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The advocacy toolbox: medical student curriculum for integrating advocacy in surgery

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Global Surgical Education - Journal of the Association for Surgical Education Aims and scope Submit manuscript

Abstract

Purpose

Surgical providers have increasingly become aware of the importance of social determinants of health on access to surgery, disease presentation, and post-operative outcomes. However, few studies have examined the feasibility of teaching surgical students and trainees tools for social advocacy. Herein, we describe a curriculum, the “Advocacy Toolbox”, tailored towards first-year medical students, focused on four practical methods of physician advocacy.

Methods

A surgically tailored curriculum was designed focusing on legislative advocacy, social determinants research, mobilizing professional organizations, and health journalism. First-year medical students at our institution were invited to participate. Mentorship was provided at the faculty, resident, and medical student level. Students engaged in longitudinal projects they were passionate about to practice applying advocacy techniques. Mastery of learning objectives was assessed with pre- and post-curriculum surveys. Changes in understanding were assessed using Wilcoxon signed-rank test.

Results

Of 12 learning objectives assessed, students showed significant improvement in mastery of five learning objectives (p < 0.05), and students trended towards significance in mastery of five other learning objectives (p < 0.10). Written feedback for the course was positive.

Conclusions

The “Advocacy Toolbox” is the first curriculum tailored towards first-year medical students interested in surgery to teach them fundamental advocacy skills they can use throughout their careers. The implementation of this curriculum improved knowledge of numerous aspects of advocacy among medical students. We hope that continued use of the curriculum in this group will foster a growing number of future surgeons interested in implementing advocacy in their careers.

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Acknowledgements

Mason Merriel, Andrea Zhang, Neil Parikh, Sunday Clark.

Funding

This article is funded by NIH Clinical Center, GM86308, Miriam Y Neufeld.

Author information

Authors and Affiliations

  1. Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA

    Max Zhu, Miriam Y. Neufeld, Sarah G. Keller, Stephanie Vaughn, Ariana Nodoushani, Alexandra L. Boden, Tracey Dechert, Sabrina E. Sanchez & Lisa Allee

  2. Department of Surgery, Boston Medical Center, Dowling 2 South, 840 Harrison Avenue, Boston, MA, 02118, USA

    Miriam Y. Neufeld, Tracey Dechert, Sabrina E. Sanchez & Lisa Allee

Authors
  1. Max Zhu
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  2. Miriam Y. Neufeld
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  3. Sarah G. Keller
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  4. Stephanie Vaughn
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  5. Ariana Nodoushani
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  6. Alexandra L. Boden
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  7. Tracey Dechert
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  8. Sabrina E. Sanchez
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Corresponding author

Correspondence to Lisa Allee.

Ethics declarations

Conflict of interest

Miriam Y Neufeld was supported, in part, by a T32 training grant (GM86308). The authors have no relevant financial or non-financial interests to disclose. This is an observational study. The Boston University Chobanian and Avedisian School of Medicine institutional review board has confirmed that no ethical approval is required. Informed consent was obtained from all individual participants included in the study.

Appendix A: advocacy mastery survey

Appendix A: advocacy mastery survey

  1. (1)

    I know how medical societies, such as the American Medical Association (AMA), are able to create policies that affect healthcare.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  2. (2)

    I know how medical societies, such as the American Medical Association (AMA), are able to fund advocacy projects.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  3. (3)

    I am confident in explaining topics in science and health to a general audience.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  4. (4)

    I understand ways to leverage social media for information sharing.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  5. (5)

    I understand how legislature works on a local level.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  6. (6)

    I understand how legislature works on a national level.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  7. (7)

    I know how to work with political systems to advocate for my patients as a medical student.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  8. (8)

    I understand the social determinants of health.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  9. (9)

    I understand how social determinants of health affect surgical patients and patient outcomes.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  10. (10)

    I know how to utilize research to advocate for change in healthcare.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  11. (11)

    I feel confident that I can integrate advocacy into my career as a physician.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

  12. (12)

    It is possible to balance advocacy work with a career in surgery.

    Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree.

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Zhu, M., Neufeld, M.Y., Keller, S.G. et al. The advocacy toolbox: medical student curriculum for integrating advocacy in surgery. Global Surg Educ 3, 19 (2024). https://doi.org/10.1007/s44186-023-00197-3

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  • DOI: https://doi.org/10.1007/s44186-023-00197-3

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