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The state of health advocacy training in postgraduate medical education: a scoping review

机译：研究生医学教育的健康宣传状态：范围审查

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Context Health advocacy is an essential component of postgraduate medical education, and is part of many physician competency frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) roles. There is little consensus about how advocacy should be taught and assessed in the postgraduate context. There are no consolidated guides to assist in the design and implementation of postgraduate health advocacy curricula. Objectives This scoping review aims to identify and analyse existing literature pertaining to health advocacy education and assessment in postgraduate medicine. We specifically sought to summarise themes from the literature that may be useful to medical educators to inform further health advocacy curriculum interventions. Methods MEDLINE, Embase and ERIC were searched using MeSH (medical student headings) and non-MeSH search terms. Additional articles were found using forward snowballing. The grey literature search included Google and relevant stakeholder websites, regulatory bodies, physician associations, government agencies and academic institutions. We followed a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. Results Of the 123 documents reviewed in full, five major themes emerged: (i) conceptions of health advocacy have evolved towards advocating with rather than for patients, communities and populations; (ii) longitudinal curricula were less common but appeared the most promising, often linked to scholarly or policy objectives; (iii) hands-on, immersive opportunities build competence and confidence; (iv) community-identified needs and partnerships are increasingly considered in designing curriculum, and (v) resident-led and motivated programmes appear to engage residents and allow for achievement of stated outcomes. There remain significant challenges to assessment of health advocacy competencies, and assessment tools for macro-level health advocacy were notably absent. Conclusions There is considerable heterogeneity in the way health advocacy is taught, assessed and incorporated into postgraduate curricula across programmes and disciplines. We consolidated recommendations from the literature to inform further health advocacy curriculum design, implementation and assessment.
机译：背景健康宣传是研究生医学教育的重要组成部分，是许多医生能力框架的一部分，如加拿大医学教育指令（CANMEDS）角色。关于在研究生背景下应教导和评估宣传如何达成共识。没有合并指南，协助研究生健康宣传课程的设计和实施。目的这一裁视审查旨在识别和分析现有文学，与生命宣传教育和研究生医学评估有关。我们专门寻求将主题从文学中汇总，这些主题可能对医疗教育者提供信息，以告知进一步的健康宣传课程干预措施。方法使用网状（医学学生标题）和非网状搜索条款搜索Medline，Embase和Eric。使用前向雪球找到额外的物品。灰色文献搜索包括谷歌和相关利益相关方网站，监管机构，医师协会，政府机构和学术机构。我们遵循逐步审查方法，然后使用归纳方法进行主题分析。结果为123份文件的全额审查，五大主题出现：（i）健康宣传的概念已经发展到倡导而不是患者，社区和人口; （ii）纵向课程不太普遍，但出现了最有希望的，通常与学术或政策目标相关; （iii）实践，沉浸机会建立能力和信心; （iv）在设计课程中越来越多地考虑社区确定的需求和伙伴关系，（v）居民主导和有动机计划似乎聘请居民并允许成就陈述的结果。对卫生宣传能力的评估仍存在重大挑战，显着缺席了宏观级健康宣传的评估工具。结论在教导健康宣传的方式，跨越计划和学科的研究生课程有相当大的异质性。我们巩固了文献的建议，以告知进一步的健康宣传课程设计，实施和评估。

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