Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”

Introduction: Current approaches to health advocate (HA) training leave many physicians feeling ill-equipped to advocate effectively. Likewise, faculty perceive the HA role as challenging to teach, role model, evaluate and assess. Progress on improving HA training is further stalled by debate over...

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Main Authors: Jacqueline Dorothy Cochrane, Nancy Dudek, Kelsey Crawford, Lindsay Cowley, Kori A LaDonna
Format: Article
Language:English
Published: Canadian Medical Education Journal 2025-01-01
Series:Canadian Medical Education Journal
Online Access:https://journalhosting.ucalgary.ca/index.php/cmej/article/view/78570
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author Jacqueline Dorothy Cochrane
Nancy Dudek
Kelsey Crawford
Lindsay Cowley
Kori A LaDonna
author_facet Jacqueline Dorothy Cochrane
Nancy Dudek
Kelsey Crawford
Lindsay Cowley
Kori A LaDonna
author_sort Jacqueline Dorothy Cochrane
collection DOAJ
description Introduction: Current approaches to health advocate (HA) training leave many physicians feeling ill-equipped to advocate effectively. Likewise, faculty perceive the HA role as challenging to teach, role model, evaluate and assess. Progress on improving HA training is further stalled by debate over the role’s importance and whether it should be considered intrinsic to medical practice. Recent graduates are well-positioned to comment on how these challenges affect HA training and preparation for practice. Therefore, our purpose was to explore the perspectives of new-in-practice physicians who are keen to be effective advocates. Methods: Ten early-career physicians participated in semi-structured interviews exploring their perceived competence and motivation to engage in health advocacy. Constructivist grounded theory informed the iterative data collection and analysis process. Results: Participants wished they knew during training how much they would use advocacy in practice. While training imparted adequate patient-level advocacy skills, participants felt underprepared to enact system-level advocacy–which they conceptualized as a wide-range of activities including political advocacy. In turn, participants grappled with lack of preparation, waning motivation, feelings of futility, lack of value for advocacy and need for self-preservation. For these reasons, they questioned whether system-level advocacy should be expected of all physicians. Conclusions: Although training may adequately prepare physicians for patient-level advocacy, system-level advocacy training remains insufficient. While patient-level advocacy is integral to good care, whether system-level advocacy should be a universal expectation deserves closer consideration. Perhaps system-level health advocacy may be better conceptualized as a specialized role requiring additional training. Regardless, physician advocates’ efforts need to be valued for their contributions.
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spelling doaj-art-3564459138204e2eb80bf39c2c449bd12025-01-25T16:37:01ZengCanadian Medical Education JournalCanadian Medical Education Journal1923-12022025-01-0110.36834/cmej.78570Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”Jacqueline Dorothy Cochrane 0https://orcid.org/0009-0004-7785-0334Nancy Dudek1https://orcid.org/0000-0002-6178-406XKelsey Crawford2Lindsay Cowley 3Kori A LaDonna4University of OttawaUniversity of OttawaUniversity of OttawaOttawa Hospital Research InstituteUniversity of Ottawa Introduction: Current approaches to health advocate (HA) training leave many physicians feeling ill-equipped to advocate effectively. Likewise, faculty perceive the HA role as challenging to teach, role model, evaluate and assess. Progress on improving HA training is further stalled by debate over the role’s importance and whether it should be considered intrinsic to medical practice. Recent graduates are well-positioned to comment on how these challenges affect HA training and preparation for practice. Therefore, our purpose was to explore the perspectives of new-in-practice physicians who are keen to be effective advocates. Methods: Ten early-career physicians participated in semi-structured interviews exploring their perceived competence and motivation to engage in health advocacy. Constructivist grounded theory informed the iterative data collection and analysis process. Results: Participants wished they knew during training how much they would use advocacy in practice. While training imparted adequate patient-level advocacy skills, participants felt underprepared to enact system-level advocacy–which they conceptualized as a wide-range of activities including political advocacy. In turn, participants grappled with lack of preparation, waning motivation, feelings of futility, lack of value for advocacy and need for self-preservation. For these reasons, they questioned whether system-level advocacy should be expected of all physicians. Conclusions: Although training may adequately prepare physicians for patient-level advocacy, system-level advocacy training remains insufficient. While patient-level advocacy is integral to good care, whether system-level advocacy should be a universal expectation deserves closer consideration. Perhaps system-level health advocacy may be better conceptualized as a specialized role requiring additional training. Regardless, physician advocates’ efforts need to be valued for their contributions. https://journalhosting.ucalgary.ca/index.php/cmej/article/view/78570
spellingShingle Jacqueline Dorothy Cochrane
Nancy Dudek
Kelsey Crawford
Lindsay Cowley
Kori A LaDonna
Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”
Canadian Medical Education Journal
title Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”
title_full Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”
title_fullStr Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”
title_full_unstemmed Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”
title_short Exploring the perspectives of new-in-practice specialists about the Health Advocate role: “I didn’t even know where to start”
title_sort exploring the perspectives of new in practice specialists about the health advocate role i didn t even know where to start
url https://journalhosting.ucalgary.ca/index.php/cmej/article/view/78570
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