Formal Advocacy Curricula in Family Medicine Residencies:

Abstract

Background and Objectives: Health advocacy has been declared an essential physician skill in numerous professional physician charters. However, there is limited literature on whether, and how, family medicine residencies teach this skill. Our aim was to determine the prevalence of a formal mandatory advocacy curriculum among US family medicine residencies, barriers to implementation, and what characteristics might predict its presence. Methods: Questions about residency advocacy curricula, residency characteristics, and program director (PD) attitudes toward family medicine and advocacy were included in the 2017 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency PDs. We used univariate and bivariate statistics to describe residency characteristics, PD attitudes, the presence of a formal advocacy curriculum, and the relationship between these. Results: Of 478 PDs, 261 (54.6%) responded to the survey and 236/261 (90.4%) completed the full advocacy module. Just over one-third (37.7%, (89/236)) of residencies reported the presence of a mandatory formal advocacy curriculum, of which 86.7% (78/89) focused on community advocacy. The most common barrier was curricular flexibility. Having an advocacy curriculum was positively associated with faculty experience and optimistic PD attitudes toward advocacy. Conclusions: In a national survey of family medicine PDs, only one-third of responding PDs reported a mandatory advocacy curriculum, most focusing on community advocacy. The largest barrier to implementation was curricular flexibility. More research is needed to explore the best strategies to implement these types of curricula and the long-term impacts of formal training.

Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022

“…Advocacy is a core part of physician training that requires active instruction; it is no longer sufficient to assume trainees will acquire essential advocacy knowledge and skills through just passive exposure 21 . Authors of prior publications have sought to determine components of an ideal curriculum for advocacy education 14 , 34 , 43 – 45 , and our work builds upon this. Similar to Howell et al, we found that GME advocacy curricula most frequently focus on grassroots advocacy and community partnership, legislative advocacy, and persuasive communication in terms of topics covered, and most utilize lecture and experiential learning elements for teaching methods.…”

Barriers to Voting in 2020 Among Resident Physicians

“…3 These findings, given long resident work hours 4 and increasing physician burnout, illustrate the need for residency programs to address underlying barriers to voting. Training programs are beginning to encourage engagement in social advocacy for patients, 5 but they may be unknowingly discouraging a bedrock form of civic engagement. More than 1400 employers already offer paid time off to vote as part of the Time To Vote campaign, and training programs could offer this as well.…”

Even one voice: Teaching legislative advocacy as a core competency in family medicine

“…Despite this, there is no defined or consensus framework for advocacy training in graduate medical education. 5 Nevertheless, there is evidence to suggest that exposure to advocacy activities during training results in increased early-career engagement. 6 Advocacy modules created by STFM provide a good template for an advocacy curriculum, but incorporating new domains of learning and instruction into a full curriculum is a challenge.…”