Teaching the CanMEDS role of Health Advocate: A modular format easily applied to any residency program

Transcription

1 Teaching the CanMEDS role of Health Advocate: A modular format easily applied to any residency program Drs. Ruth Padmore and Marcio Gomes The Ottawa Hospital and University of Ottawa Problem Statement: Teaching the role of Health Advocate is always challenging. We have developed a workshop lasting approximately 2 hours, with a modular format for teaching this role. This format is easily applied to any residency training program. Methods: The first 20 minutes of the workshop consists of a didactic presentation, reviewing the role of Health Advocate, including its definition, elements and key competencies. The next 20 minutes is spent viewing the Health Advocate video from the Royal College of Physicians and Surgeons of Canada. The workshop participants then divide into small groups. Each group is provided with one journal article from the medical literature pertaining to a Health Advocate topic. Each group is given a different article. Examples of articles used in previous presentations of this workshop are listed at the end of the abstract. The groups are given 45 minutes to read and discuss the assigned articles, and complete the provided worksheet, which give a checklist of methods to teach and evaluate the Health Advocate role identified in the assigned articles. In the last 30 minutes of the workshop, each group presents how they would teach and evaluate the Health Advocate role identified in their assigned article. Results: This Health Advocate workshop is an innovation with broad applicability. Previous participants in this workshop have included representation from a wide variety of clinical specialties, including but not limited to pathology, anesthesia, pediatrics and obstetrics/gynecology, and the types of learners have included residents, specialists with an interest in advocacy and directors of residency training programs. Besides providing basic knowledge about the Health Advocate role, this workshop raises awareness about different health advocacy issues in many specialties, providing a framework to launch a teaching program. Conclusion: This workshop format for teaching the role of Health Advocate provides a modular format easily applied to any residency program and a framework for launching a structured teaching program. This workshop may provide a springboard for subsequent resident projects in this challenging role.

2 Suggested articles for use in workshop Health advocate role (in general terms) Flynn L, Verma S. Fundamental components of a curriculum for residents in health advocacy. Medical Teacher 30:e178-e183, Health advocate role (political action) Gill PJ, Gill HS. Health advocacy training: why are physicians withholding lifesaving care? Medical Teacher 33: , Health advocate role (for basic sciences) Gregory JK, Camp CL, Chen LP et al. Restructuring a basic science course for core competencies: An example from anatomy teaching. Medical Teacher 31: , Health advocate role (for laboratory medicine specialties) Zardawi IM, Bennett G, Jain S et al. Internal quality assurance activities of a surgical pathology department in an Australian teaching hospital. J Clin Pathol 51: , Health advocate role (for medical/surgical specialties) Sherris J, Agurto I, Arrossi S et al. Advocating for cervical cancer prevention. Int J Gynecol Obstet 89: , Goldberg RJ. Financial management challenges for general hospital psychiatry Gen Hosp Psych 23:67-72, Møller AM, Villebro N. Interventions for preoperative smoking cessation. Cochrane Database of Systematic Reviews, Issue 3, Zborovski S, Rohekar G, Rohekar S. Strategies to improve recruitment into rheumatology: results of the workforce in rheumatology issues study (WRIST). J Rheumatol 37: , Holland R, Meyers D, Hildebrand C et al. Creating champions for health care quality and safety. Am J Med Quality 25; , 2010.

3 Step One Identify the main Health Advocate Issue(s): Health Advocate Worksheet Using Table 1, select the relevant elements of health advocate which are involved in this health advocate issue, and briefly describe how it is related to this element. TABLE 1: Elements of Health Advocate Elements of Health Advocate 1. Advocacy for individual patients, populations and communities 2. Health promotion and disease prevention 3. Determinants of health, including psychological, biological, social, cultural and economic 4. Fiduciary duty to care 5. The medical profession s role in society 6. Responsible use of authority and influence 7. Mobilizing resources as needed Check if relevant Describe how the health advocate issue is related to this element 8. Adapting practice, management and education to the needs of the individual patient 9. Patient safety 10. Principles of health policy and its implications 11. Interactions with other CanMEDS roles and competencies

4 Step Two Using Table 2, select three or four methods that can be used to teach this specific health advocate issue. For each method selected, describe one advantage and one disadvantage. TABLE 2: Teaching Methods Teaching Method One strength of this method One weakness of this method Rounds Lectures Core seminars Hands on lab work Hands on research project Chart review/audit Journal club Workshops Attending national conferences Reading on your own Day to day interactions with staff/patients Having a special rotation in an outside agency or organization Membership in a professional association Other:

5 Step Three Using Table 3 develop an assessment plan for the specific health advocate issue. For each item of your assessment plan describe one strength and one weakness. TABLE 3: Assessment Tools Preferred Assessment Tools for Health Advocate Essays One strength of this method One weakness of this method Short-answer questions (SAQs) Direct observation and in-training evaluation reports (ITERs) OSCEs Objective structured clinical evaluations and standardized patients Multi-source feedback and peer evaluation Portfolios Other:

6 Step Four Using Table 4, describe possible actions to actively respond to and advocate for the specific issue above and beyond teaching and assessment, and indicate the goal of this advocacy activity/change to be implemented. TABLE 4: Actions for advocacy/change implementation Action Goal of Advocacy/Change to be implemented