Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Parnassia Psychiatric Institute, The Hague, The Netherlands.
BMC Med Educ. 2024 Sep 28;24(1):1064. doi: 10.1186/s12909-024-06039-0.
Health advocacy is considered to be a core competence for physicians, but it remains unclear how the health advocacy role, despite being described in overarching competency frameworks, is operationalized in undergraduate medical education (UME). This study aimed to identify how health advocacy is conceptualized and taught in undergraduate medical curricula.
We performed a qualitative analysis of curriculum documents from all eight medical schools in the Netherlands, all of which offered competency-based UME. Thematic analysis was used to code all the documents and generate themes on health advocacy conceptualization and teaching. To categorize the emerging themes, we used the framework of Van Melle et al. for evaluating the implementation of competency-based medical educational programs.
Health advocacy was mostly conceptualized in mission statements about social responsibility of future physicians, related to prevention and promoting health. We found key concepts of health advocacy to be taught mainly in public health and social medicine courses in the bachelor stage and in community-based clerkships in the master stage. Specific knowledge, skills and attitudes related to health advocacy were taught mostly in distinct longitudinal learning pathways in three curricula.
Health advocacy is conceptualized mostly as related to social responsibility for future physicians. Its teaching is mostly embedded in public health and social medicine courses and community-based settings. A wider implementation is warranted, extending its teaching to the full width of medical teaching, with longitudinal learning pathways providing a promising route for more integrative health advocacy teaching.
健康倡导被认为是医生的核心能力之一，但目前尚不清楚健康倡导角色，尽管在总体能力框架中有所描述，如何在本科医学教育（UME）中实施。本研究旨在确定健康倡导在本科医学课程中是如何被概念化和教授的。
我们对荷兰所有八所医学院的课程文件进行了定性分析，这些医学院都提供基于能力的 UME。使用主题分析对所有文件进行编码，并生成关于健康倡导概念化和教学的主题。为了对新出现的主题进行分类，我们使用了 Van Melle 等人的框架来评估基于能力的医学教育项目的实施情况。
健康倡导主要在未来医生社会责任的使命陈述中被概念化，与预防和促进健康有关。我们发现健康倡导的主要教学内容是在本科阶段的公共卫生和社会医学课程以及硕士阶段的基于社区的实习中教授的。与健康倡导相关的具体知识、技能和态度主要在三门课程中的三个纵向学习途径中教授。
健康倡导主要被概念化为未来医生的社会责任。它的教学主要嵌入在公共卫生和社会医学课程以及基于社区的环境中。需要更广泛的实施，将其教学扩展到医学教学的全部范围，通过纵向学习途径为更综合的健康倡导教学提供有希望的途径。
