Introduction: Physician advocacy can be defined as an action by a physician to promote social, economic, educational, and political changes that address social drivers of health and decrease the suffering and threats to human well-being that they identify1. While considered a necessary skill for physicians, a formal skills-based curriculum is often lacking for undergraduate medical students. The Pediatric Clerkship Advocacy project at Dell Medical School (DMS) was designed as an opt-in curriculum to train medical students to become effective advocates through ongoing initiatives.

Approach: To address the need for formal advocacy education, students in the pediatric clerkship could opt-in to the advocacy project. Students participated in an initial, hour-long advocacy lecture, engaged in a current advocacy project with the Associate Chair for Advocacy, and attended weekly advocacy project debrief meetings over six weeks. Through a pre- and post-project survey, we evaluated student interest in the advocacy work, the impact of the curriculum on their confidence, manageability during the pediatric clerkship, and the most helpful aspects of the curriculum.

Results: 38 out of 48 clerkship students participated in the advocacy curriculum. Of those, 27 completed a pre-survey, 17 completed a post-survey, and 16 completed both pre- and post-surveys. At the start of the rotation, students reported low confidence in explaining practical involvement (mean= 2.48 on 1 to 5 likert scale), defining different levels of advocacy (mean= 2.18), explaining the policy process (mean= 2.04), and differentiating advocacy strategy and tactics (mean= 2.15). Statistically significant improvements in confidence were attained for practical involvement (mean=3.24, p=0.007), defining advocacy levels (mean=2.94, p=0.005), and differentiating strategy and tactics (mean=2.88, p=0.023), with no statically significant difference in confidence in explaining the policy process (mean= 2.88, p=0.10). Students on average found all components of the curriculum helpful. Furthermore, 87% of students felt the time commitment was mild intensity or less.

Conclusions: A project-based advocacy curriculum during the pediatric clerkship allowed students to gain tangible skills that increased student confidence to further engage in advocacy work. By creating an advocacy-centered experiential learning project, undergraduate medical students felt better prepared on how to advocate for themselves, patients, and systems.

References and Resources

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4. Cruess RL, Cruess SR. Teaching Medicine as a Profession in the Service of Healing. Acad Med. 1997;22(11).
5. David J. Rothman. Medical Professionalism- Focusing on the Real Issues. N Engl J Med. 2000;342(17).