First year medical student attitudes about advocacy in medicine across multiple fields of discipline: analysis of reflective essays

BACKGROUND: Advocacy is often described as a pillar of the medical profession. However, the impact of advocacy training on medical students' identity as advocates in the medical profession is not well-described.

AIM/SETTING/PARTICIPANTS: We sought to introduce an advocacy curriculum to a mandatory Health Care Disparities (HCD) course for 88 first year medical students.

PROGRAM DESCRIPTION: The 2013 HCD added advocacy curriculum that included: guest lecturers' perspectives on their advocacy experience; reflective essay assignments assessing self-identify as an advocate; advocacy-specific lectures and large group discussions; and participation in small group community projects.

EVALUATION: A mixed methods approached was used to evaluate 88 first year medical students' advocacy themed reflective essays, independently coded by three investigators, and Likert-response questions were compared to published benchmarked items. The IRB exempted this study. Analysis of student essays revealed that students were better able to identify as an advocate in medicine. The survey also revealed that 86% post-course vs. 73% precourse agreed/strongly agreed with the statement: "I consider myself an advocate" (p=0.006).

DISCUSSION: Exposing all medical students to advocacy within medicine may help shape and define their perceived professional role. Future work will explore adding advocacy and leadership skill training to the HCD course.