Burnett Joel R, De Lima Bryanna, Wang Emily S, McGarry Kelly, Kim Daniel I, Kisielewski Michael, Manley Kelsi, Desai Sima S, Eckstrom Elizabeth, Henry Tracey L
Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA.
UT Health San Antonio Long School of Medicine, San Antonio, TX, USA.
J Gen Intern Med. 2025 Jan;40(1):89-95. doi: 10.1007/s11606-024-08753-3. Epub 2024 May 6.
Although internal medicine (IM) physicians accept public advocacy as a professional responsibility, there is little evidence that IM training programs teach advocacy skills. The prevalence and characteristics of public advocacy curricula in US IM residency programs are unknown.
To describe the prevalence and characteristics of curricula in US IM residencies addressing public advocacy for communities and populations; to describe barriers to the provision of such curricula.
Nationally representative, web-based, cross-sectional survey of IM residency program directors with membership in an academic professional association.
A total of 276 IM residency program directors (61%) responded between August and December 2022.
Percentage of US IM residency programs that teach advocacy curricula; characteristics of advocacy curricula; perceptions of barriers to teaching advocacy.
More than half of respondents reported that their programs offer no advocacy curricula (148/276, 53.6%). Ninety-five programs (95/276, 34.4%) reported required advocacy curricula; 33 programs (33/276, 12%) provided curricula as elective only. The content, structure, and teaching methods of advocacy curricula in IM programs were heterogeneous; experiential learning in required curricula was low (23/95, 24.2%) compared to that in elective curricula (51/65, 78.5%). The most highly reported barriers to implementing or improving upon advocacy curricula (multiple responses allowed) were lack of faculty expertise in advocacy (200/276, 72%), inadequate faculty time (190/276, 69%), and limited curricular flexibility (148/276, 54%).
Over half of US IM residency programs offer no formal training in public advocacy skills and many reported lack of faculty expertise in public advocacy as a barrier. These findings suggest many IM residents are not taught how to advocate for communities and populations. Further, less than one-quarter of required curricula in public advocacy involves experiential learning.
尽管内科医生将公众宣传视为一项职业责任，但几乎没有证据表明内科培训项目会教授宣传技能。美国内科住院医师培训项目中公众宣传课程的普及程度和特点尚不清楚。
描述美国内科住院医师培训项目中针对社区和人群进行公众宣传的课程的普及程度和特点；描述提供此类课程的障碍。
对加入学术专业协会的内科住院医师培训项目主任进行具有全国代表性的基于网络的横断面调查。
2022年8月至12月期间，共有276名内科住院医师培训项目主任（61%）做出了回应。
教授宣传课程的美国内科住院医师培训项目的百分比；宣传课程的特点；对教授宣传课程障碍的看法。
超过一半的受访者表示他们的项目没有提供宣传课程（148/276，53.6%）。95个项目（95/276，34.4%）报告有必修的宣传课程；33个项目（33/276，12%）仅提供选修课程。内科项目中宣传课程的内容、结构和教学方法各不相同；与选修课程（51/65，78.5%）相比，必修课程中的体验式学习比例较低（23/95，24.2%）。报告最多的实施或改进宣传课程的障碍（允许多选）是缺乏宣传方面的教师专业知识（200/276，72%）、教师时间不足（190/276，69%）和课程灵活性有限（148/276，54%）。
超过一半的美国内科住院医师培训项目没有提供公众宣传技能的正规培训，许多项目报告称缺乏公众宣传方面的教师专业知识是一个障碍。这些发现表明，许多内科住院医师没有学习如何为社区和人群进行宣传。此外，公众宣传必修课程中只有不到四分之一涉及体验式学习。
