Health Advocacy Training for Medical Residents

Addressing the CanMEDS role of Health Advocate through the involvement of patients and community organizations in postgraduate medical education

Project History
In Canada, medical education is organized around a set of seven roles that physicians are expected to perform (the CanMEDS framework). These seven roles are Medical Expert, Communicator, Collaborator, Health Advocate, Manager, Scholar and Professional. Trainee physicians are expected to demonstrate they are competent in each of these roles.

The physician roles, including Health Advocate, were originally identified through public consultations in the early 1990s to determine what the people of Ontario expected of their physicians and how programs that prepare future physicians should change in response (the Educating of Future Physicians for Ontario (EFPO) project).

Of all CanMEDS roles, Health Advocate has proved to be the most problematic to define, teach and assess.

Research
We conducted a needs assessment to determine if public consultations could contribute to better understanding of the Health Advocate role by asking representatives of community organizations how they describe health advocacy and the role that physicians do or could play, and how they might help teach medical trainees. The study included interviews and an educational forum with:

·         Leaders of 19 community-based organizations

·         15 postgraduate medical education (PGME) leaders

·         7 medical residents (physician trainees)

Findings
Community leaders described the skills they use and ways in which physicians can support and enhance their advocacy work.

·         Community organizations prefer goals of advocacy that are facilitational (empowerment of the disadvantaged) rather than representational (protection of the vulnerable), and view advocacy as a collaborative enterprise in which physicians are important players.

·         Community organizations have a wealth of expertise in health advocacy and employ many of CanMEDS roles their advocacy work. However, preceptors (physician teachers) and residents were unfamiliar with local community organizations (e.g. many come from out of town) and do not have an easy way to connect with them for the purposes of teaching and learning about health advocacy.

Health Advocacy Summary Report, 2013

POSTER: "Health Advocacy, New Perspectives from Public Consultations", 2013

Workshop
Based on research findings we developed and piloted a workshop for geriatric psychiatry residents (in years 5 & 6 of their training) about Health Advocacy, focused on advocacy for seniors, that involved members of community organizations. This pilot workshop could serve as a model for developing other educational programs about health advocacy.

Health Advocacy Draft Workshop Package

Project Partners: Sue Macdonald (Vancouver Community Mental Health & Addictions Services), Cheryl Hewitt (PeerNetBC), Maria Hubinette (UBC Department of Family Practice), Susan Moore (West End Senior’s Network), Matthew Laing (Vancouver Second Mile Society), Rebecca Morris (Alzheimer’s Society of BC), Linda Forsythe & Sheila Pither (Council of Senior Citizens’ Organizations of BC).

Funded by: UBC Faculty of Medicine Special Populations Funds (SPF) 2012-14

Next steps: Community involvement in the co-creation of educational materials for health advocacy