Assessing resident experience of a new experiential learning health advocacy curriculum: a mixed methods study

Health Advocacy is considered one of the most difficult skills to teach. Many medical learners feel ill-equipped in social competencies and identify it as a significant gap in their medical training. Experiential learning has recently been emerging as a more effective method to teach health advocacy. The Post Graduate Medical Education (PGME) Health Advocacy Day is a new experiential learning curriculum designed to teach important competencies of health advocacy and social accountability to post-graduate medical residents at the University of Ottawa in Ottawa, Canada. The objective of this mixed-methods study was to assess resident experiences.

Second-year trainees from all adult residency programs attended the Advocacy Day as part of a mandatory academic day. All participants completed a mandatory pre-and post-session quiz to assess knowledge of key topics before and after the course. We also distributed a voluntary survey to all participants and invited residents to participate in semi-structured interviews to provide feedback on the course. We used descriptive statistics to analyze quiz scores and survey results and conducted a paired t-test of pre and post-test quiz scores. We also performed a thematic analysis of qualitative feedback, specifically survey comments and semi-structured interviews.

One hundred and eighty-three residents participated in the Advocacy Day and 112 (61.2%) completed the post-course survey. Ten residents volunteered to be interviewed. Respondents were generally satisfied by the session and felt it was of good quality. Most residents felt the course enhanced their ability to advocate for individual patients or communities (N = 80; 71.5%) and understand patients and families' lived experience with illness (N = 87; 77.5%). Most residents also felt the course improved their knowledge of the impact of social determinants of health (N = 91; 81.2%) and increased their awareness of local resources that can support patients and their families (N = 88; 78.3%). Visiting community sites in-person and meeting persons with lived experiences were highlighted as the most valuable components of the course.

Experiential learning can be integrated within post-graduate medical curricula to teach health advocacy competencies. Future studies should examine the longitudinal impact of the curricula, to determine whether shifts in perspectives persist over time.