Continuing Professional Development and Division of Medical Education, Clinical Research Centre, C-104, Dalhousie University, 5849 University Ave, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Adv Health Sci Educ Theory Pract. 2023 May;28(2):411-426. doi: 10.1007/s10459-022-10162-2. Epub 2022 Oct 10.
Heath advocacy (HA) remains a difficult competency to train and assess, in part because practicing physicians and learners carry uncertainty about what HA means and we are missing patients' perspectives about the role HA plays in their care. Visual methods are useful tools for exploring nebulous topics in health professions education; using these participatory approaches with physicians and patients might counteract the identified training challenges around HA and more importantly, remedy the exclusion of patient perspectives. In this paper we share the verbal and visual reflections of patients and physicians regarding their conceptualizations of, and engagement in 'everyday' advocacy. In doing so, we reveal some of HA's hidden dimensions and what their images uncovered about the role of advocacy in patient care. Constructivist grounded theory guided data collection and analysis. Data was collected through semi-structured interviews and photo-elicitation, a visual research method that uses participant generated photographs to elicit participants knowledge and experiences around a particular topic. We invited patients living with chronic health conditions (n = 10) and physicians from diverse medical and surgical specialties (n = 14) to self-select photographs representing their experiences navigating HA in their personal and professional lives. Both groups found taking photographs useful for revealing the nuanced and circumstantial factors that either enabled or challenged their engagement in HA. While patients' photos highlighted their embodiment of HA, physicians' photos depicted HA as something quite elusive or as a complicated and daunting task. Photo-elicitation was a powerful tool in eliciting a diversity of perspectives that exist around the HA role and the work advocates perform; training programs might consider using visuals to augment teaching for this challenging competency.
健康倡导（HA）仍然是一项难以培训和评估的能力，部分原因是执业医生和学习者对 HA 的含义存在不确定性，并且我们错过了患者对 HA 在其护理中所扮演角色的看法。视觉方法是探索健康专业教育中模糊主题的有用工具；与医生和患者一起使用这些参与式方法可能会克服围绕 HA 的既定培训挑战，更重要的是，纠正排除患者观点的问题。在本文中，我们分享了患者和医生对他们对“日常”倡导的概念化和参与的口头和视觉反思。通过这样做，我们揭示了 HA 的一些隐藏维度，以及他们的图像揭示了倡导在患者护理中的作用。建构主义扎根理论指导了数据收集和分析。通过半结构化访谈和照片引出进行数据收集，这是一种视觉研究方法，使用参与者生成的照片来引出参与者对特定主题的知识和经验。我们邀请了患有慢性疾病的患者（n=10）和来自不同医学和外科专业的医生（n=14），让他们自行选择照片，代表他们在个人和专业生活中应对 HA 的经验。两组人都发现拍摄照片有助于揭示使他们参与 HA 的细微和环境因素。虽然患者的照片突出了他们对 HA 的体现，但医生的照片则将 HA 描绘为相当难以捉摸的东西，或者是一项复杂而艰巨的任务。照片引出是一种引出围绕 HA 角色和倡导者所执行工作的各种观点的有力工具；培训计划可能会考虑使用视觉效果来增强对这一具有挑战性的能力的教学。
