R obert S. Ledley, one of the founding fathers of the field of medical decision making and the man who applied computer science to medical judgment and diagnosis, died July 24, 2012, after a prolonged struggle with Alzheimer's. 1 Our community, as well as the medical field as a whole, has lost a pioneering genius. Bob Ledley's legacy will live on through his magnum opus ''Reasoning Foundations of Medical Diagnosis,'' coauthored with Lee B. Lusted, MD, FACMI. 2 Lee Lusted was one of the founders of the Society for Medical Decision Making and the founding editor of Medical Decision Making. In their seminal work, the authors showed how computers could help physicians with diagnoses and even taught medical workers how to use edge-notched cards to create diagnostic databases. Most important, this article addressed decision making under uncertainty and valuing outcomes. Citation analyses have demonstrated that this paper lies at the root of medical decision science. 3 In fact, many readers may recall their introduction to our discipline through this article. We now explore the rest of his talent for technological innovation.

BackgroundThere is a dearth of advocacy training in graduate medical education in the United States. To address this void, the Legislative Education and Advocacy Development (LEAD) course was developed as an interprofessional experience, partnering a cohort of pediatrics residents, fourth-year medical students, and public health students to be trained in evidence-informed health policy making.ObjectiveThe objective of our study was to evaluate the usefulness and acceptability of a service-based legislative advocacy course.MethodsWe conducted a pilot study using a single-arm pre-post study design with 10 participants in the LEAD course. The course’s didactic portion taught learners how to define policy problems, research the background of the situation, brainstorm solutions, determine evaluation criteria, develop communication strategies, and formulate policy recommendations for state legislators. Learners worked in teams to create and present policy briefs addressing issues submitted by participating Illinois State legislators. We compared knowledge and attitudes of learners from pre- and postcourse surveys. We obtained qualitative feedback from legislators and pediatric residency directors.ResultsSelf-reported understanding of the health care system increased (mean score from 4 to 3.3, P=.01), with answers scored from 1=highly agree to 5=completely disagree. Mean knowledge-based scores improved (6.8/15 to 12.0/15 correct). Pediatric residency program directors and state legislators provided positive feedback about the LEAD course.ConclusionsPromising results were demonstrated for the LEAD approach to incorporate advocacy training into graduate medical education.