National Clinician Scholars Program, Yale University School of Medicine, New Haven, CT, USA.
VA Connecticut Healthcare System, West Haven, CT, USA.
J Gen Intern Med. 2019 Nov;34(11):2592-2601. doi: 10.1007/s11606-019-05184-3.
Professionalism standards encourage physicians to participate in public advocacy on behalf of societal health and well-being. While the number of publications of advocacy curricula for GME-level trainees has increased, there has been no formal effort to catalog them.
To systematically review the existing literature on curricula for teaching advocacy to GME-level trainees and synthesize the results to provide a resource for programs interested in developing advocacy curricula.
A systematic literature review was conducted to identify articles published in English that describe advocacy curricula for graduate medical education trainees in the USA and Canada current to September 2017. Two reviewers independently screened titles, abstracts, and full texts to identify articles meeting our inclusion and exclusion criteria, with disagreements resolved by a third reviewer. We abstracted information and themes on curriculum development, implementation, and sustainability. Learning objectives, educational content, teaching methods, and evaluations for each curriculum were also extracted.
After reviewing 884 articles, we identified 38 articles meeting our inclusion and exclusion criteria. Curricula were offered across a variety of specialties, with 84% offered in primary care specialties. There was considerable heterogeneity in the educational content of included advocacy curriculum, ranging from community partnership to legislative advocacy. Common facilitators of curriculum implementation included the American Council for Graduate Medical Education requirements, institutional support, and preexisting faculty experience. Common barriers were competing curricular demands, time constraints, and turnover in volunteer faculty and community partners. Formal evaluation revealed that advocacy curricula were acceptable to trainees and improved knowledge, attitudes, and reported self-efficacy around advocacy.
Our systematic review of the medical education literature identified several advocacy curricula for graduate medical education trainees. These curricula provide templates for integrating advocacy education into GME-level training programs across specialties, but more work needs to be done to define standards and expectations around GME training for this professional activity.
专业标准鼓励医生代表社会健康和福祉参与公共宣传。尽管针对研究生医学教育（GME）水平受训者的宣传课程出版物数量有所增加，但尚未对此进行正式编目。
系统审查现有的针对 GME 水平受训者进行宣传教学的课程文献，并对结果进行综合，为有兴趣开发宣传课程的计划提供资源。
进行了系统的文献回顾，以确定在美国和加拿大发表的描述研究生医学教育受训者宣传课程的英文文章，截至 2017 年 9 月。两名审查员独立筛选标题、摘要和全文，以确定符合我们纳入和排除标准的文章，有分歧的文章由第三名审查员解决。我们提取了课程开发、实施和可持续性方面的信息和主题。还提取了每个课程的学习目标、教育内容、教学方法和评估。
在审查了 884 篇文章后，我们确定了 38 篇符合我们纳入和排除标准的文章。课程涵盖了各种专业，其中 84%的课程在初级保健专业中提供。纳入的宣传课程教育内容存在很大的异质性，从社区伙伴关系到立法宣传。课程实施的常见促进因素包括美国研究生医学教育委员会的要求、机构支持和预先存在的教师经验。常见的障碍包括竞争课程需求、时间限制以及志愿教师和社区合作伙伴的更替。正式评估表明，宣传课程受训者可接受，并且提高了他们在宣传方面的知识、态度和报告的自我效能感。
我们对医学教育文献的系统审查确定了一些针对研究生医学教育受训者的宣传课程。这些课程为将宣传教育纳入跨专业的 GME 培训计划提供了模板，但需要做更多的工作来定义围绕 GME 培训的标准和期望，以进行这项专业活动。
