Health Advocacy Competency: Integrating Social Outreach into Surgical Education

Objective Being a strong health advocate is recognized as being an important part of being a good surgeon. Residency training programs have struggled with teaching health advocacy beyond didactic sessions, and in a way that encourages trainees to incorporate changes into their practice. This curriculum development aimed to incorporate reflective practice to encourage patient compassion and advocacy. Design Community service was incorporated as a mandatory component of a postgraduate surgical training program. Residents participated in a community service activity, and reflected upon their learning with a presentation to their peers. Participants Mandatory advocacy curriculum for all 67 first and second year surgical residents. Sixty-four residents chose to participate in a community service activity. Forty-six residents completed year end evaluations on the curriculum. Results Seventy percent of outreach activities were medically related, and 30% nonmedical. Most residents felt that the amount of work required to complete this project was reasonable (90%), and learned from their experiences (76%). Residents who participated in medically related projects self-described greater learning from their activity (93%), and from watching their peer presentations (79%). These trainees were also more likely to alter their patient management based on their experiences (68%). Trainees who participated in nonmedically related outreach projects were less likely to self-reflect learning from their experiences. Despite mandatory teaching in health advocacy, trainees are often unaware of this teaching within their curriculum. Conclusions A mandatory outreach project in residency can encourage trainees to reflect on their volunteer activities as a physician and how it impacts their patient's health. Academic departments should try to encourage volunteerism within their trainees by providing opportunities for residents to participate in outreach activities related to their specialty.