved developing the ACEs curricular model, selecting key courses for integration, engaging faculty with the integration process and designing future studies. ACEs Curriculum Integration Model The ACEs Curriculum Integration (ACI) Model stems from the Culture of Health (COH) Action Framework developed by the Robert Wood Johnson Foundation (RWJF) in partnership with the RAND Corporation (Robert Wood Johnson Foundation, 2017). The COH Action Framework is an exemplar framework to illustrate building health equity (Plough, 2015a). Health equity is the highest attainment of health for all people and an overarching goal of the ACI Model (Healthy People, 2018). The four major constructs of the COH Action Framework are: a) making health a shared value; b) fostering interdisciplinary collaboration; c) creating healthier, more equitable communities; and d) strengthening integration of health systems and services (Robert Wood Johnson Foundation, 2017). The ACI Model was developed to guide ACEs curriculum integration in the BSN program. The model follows a scaffolding approach to teaching and learning through building concepts across the five semesters of the BSN curriculum. Major conceptual constructs of the ACI Model are: a) develop ACEs awareness and prevention, b) reduce toxic stress and improve socio-ecological conditions, c) build resiliency and enable care providers, d) implement trauma-informed care and e) inform policy (Fig. 1.0). Conceptual definitions and propositions in the ACI Model will be discussed followed by a description of courses selected for curriculum integration.