An Advocacy and Leadership Curriculum to Train Socially Responsible Medical Learners

Abstract

Physician advocacy and leadership is increasingly recognized as an important part of our social responsibility. Frameworks, such as CanMEDS, have set out definitions of health advocacy and leadership for medical education. Despite calls for mandatory advocacy and leadership teaching and potential wellness benefits, presently medical curricula do not usually teach practical advocacy and leadership skills to learners. There is also a demonstrated disconnect between staff and resident perceptions of advocacy. Our group set out to create an innovative Advocacy and Leadership Curriculum (ALC) to fill this gap. A collaboration of over twenty medical students and professors from across Canada and the U.S worked over the past year to survey students, conduct curriculum mapping, Page | 2 examine current literature and practices in order to inform the creation of an ALC. A competency-and milestonebased ALC was created based on this data and reviewed by experts in medical education and/or physician advocacy. This ALC addresses three spheres of advocacy: the Patient level, the Institutional level, and the Population level (which includes the Community). A guiding principle of the ALC is to form positive working partnerships with communities and patients and to collaborate with other health professionals to advocate with, and on behalf of, patients. CanMEDS-based Learning Objectives, divided into theoretical, skills-based, and application-based categories, form the core of the program. The curriculum prepares learners for real-world advocacy through longitudinal projects, interdisciplinary work, and community-based service learning. Novel engagement of other professionals and physician advocates to act as advocacy preceptors is central to the curriculum. Innovative assessment techniques-such as advocacy simulations, longitudinal study of physician advocacy activity, and focus on attitudes and behaviour as well as knowledge and practical advocacy skills-are introduced. The ALC serves as an adaptable model for the training of socially responsible medical learners who are conversant in advocacy techniques and able to advocate with patients, within institutions, and with populations. Projects resulting from the ALC will improve medical school social accountability.

Lessons learned from a student-driven initiative to design and implement an Organ and Tissue Donation course across Canadian medical schools

“…There is widespread endorsement by physician organizations for integrating advocacy into competency frameworks [ 13 , 14 ], and faculties have made efforts to adjust their curricula accordingly [ 14 , 15 ]. However, it would appear that this strategy needs fine-tuning—for instance, a survey of residents trained within a CanMEDS-defined curricula found the majority do not engage in advocacy [ 14 , 16 ].…”

Finding a path to growth as a leader: a medical learner perspective

“…Leadership is a skill that must be taught and practised 5. In our case, the experience of working with senior colleagues who valued our contributions empowered us to pursue further leadership development opportunities.…”

“…For example, some undergraduate medical programmes, such as the University of Toronto, offer a master’s degree or certificate in leadership to a select group of interested students 5. To enhance leadership and advocacy training for all students, the University of Manitoba has incorporated a workshop that teaches medical students to write letters to their members of parliament about healthcare-related issues 5.…”

“…To enhance leadership and advocacy training for all students, the University of Manitoba has incorporated a workshop that teaches medical students to write letters to their members of parliament about healthcare-related issues 5. Across Canada and the USA, medical students are supported by their faculties to attend ‘lobby days’, events where groups of medical students meet with local and national politicians to discuss issues such as universal drug coverage; many faculties also support programmes where students or physicians offer mentorship on the leader role 5.…”

“…To enhance leadership and advocacy training for all students, the University of Manitoba has incorporated a workshop that teaches medical students to write letters to their members of parliament about healthcare-related issues 5. Across Canada and the USA, medical students are supported by their faculties to attend ‘lobby days’, events where groups of medical students meet with local and national politicians to discuss issues such as universal drug coverage; many faculties also support programmes where students or physicians offer mentorship on the leader role 5. Blumenthal and colleagues8 describe implementing a pilot leadership curriculum for internal medicine residents consisting of case studies and discussions about leadership at the clinical level and note that participants found that the course provided content and skills training relevant to their daily roles.…”