Laying the foundation: Teaching policy and advocacy to medical trainees

Abstract

Despite residents' positive evaluations, questions remain as to how best to assess the success of health policy curricula. Moving beyond the popular pre-post test, less traditional approaches might complement standard program evaluation methods in future. As educators increasingly develop curricula aimed at non-biomedical expertise, we must consider how we can most meaningfully evaluate long-term impact on graduates' approach to clinical practice and their engagement in health system advocacy.

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

“…103 However, the current assessment frameworks that prioritise reliability, defensibility and standardisation may be incompatible with the intended goals of meso-and macro-level advocacy, and the collective representation and action necessary to effect social change and improve the health of communities and populations. 130 We agree with Martin et al 41 that common assessment parameters do not capture the end goal of producing engaged and committed health advocates. Rather, long-term health advocacy engagement using postgraduate career tracking can be a meaningful measure of success in health advocacy training.…”

“…25,26 A total of 15 studies used a prospective study design without a control group (see Appendix S2). Of which, 12 of these studies assessed 'discrete' curricula [27][28][29][30][31][32][33][34][35][36][37][38] (defined by <4 weeks in total); the remaining three studies were 'longitudinal' [39][40][41] (defined by ≥4 weeks in total). Although a number of different medical specialties were represented, nearly half (7/15) were from paediatric medicine training programmes.…”

Health Policy Training: A Review of the Literature

“…The majority of articles identified from the literature search were targeted toward medical audiences—medical students, residents, or medical school faculty [ 4 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] (39%, n = 13) or nursing audiences—nursing students or nursing school faculty [ 5 , 6 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] (36%, n = 12). Fewer articles were directed to public health professionals and students [ 7 , 39 , 40 ] (9%, n = 3), health administration and management faculty and students [ 41 , 42 ] (6%, n = 2), psychology faculty and students [ 1 ] (3%, n = 1), public policy and public administration faculty and students [ 43 ] (3%, n = 1), and a combination of business, public policy, and health administration faculty and students [ 44 ] (3%, n = 1).…”

“…Sixteen articles (48%) proposed and piloted a health policy training program for a defined set of learners, primarily a specific group of heath professional trainees, either in a particular venue, such as a hospital or community-based setting, or as a health policy component added or integrated into a training program. These programs varied in intensity and time commitment, ranging from a single “Health Care Reform Day” for medical students [ 4 ] to a three week intensive [ 20 ] or two year-long integrated curriculum [ 23 ] for medical residents. Similarly, nursing programs ranged from policy-oriented service learning programs over 2–3 semesters [ 31 , 32 , 36 ] to multidisciplinary programs in health policy for nursing masters and doctoral level students [ 34 ].…”

A Web-Based Survey of Residents’ Views on Advocating with Patients for a Healthy Built Environment in Canada

“…These results suggest that current medical education in Canada on this determinant of health is lacking. Other studies also note the knowledge gap [ 28 ] and that opportunities for medical trainees to acquire knowledge and skills for health advocacy are lacking [ 28 , 29 ]. Medical school curriculum has been largely based on biomedical science to the detriment of knowledge acquisition required to achieve and integrate nonmedical expert roles such as communicator and health advocate.…”