ANZCA & FPM CPD Program resources: Teaching

Abstract
The health advocate role is an essential and underappreciated component of the CanMEDs competency framework. It is tied to the concept of social accountability and its application to medical schools for preparing future physicians who will work to ensure an equitable healthcare system. Student involvement in health advocacy throughout medical school can inspire a long-term commitment to address health disparities. The Social Medicine Network (SMN) provides an online platform for medical trainees to seek opportunities to address health disparities, with the goal of bridging the gap between the social determinants of health and clinical medicine. This online platform provides a list of health advocacy related opportunities for addressing issues that impede health equity, whether through research, community engagement, or clinical care.First implemented at the University of British Columbia, the SMN has since expanded to other medical schools across Canada. At the University of Ottawa, the SMN is being used to augment didactic teachings of health advocacy and social accountability. This article reports on the development and application of the SMN as a resource for medical trainees seeking meaningful and actionable opportunities to enact their role as health advocates.

Abstract
Introduction: There is growing agreement that physician advocacy is important and is a part of medical professionalism. The specialty societies of internal medicine and pediatrics include advocacy as part of professional responsibilities, and it is currently becoming integrated in residency education and training. The purpose of this resource is to provide learners with an introduction to social determinants of health and patient advocacy. The elements of this multidimensional curriculum may be used together or separately based on the needs of the learners and the institutional resources available. Methods: In a modified flipped-classroom approach, students are given readings to complete prior to small group sessions of 8 to 15 students. Students are expected to contribute to the learning occurring in the small group session through dialogue, discussion, and group project work. Students are then given assignments to apply the curriculum in outpatient, inpatient, and home care settings. Results: Two medical school classes (approximately 180 students) have completed this curriculum at this time. We asked students to evaluate the effectiveness of this curriculum on their learning with a pre− and postcurricula self-assessment. Using a five-point Likert scale, students were asked to rate their skill level with each objective (1 = unfamiliar/never used it; 5 = use with ease). Students were given the same self-assessment before and after the coursework. Seventy-eight students responded to the precourse survey. Fifty students responded to the postcourse survey. Average reported skill level increased by at least 0.4 points for all skill levels. Notably, in the precourse survey, students rated their skill level lowest in identifying resources and collaborating for system change (2.3 and 2.0, respectively). These also were the skills that students rated themselves as most improved at (increase in 0.60 and 0.76 Likert points, respectively) on the postcourse survey. Discussion: The purpose of this resource is to provide learners with an introduction to social determinants of health and patient advocacy. This curriculum has been implemented and evaluated for medical students, but it is broadly applicable to interprofessional students and residents in health-related fields. It includes an interprofessional practice component.

FILES INCLUDED
Included in this publication:
Instructor's Guide.docx
Appendix 1 Social Determinants of Health.ppt
Appendix 2 Small Group Guide.docx
Appendix 3 Macrosystem Advocacy.pptx
Appendix 4 Student Assignments.docx
Appendix 5 Additional Curricular Resources.docx

Abstract
The health advocate role is an essential and underappreciated component of the CanMEDs competency framework. It is tied to the concept of social accountability and its application to medical schools for preparing future physicians who will work to ensure an equitable healthcare system. Student involvement in health advocacy throughout medical school can inspire a long-term commitment to address health disparities. The Social Medicine Network (SMN) provides an online platform for medical trainees to seek opportunities to address health disparities, with the goal of bridging the gap between the social determinants of health and clinical medicine. This online platform provides a list of health advocacy related opportunities for addressing issues that impede health equity, whether through research, community engagement, or clinical care.

First implemented at the University of British Columbia, the SMN has since expanded to other medical schools across Canada. At the University of Ottawa, the SMN is being used to augment didactic teachings of health advocacy and social accountability. This article reports on the development and application of the SMN as a resource for medical trainees seeking meaningful and actionable opportunities to enact their role as health advocates.