Off to a Jump Start: Using Immersive Activities to Integrate Continuity Clinic and Advocacy

BACKGROUND Training in advocacy is an important component of graduate medical education. Several models have been implemented by residency programs to address this objective. Little has been published regarding application of immersive advocacy activities integrated into continuity clinic. OBJECTIVE To create an Integrated Community Health and Child Advocacy Curriculum (ICHCA) by integrating advocacy activities that were immersive and contextualized in a continuity clinic setting and to familiarize interns with continuity clinic immediately at the beginning of their training. METHODS We utilized a socio-constructivist lens, Kern's Six-step curriculum development and a published curriculum mapping tool to create the curriculum. Twenty residents completed ICHCA in 2019. Evaluations from key stakeholders including participants, support staff and attendings were analyzed on four levels of Kirkpatrick's model. We compared results before intervention, immediately following intervention and ten months following intervention. RESULTS We demonstrated improvement in learner satisfaction, knowledge and behaviors with respect to advocacy in the clinical environment. Response rate was 70% (7/10) for attendings, 75% for support staff (15/20) and 72.5% for residents (29/40). Our intervention was feasible, no cost, and required no additional materials or training as it relied on learning in real time. CONCLUSIONS An integrated advocacy curriculum utilizing the mapping tool for curricular design and evaluation is feasible and has value demonstrated by improvements in reaction, knowledge, and behaviors. This model improves understanding of social responsibility and can be implemented similarly in other residency programs.