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Attridge MM, Kester KM, Kemal S, Varma Thomas S, Mangold K, Hoffmann JA. Development and Evaluation of an Advocacy Curriculum for Pediatric Emergency Medicine Fellows. Pediatrics 2025; 155:e2024067564. [PMID: 40228817 DOI: 10.1542/peds.2024-067564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 12/16/2024] [Indexed: 04/16/2025] Open
Abstract
Advocacy is a key skill for pediatric emergency medicine (PEM) physicians; however, advocacy education is not a PEM fellowship program requirement, and literature describing the design, implementation, or evaluation of PEM advocacy curricula have not been published. We aimed to develop, implement, and evaluate a curriculum to teach core advocacy concepts to PEM fellows that builds on advocacy training in residency. An advocacy curriculum for PEM fellows, informed by a needs assessment, was implemented at an urban academic children's hospital during the 2021 to 2022 academic year. Eight fellows participated in the curriculum, which consisted of didactic and work group sessions integrated into the fellows' educational conference. PEM fellows were surveyed before and after 1 year of curriculum participation to assess advocacy attitudes, knowledge, skills, and participation in advocacy activities. After the curriculum, most fellows agreed or strongly agreed they had the skills to conduct specific advocacy activities, and fellows reported participating in a range of advocacy activities including use of social media for advocacy, legislative advocacy, and speaking with community partners. Fellows completed mentored longitudinal advocacy projects focused on firearm injury prevention, increasing underrepresented minority student exposure to health careers, and understanding caregiver hesitancies regarding the COVID-19 vaccine. This curriculum may serve as a model for integration of advocacy education into PEM and other pediatric subspecialty fellowships.
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Affiliation(s)
- Megan M Attridge
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kristen M Kester
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Samaa Kemal
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Selina Varma Thomas
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen Mangold
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer A Hoffmann
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Willing L, Schreiber J. Using Advocacy to Address the Crisis of Children's Mental Health. Child Adolesc Psychiatr Clin N Am 2024; 33:319-330. [PMID: 38823806 DOI: 10.1016/j.chc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
Children and youth in the United States are experiencing a mental health crisis that predates the COVID-19 pandemic. Child and adolescent psychiatrists have the knowledge and skillset to advocate for improving the pediatric mental health care system at the local, state, and federal levels. Child psychiatrists can use their knowledge and expertise to advocate legislatively or through regulatory advocacy to improve access to mental health care for youth. Further, including advocacy education in psychiatry and child psychiatry graduate medical education would help empower child psychiatrists to make an impact through their advocacy efforts.
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Affiliation(s)
- Laura Willing
- Children's National Hospital and George Washington University School of Medicine, 6833 4th Street NW Washington, DC 20012, USA.
| | - Justin Schreiber
- University of Pittsburgh Medical Center, Western Psychiatric Hospital, UPMC Children's Hospital of Pittsburgh, Lawrenceville Medical Building, 4117 Penn Avenue, 3rd Floor- 3111, Pittsburgh, PA 15224, USA
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Krishnamoorthi VR, Johnson DY, Asay S, Beem A, Vuppaladhadiam L, Keegan GE, Zietowski ML, Chen S, Jain S, Arora VM. An Op-Ed Writing Curriculum for Medical Students to Engage in Advocacy Through Public Writing. J Gen Intern Med 2024; 39:1058-1062. [PMID: 38413538 PMCID: PMC11074088 DOI: 10.1007/s11606-024-08629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Op-ed writing can be a powerful and accessible advocacy tool for physicians, but training is lacking in undergraduate medical education. AIM To train and engage first-year medical students in op-ed writing. SETTING Midwestern research-intensive medical school. PARTICIPANTS All students in a required first-year health policy course in 2021 and 2022. PROGRAM DESCRIPTION For their health policy course's final assignment, students could opt to write an op-ed on a healthcare issue of their choice. All students received written instruction on op-ed writing. Additionally, they could access a seminar, coaching and editing by peers and faculty, and publication guidance. PROGRAM EVALUATION Of 179 students over 2 years, 105 chose to write op-eds. Fifty-one attended the seminar, 35 attended peer coaching sessions, 33 accessed structured peer editing, and 23 received faculty assistance. Thirty-eight students submitted a total of 42 op-eds for publication. Twenty-two pieces were published in major outlets and 17 in the university's health policy review. Of the 22 in major outlets, 21 received editing from either peers or faculty. DISCUSSION An op-ed writing curriculum can be integrated into an existing medical school health policy course, resulting in a high level of engagement and in published op-eds by medical students.
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Affiliation(s)
- V Ram Krishnamoorthi
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
- Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.
| | - Daniel Y Johnson
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Spencer Asay
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Alexandra Beem
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Grace E Keegan
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Samuel Chen
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Shikha Jain
- University of Illinois Cancer Center, University of Illinois College of Medicine, Chicago, IL, USA
| | - Vineet M Arora
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
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Kaushik R. A Pediatric Resident Advocacy in Complex Care Curriculum. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11358. [PMID: 37881365 PMCID: PMC10593913 DOI: 10.15766/mep_2374-8265.11358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/07/2023] [Indexed: 10/27/2023]
Abstract
Introduction Children and youth with special health care needs (CYSHCN) are a special, vulnerable population. Children with medical complexity (CMC) represent a smaller, medically fragile sliver (6%) of the US child population. Several professional pediatric entities direct (or require) pediatric educators to instruct residents in advocacy for all children, explicitly including CYSHCN/CMC populations. While many existing curricula address pediatric advocacy education, a gap remains in curricula specifically designed to aid learners in advocacy of CYSHCN/CMC. Methods Using Kolb's experiential learning cycle as a framework, we designed and delivered a comprehensive outpatient complex care curriculum, including several didactic video lectures (total: 60:04 minutes, median: 6:25 minutes) and experiential site visits devoted to advocacy topics for CMC, as one portion of a 4-week elective complex care rotation. Residents completed pre- and posttests of knowledge and pre- and postsurveys to self-assess attitudes, comfort, and behavior; viewed didactic video lectures; and engaged in experiential site visits. Reflective statements captured attitudes regarding advocacy for CMC. Results Between July 2016 and June 2020, 47 trainees completed the rotation; data were available for 30 trainees. Residents demonstrated a statistically significant improvement in knowledge (p < .001), as well as improved attitudes, diversity sensitivity, and comfort in advocating for CMC postrotation. Qualitative comments showed overwhelmingly positive learner reaction. Discussion This curriculum, which can be offered as a stand-alone resource or a supplement to a comprehensive complex care curriculum, incorporates didactic and experiential teaching methods and addresses a significant competency in advocacy education.
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Affiliation(s)
- Ruchi Kaushik
- Medical Director of Education and Research and Complex and Palliative Care Physician, Imagine Pediatrics
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Agrawal N, Lucier J, Ogawa R, Arons A. Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022. J Gen Intern Med 2023; 38:2792-2807. [PMID: 37340255 PMCID: PMC10507002 DOI: 10.1007/s11606-023-08244-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/15/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Advocacy is an integral component of a physician's professional responsibilities, yet efforts to teach advocacy skills in a systematic and comprehensive manner have been inconsistent and challenging. There is currently no consensus on the tools and content that should be included in advocacy curricula for graduate medical trainees. OBJECTIVE To conduct a systematic review of recently published GME advocacy curricula and delineate foundational concepts and topics in advocacy education that are pertinent to trainees across specialties and career paths. METHODS We conducted an updated systematic review based off Howell et al. (J Gen Intern Med 34(11):2592-2601, 2019) to identify articles published between September 2017 and March 2022 that described GME advocacy curricula developed in the USA and Canada. Searches of grey literature were used to find citations potentially missed by the search strategy. Articles were independently reviewed by two authors to identify those meeting our inclusion and exclusion criteria; a third author resolved discrepancies. Three reviewers used a web-based interface to extract curricular details from the final selection of articles. Two reviewers conducted a detailed analysis of recurring themes in curricular design and implementation. RESULTS Of 867 articles reviewed, 26 articles, describing 31 unique curricula, met inclusion and exclusion criteria. The majority (84%) represented Internal Medicine, Family Medicine, Pediatrics, and Psychiatry programs. The most common learning methods included experiential learning, didactics, and project-based work. Most covered community partnerships (58%) and legislative advocacy (58%) as advocacy tools and social determinants of health (58%) as an educational topic. Evaluation results were inconsistently reported. Analysis of recurring themes showed that advocacy curricula benefit from an overarching culture supportive of advocacy education and should ideally be learner-centric, educator-friendly, and action-oriented. DISCUSSION Combining core features of advocacy curricula identified in prior publications with our findings, we propose an integrative framework to guide design and implementation of advocacy curricula for GME trainees. Additional research is needed to build expert consensus and ultimately develop model curricula for disseminated use.
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Affiliation(s)
- Nupur Agrawal
- Division of Internal Medicine and Pediatrics, Department of Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA USA
| | - Jessica Lucier
- Palliative Care Program, Division of General Internal Medicine & Health Services Research, Department of Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA USA
| | - Rikke Ogawa
- UCI Libraries, University of California Irvine, Irvine, CA USA
| | - Abigail Arons
- Division of General Internal Medicine, Department of Internal Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, CA USA
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Rosencranz H, Ramkumar J, Herzog L, Lavey W. Policy Advocacy Workshop Tools for Training Medical Students to Act on Climate Change. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11337. [PMID: 37601458 PMCID: PMC10432578 DOI: 10.15766/mep_2374-8265.11337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/19/2023] [Indexed: 08/22/2023]
Abstract
Introduction Doctors are trusted voices for communities and can influence lawmakers on climate change. Effective climate policy advocacy requires awareness, knowledge, and skills not typically taught in medical schools. Such curriculum additions could help students describe reasons for physicians to engage in climate policy advocacy and compose advocacy presentations. Methods To empower engagement in climate policies and develop advocacy skills, we deployed three 90-minute workshops at three institutions for first-, second-, and fourth-year students. The workshops included background on various climate policies of concern to health care professionals, advocacy guidance, scripts and factsheets from physicians' meetings illustrating advocacy opportunities for students and physicians, and active learning exercises. The exercises utilized advocacy templates and actual proposed actions on climate change. Students worked in small groups on advocacy presentations' content and format. Each group shared its work, and facilitators provided feedback. Results Out of 102 participants, 29 completed a survey (28% response rate). Using a Likert scale and narratives, students reported significant improvements in readiness to advocate for legislation or policies to mitigate the health effects of climate change, awareness of advocacy opportunities, and capability to prepare advocacy documents. Discussion Workshops on climate policy advocacy can equip medical students with important perspectives on their responsibilities and opportunities, as well as skills to be effective. The physician's voice is critical to promoting policies related to the health impacts of climate change. Targeted workshops with actual examples and exercises on climate advocacy are feasible and important additions to the curriculum.
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Affiliation(s)
- Holly Rosencranz
- Clinical Associate Professor, Department of Medicine, University of Illinois College of Medicine at Urbana and Carle Illinois College of Medicine
| | - Japhia Ramkumar
- Clinical Associate Professor, Department of Medicine, University of Illinois College of Medicine at Urbana and Carle Illinois College of Medicine
| | | | - Warren Lavey
- Adjunct Professor, School of Earth, Society & Environment and College of Law, University of Illinois at Urbana-Champaign and Carle Illinois College of Medicine
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Hossain MS, Conteh E, Ismail S, Francois P, Tran D, MacIntosh T. Perceptions of Advocacy in High School Students: A Pilot Study. Cureus 2023; 15:e40581. [PMID: 37469825 PMCID: PMC10353703 DOI: 10.7759/cureus.40581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/17/2023] [Indexed: 07/21/2023] Open
Abstract
Assessing perceptions and attitudes of advocacy in adolescent populations is an important area of research. Previous studies have shown that advocacy programs in high schools are well-received and help promote health advocacy. This pilot study took place at the University of Central Florida College of Medicine Health Leaders Summer Academy hosted by medical students of the Student National Medical Association. A one-hour interactive workshop was administered to high school students interested in the healthcare field. Pre- and post-survey data were collected to assess participants' perceptions, methods, and barriers to engaging in advocacy. A total of 29 students were included in this study. Results indicated that students' definitions of advocacy changed after completing the workshop, as a higher percentage of students indicated that they practiced advocacy (pre-survey, 82.76% versus post-survey, 95.45%). There was a statistically significant difference in perceptions of the importance of advocacy in the student's future career (pre-survey, 3.82 versus post-survey, 4.15, p = .035). Social media was the most effective and common form of advocacy used (post-survey 72.73%). The most common barrier to practicing advocacy was a lack of education on a particular topic (31.82% post-survey). Overall, the workshop increased participants' interest in engaging in advocacy. Future directions include expanding the study to a larger population sample throughout the Orlando community and researching the use of social media as a tool for advocacy.
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Affiliation(s)
- Meer S Hossain
- Medical School, University of Central Florida College of Medicine, Orlando, USA
| | - Etta Conteh
- Medical School, University of Central Florida College of Medicine, Orlando, USA
| | - Samina Ismail
- Medical School, University of Central Florida College of Medicine, Orlando, USA
| | - Priscilla Francois
- Medical School, University of Central Florida College of Medicine, Orlando, USA
| | - Diane Tran
- Medical School, University of Central Florida College of Medicine, Orlando, USA
| | - Tracy MacIntosh
- Clinical Sciences, University of Central Florida College of Medicine, Orlando, USA
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van der List LC, Blumberg D, Li STT, Gambill L. Demystifying the Op-Ed. A Novel Group Writing Workshop to Improve Upon Existing Pediatric Advocacy Training. Acad Pediatr 2022; 22:346-348. [PMID: 34455100 DOI: 10.1016/j.acap.2021.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 11/01/2022]
Abstract
An op-ed writing workshop utilizing a group compilation exercise increases participant self-reported comfort in writing op-eds and has led to published op-eds. An experiential op-ed writing workshop could be incorporated into advocacy curricula in pediatric residency programs.
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Affiliation(s)
- Lena C van der List
- Department of Pediatrics (LC van der List, D Blumberg and S-TT Li), University of California Davis, Sacramento, Calif.
| | - Dean Blumberg
- Department of Pediatrics (LC van der List, D Blumberg and S-TT Li), University of California Davis, Sacramento, Calif
| | - Su-Ting T Li
- Department of Pediatrics (LC van der List, D Blumberg and S-TT Li), University of California Davis, Sacramento, Calif
| | - Lauren Gambill
- Department of Pediatrics (L Gambill), University of Texas at Austin Dell Medical School and Dell Children's Medical Center of Central Texas, Austin, Tex
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Emery EH, Shaffer JD, McCormick D, Zeidman J, Geffen SR, Stojicic P, Ganz M, Basu G. Preparing Doctors in Training for Health Activist Roles: A Cross-Institutional Community Organizing Workshop for Incoming Medical Residents. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2022; 18:11208. [PMID: 35106380 PMCID: PMC8763867 DOI: 10.15766/mep_2374-8265.11208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/22/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Physicians are increasingly being called on to address inequities created by social and structural determinants of health, yet few receive training in specific leadership skills that allow them to do so effectively. METHODS We developed a workshop to introduce incoming medical interns from all specialties at Boston-area residency programs to community organizing as a framework for effective physician advocacy. We utilized didactic sessions, video examples, and small-group practice led by trained coaches to familiarize participants with one community organizing leadership skill-public narrative-as a means of creating the relationships that underlie collective action. We offered this 3-hour, cross-institutional workshop just prior to intern orientation and evaluated it through a postworkshop survey. RESULTS In June 2019, 51 residents from 13 programs at seven academic medical centers attended this workshop. In the postworkshop survey, participants agreed with positive evaluative statements about the workshop's value and impact on their knowledge, with a mean score on all items of over 4 (5-point Likert scale, 1 = strongly disagree, 5 = strongly agree; response rate: 34 of 51). Free-text comments emphasized the workshop's effectiveness in evoking positive feelings of solidarity, community, and professional identity. DISCUSSION The workshop effectively introduced participants to community organizing and public narrative, allowed them to apply the principles of public narrative by developing their own stories of self, and demonstrated how these practices can be utilized in physician advocacy. The workshop also connected participants to their motivations for pursuing medicine and stimulated interest in more community organizing training.
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Affiliation(s)
- Eleanor H. Emery
- Program Officer, Center for Health Equity Education and Advocacy, Cambridge Health Alliance; Instructor of Medicine, Part-time, Harvard Medical School; Medical Officer-Physician, Department of Internal Medicine, Northern Navajo Medical Center
| | | | - Danny McCormick
- Co-Director, Center for Health Equity Education and Advocacy, Cambridge Health Alliance; Associate Professor of Medicine, Harvard Medical School
| | - Jessica Zeidman
- Primary Care Program Director, Department of Internal Medicine, Massachusetts General Hospital; Instructor of Medicine, Harvard Medical School
| | - Sophia R. Geffen
- Program Manager, Center for Health Equity Education and Advocacy, Cambridge Health Alliance
| | - Predrag Stojicic
- Instructor, Harvard T.H. Chan School of Public Health; Program Director for Community Organizing, Center for Health Equity Education and Advocacy, Cambridge Health Alliance; Executive Director, People Power Health
| | - Marshall Ganz
- Rita E. Hauser Senior Lecturer in Leadership, Organizing, and Civil Society, Harvard Kennedy School
| | - Gaurab Basu
- Co-Director, Center for Health Equity Education and Advocacy, Cambridge Health Alliance; Instructor of Medicine, Harvard Medical School
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