Background: Adverse Childhood Experiences (ACE) are strongly associated with long-term, negative psychological, physical, and mental health outcomes (CDC, 2024). Despite this concern, ACE education is not consistently integrated into undergraduate nursing curricula in the United States. The purpose of this quality improvement (QI) project was to evaluate the existing undergraduate nursing curricula at a Midwestern University for gaps in ACE and to propose targeted interventions to strengthen students’ trauma-informed care readiness.
Methods: A systematic review of all 23 courses in the BSN curriculum was conducted. Content analysis examined course objectives, descriptions and topical outlines for explicit mentions of “Adverse Childhood Experiences”, “ACEs” and “childhood trauma”.
Results: Only one course, offered in the fourth year of the program, explicitly addressed ACEs. A supporting literature review identified five themes: 1) persistent gaps in ACE education within BSN curricula, 2) benefits of structured, longitudinal integration, 3) lack of standardized teaching strategies, 4) improved trauma-informed readiness after ACE education, and 5) enhanced student self-awareness through ACE content.
Conclusion: The project revealed significant gaps in early and explicit ACE education in undergraduate nursing curricula. To address these gaps, three revised course objectives and a multi-semester educational intervention are proposed for integration across the program. Incorporating comprehensive ACE education has the potential to enhance nursing students’ trauma-informed care competencies, improve recognition of trauma-related health impacts, and ultimately promote more compassionate and effective patient care.
