P3.Q334: Advocacy 101: A multi-modal approach to healthcare policy education in medical education

Background: Physicians are called to be effective health advocates, yet many report lack of training or skills specifically in advocacy. There is a recognized lack of consistent education in introductory skill-based advocacy in undergraduate medical education (UME), thus creating an opportunity for action.

Methods: As part of interdisciplinary approach to improve student learning, a steering committee of experts in health care policy was convened to create learning materials in civics, health policy and advocacy, addressing two key student learning outcomes (SLOs): (1) Evaluate key factors in how health policy is made and changed in the U.S. healthcare system and (2) Analyze how health policy influences how healthcare is accessed, delivered and financed in the U.S.

Civics was addressed through a self-paced module on the American legislative system. Health policy was adapted through a virtual inter-professional activity (VIPS) with medical students, masters level students in the school of public health and nursing students, where they assumed roles as various decision makers and were challenged to draft an outline for a policy intervention involving Medicare. Advocacy skills were translated through a flipped classroom approach with an asynchronous module encompassing topics like a how-to-guides on identifying legislators, utilizing social media campaigns, writing op-eds and policy briefs, and conducting effective legislative communications via phone calls, emails and in-person visits. After the module was completed, an in-person lecture, “Introduction to Advocacy,” was conducted with a case-based discussion on opportunities for advocacy.

Pre- and post-evaluations were conducted with descriptive analyses and ANOVA performed.

Results: : Average post evaluation score on the Civics module was a 90%. In the VIPS, students demonstrated an improvement in their SLO-1 assessment from 1.79 to 2.84/4 (p < 0.001) in SLO-2 an improvement from 2.02 to 2.9/4 (p < 0.001)). (see table) For the advocacy module, students reported an increase in their self-assessed knowledge about advocacy from somewhat knowledgeable (pre: n=232, M=2.08/5, SD 0.61) to knowledgeable (post: n=229, M=3.3/5, SD 0.52) (p < 0.001) on a 4-point scale. Students also reported a significant increase in their understanding of what it means to advocate for the health profession with an increase from a mean of 2.25 to 3.37 on a 4-point Likert scale (p < 0.001). Post-activity, 82% of students could correctly identify their legislator, as compared to prior to the activity when 82% of students could not identify their legislator. Overall, students found the module informative and that the self-paced nature was appropriate (see figure), responding favorably to the module evaluation. Students also demonstrated achievement on the SLO-linked assessments, earning a 75% or higher overall and by SLO.

Conclusion: The use of novel platforms to introduce advocacy topics in UME are effective in translating key topics to learners. Students demonstrated knowledge-gains and responded positively to the educational experience.