Hakim Julie, Black Amanda, Gruslin Andrée, Fleming Nathalie
Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON.
Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Division of Pediatric and Adolescent Gynecology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON.
J Obstet Gynaecol Can. 2013 Jun;35(6):539-546. doi: 10.1016/S1701-2163(15)30913-0.
Health advocacy (HA) is a core competency in Canadian obstetrics and gynaecology postgraduate programs. Our objectives were to assess awareness and understanding of the health advocate role among trainees, their current HA training and exposure, and the desire and needs for future HA training.
An anonymous, cross-sectional, Internet-based, self-reported health advocacy questionnaire was distributed to Canadian obstetrics and gynaecology trainees. Descriptive analysis was conducted for all study variables. Chi-square tests, Cochran-Armitage trend test, and Fisher exact test were performed where appropriate.
Most trainees (93.9% of respondents) were aware of the CanMEDS HA role and that it is a training objective (92.9%). Only 52.4% had clear objectives while 58.4% understood the role requirements. Most trainees (95.1% of respondents) felt HA was important to address during training. Only 30.4% had HA training, and just 36.3% felt their training needs were addressed. Training included teaching sessions (11.9%), clinical teaching (4.7%), and role modelling (4.7%). Although 82.9% of respondents had HA opportunities with patients, there were fewer opportunities at community (45.1%) and societal (30.0%) levels. Awareness of community groups and activities was low (28.6%), and few (20.0%) had participated in community advocacy programs during their residency. Incorporating advocacy activities into training was valued (80.0%). Many residents supported mandatory HA training (60.0%), more training time on HA experiences (66.3%), and HA experiences during protected time (71.3%).
Awareness of and interest in the HA role is high, but clear objectives and training are lacking or inadequate. A standardized curriculum would ensure health advocacy exposure and emphasize active participation in community and societal activities. Trainees support this training during protected time.
健康倡导（HA）是加拿大妇产科研究生课程的一项核心能力。我们的目的是评估实习生对健康倡导者角色的认识和理解、他们当前的HA培训和接触情况，以及对未来HA培训的愿望和需求。
向加拿大妇产科实习生发放一份基于互联网的匿名横断面自我报告健康倡导问卷。对所有研究变量进行描述性分析。在适当情况下进行卡方检验、 Cochr an - Armitage趋势检验和Fisher精确检验。
大多数实习生（93.9%的受访者）知晓CanMEDS HA角色且知道这是一项培训目标（92.9%）。只有52.4%有明确目标，58.4%理解角色要求。大多数实习生（95.1%的受访者）认为HA在培训期间很重要需要加以应对。只有30.4%接受过HA培训，只有36.3%觉得他们的培训需求得到了满足。培训包括教学课程（11.9%）、临床教学（4.7%）和榜样示范（4.7%）。虽然82.9%的受访者有与患者进行HA的机会，但在社区（45.1%）和社会层面（30.0%）的机会较少。对社区团体和活动的知晓度较低（28.6%），很少有人（20.0%）在住院医师期间参加过社区倡导项目。将倡导活动纳入培训受到重视（80.0%）。许多住院医师支持强制性HA培训（60.0%）、增加HA经历的培训时间（66.3%）以及在受保护时间内进行HA经历（71.3%）。
对HA角色的认识和兴趣较高，但缺乏明确目标或培训不足。标准化课程将确保健康倡导的接触，并强调积极参与社区和社会活动。实习生支持在受保护时间内进行这种培训。
