Teaching physician advocacy: A collaborative learning approach

Abstract

Physician advocacy is defined as the use of professional expertise to address socioeconomic factors that affect health.¹ In the USA, physician advocacy is recognised as a professional responsibility, and the Accreditation Council for Graduate Medical Education has even adopted competencies for post-graduate education. However, there is no consensus on how to incorporate advocacy training into undergraduate medical education.

The Advocacy and Public Health Pathway utilises a collaborative learning approach to teaching advocacy. Developed through the co-direction of the student-led Health Advocacy Organization (HAO) and faculty leadership at the medical and law schools, the Pathway offers opportunities for students to engage with advocacy organisations and develop advocacy skills (e.g. opinion piece writing, policy development and engaging in the legislative process). This is achieved through four structured electives that include workshops, professional panels, interdisciplinary courses at the law school and a community service project. HAO student leaders collaborate with medical and legal faculty to select the organisations and topics for the Pathway electives. Additionally, Pathway students receive mentorship from physician faculty and develop an advocacy portfolio to document the quality, quantity and scholarly approach for their advocacy activities. Up to 10 first-year medical students are selected for the Pathway following an interview and application process. Since its introduction in 2021, 33 students have enrolled in the Pathway.

Given the complex political environment and diverse population subject to dynamic socioeconomic factors, it is unsurprising that no consensus exists on incorporating advocacy training into undergraduate medical education in the USA. However, preliminary survey results suggest that the Pathway may enhance advocacy skills and inspire advocacy participation among medical students, demonstrating its potential value. A key lesson learned is the importance of integrating structured opportunities and guidance on taking tangible advocacy action steps (e.g. submitting opinion pieces and writing policy proposals) within the curriculum. This approach may empower students to translate advocacy concepts into meaningful action, fostering their development as physician advocates.

Another key lesson learned is that the Pathway's collaborative learning approach appears to be an effective and sustainable model for training medical students in advocacy skills. In our experience, the longitudinal, co-created nature of the Pathway offers the benefit of centering student interests while providing a structured framework to discuss the nuances of organisational and institutional advocacy. The Pathway also helps students navigate lobbying laws and supports their engagement in political activism, all while adhering to educational policies and upholding professional responsibilities.

As the first cohort graduates this year, further investigation into the efficacy of the described advocacy curriculum to prepare students to utilise advocacy skills during residency is warranted.

Ellen Hutchinson: Conceptualization; methodology; investigation; formal analysis; writing—original draft; writing—review and editing. Caitlin Bowers: Investigation; formal analysis; writing—review and editing. Vanessa Maier: Conceptualization; methodology; writing—review and editing. Kelli Qua: Supervision; methodology; writing—review and editing.

The authors have no conflicts of interest to disclose.