Training Internal Medicine Residents in Social Medicine and Research-Based Health Advocacy: A Novel, In-Depth Curriculum

Basu, Gopal; Pels, Richard J.; Stark, Rachel; Jain, Priyank; Bor, David H.; McCormick, Danny

doi:10.1097/acm.0000000000001580

Cited by 32 publications

(41 citation statements)

References 6 publications

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“…Nonetheless, these articles provided a helpful overview of current practices in health advocacy education. Of the 26 articles, 15 detailed longitudinal programmes, [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] whereas 11 outlined discrete programmes. [57][58][59][60][61][62][63][64][65][66][67] The majority (15/26) were from paediatric medicine training programmes.…”

Section: Descriptive Articlesmentioning

confidence: 99%

The state of health advocacy training in postgraduate medical education: a scoping review

et al. 2019

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Context Health advocacy is an essential component of postgraduate medical education, and is part of many physician competency frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) roles. There is little consensus about how advocacy should be taught and assessed in the postgraduate context. There are no consolidated guides to assist in the design and implementation of postgraduate health advocacy curricula. Objectives This scoping review aims to identify and analyse existing literature pertaining to health advocacy education and assessment in postgraduate medicine. We specifically sought to summarise themes from the literature that may be useful to medical educators to inform further health advocacy curriculum interventions. Methods MEDLINE, Embase and ERIC were searched using MeSH (medical student headings) and non‐MeSH search terms. Additional articles were found using forward snowballing. The grey literature search included Google and relevant stakeholder websites, regulatory bodies, physician associations, government agencies and academic institutions. We followed a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. Results Of the 123 documents reviewed in full, five major themes emerged: (i) conceptions of health advocacy have evolved towards advocating with rather than for patients, communities and populations; (ii) longitudinal curricula were less common but appeared the most promising, often linked to scholarly or policy objectives; (iii) hands‐on, immersive opportunities build competence and confidence; (iv) community‐identified needs and partnerships are increasingly considered in designing curriculum, and (v) resident‐led and motivated programmes appear to engage residents and allow for achievement of stated outcomes. There remain significant challenges to assessment of health advocacy competencies, and assessment tools for macro‐level health advocacy were notably absent. Conclusions There is considerable heterogeneity in the way health advocacy is taught, assessed and incorporated into postgraduate curricula across programmes and disciplines. We consolidated recommendations from the literature to inform further health advocacy curriculum design, implementation and assessment.

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Section: Descriptive Articlesmentioning

confidence: 99%

The state of health advocacy training in postgraduate medical education: a scoping review

et al. 2019

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“…At Cambridge Health Alliance (CHA), a Harvard affiliated internal medicine training programme, we developed a novel, required social medicine and advocacy curriculum. The course has been previously described 1 . Residents receive over 100 hours of small group discussions, field trips, workshops, and experiential learning through a research‐based advocacy project.…”

Section: What Was Tried?mentioning

confidence: 99%

Lessons from a social medicine and advocacy curriculum

Basu¹,

Dryden²,

Pels³

et al. 2020

Medical Education

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Systemic injustices cause vast inequities in health and health care outcomes. Medical education has the potential to support trainees to develop as agents of social change but United States residency programmes rarely deliver social medicine and advocacy curricula.The impact of such curricula on learners is not well understood. | WHAT WA S TRIED?At Cambridge Health Alliance (CHA), a Harvard affiliated internal medicine training programme, we developed a novel, required social medicine and advocacy curriculum. The course has been previously described. 1 Residents receive over 100 hours of small group discussions, field trips, workshops, and experiential learning through a research-based advocacy project. We interviewed 15 current residents and alumni who took our course to evaluate perceptions of its quality and impact. We used a Framework approach to analyse the qualitative data. | WHAT LE SSON S WERE LE ARNED?Participants consistently stated that the advocacy curriculum helped them to reconnect with the values that prompted them to pursue medicine. One participant said: 'I feel like the impact of the curriculum of the advocacy course is in taking the spark that people come in with, and teaching them how to light a fire … it is trying to figure out how to not just keep (empathy and connection to values) alive, but actually help it blossom.' Many course participants found the advocacy curriculum to be protective against burnout. For example, one person stated:'I think one of the ways to address (depression/burnout during residency training) is to have meaning and purpose. And the advocacy course really brought a lot of that in connection with the initial values that brought you into medicine, and building you as a physician with the skills to act on those values. So, I think it provided a lot of meaning and probably protection against depression and burnout.'Participants consistently noted that the course increased self-efficacy, a sense they had the power to make positive change. A participant reflected: 'There were many times, given the resources that we had, given our patient population (is) largely uninsured, it was very easy to have the feeling of hopelessness … You know that even though you give patients these medicines, these medicines couldn't begin to fix their situation. I came to learn … health depends so much on your social environment, your relationships, and all these other fundamental structures that are beyond what is traditionally seen in the purview of healthcare … Because of the course, I felt much more empowered in how we could affect change … I think it really changed how I saw myself as a physician into the future.'In conclusion, rather than being inspired and capable of addressing the profound systemic factors that prevent the attainment of health equity, much of the nation's health care workforce is dispirited, disengaged and disconnected from this important task and from one another.Reflections from course participants on our social medicine and advocacy course challenge us to further inve...

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“…The benefits of inter-disciplinary collaboration and advocacy can be widely incorporated into both legal and health care professional curricula; however, few medical training programmes include formal advocacy training. 9 One novel curriculum for internal medicine residents incorporates social change, leadership, and advocacy, including community organising, public speaking, power mapping, and media and legislative advocacy. 9 Such curricula should be replicated in other health professional schools.…”

Section: Collaboration Among Health and Legal Professionalsmentioning

confidence: 99%

“…9 One novel curriculum for internal medicine residents incorporates social change, leadership, and advocacy, including community organising, public speaking, power mapping, and media and legislative advocacy. 9 Such curricula should be replicated in other health professional schools.…”

Section: Collaboration Among Health and Legal Professionalsmentioning

confidence: 99%

Impact of a US asylum decision on sexual and reproductive health and rights: a call to action for health and legal professionals

Molina

Ardalan²,

Scott

2019

Sexual and Reproductive Health Matters

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Training Internal Medicine Residents in Social Medicine and Research-Based Health Advocacy: A Novel, In-Depth Curriculum

Cited by 32 publications

References 6 publications

The state of health advocacy training in postgraduate medical education: a scoping review

The state of health advocacy training in postgraduate medical education: a scoping review

Lessons from a social medicine and advocacy curriculum

Impact of a US asylum decision on sexual and reproductive health and rights: a call to action for health and legal professionals

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