Efficacy of Pediatric Residency Advocacy Curriculum in Improving Skills and Intent

Program Goals: The importance of training in child advocacy has reached national recognition, and the Accreditation Council for Graduate Medical Education (ACGME) now mandates pediatric residency training have “experiences that include elements in community pediatrics and child advocacy." The literature supports a clear interest in advocacy among pediatric residents, from disease prevention to healthcare access. To address this need, we partnered with experts from the Washington Chapter of the American Academy of Pediatrics (WCAAP), local legislators, and advocacy groups to create a curriculum teaching tangible advocacy skills to all pediatric residents at the University of Washington. The objectives of this study are to determine if an interactive advocacy lecture series increases pediatric resident confidence in performing advocacy skills as well as pediatric resident intent to participate in advocacy activities. Evaluation: The study population included pediatric residents training at the University of Washington during the 2019-2020 academic year. The curriculum included eight sessions to teach residents tangible advocacy skills focusing on the following “how to” topics: write a letter of social need, advocate on social media, interview on television, advocate for immigrant families, testify, submit a public comment, write an opinion editorial, and meet with a legislator. Pre- and post-surveys were administered prior to curriculum implementation and after the final session. Post-surveys were also administered to attendees after each individual session. Questions assessed resident confidence and self-reported skills. The pre- and post-curriculum data were compared and analyzed for statistical significance using the Mann-Whitney U-test. Sixty-four residents completed the pre-curriculum survey and 34 residents completed the post-curriculum survey. The majority of residents reported receiving at least some advocacy training in all topic areas. Increase in resident confidence was noted to be statistically significant when advocating for immigrant families (p=0.04). Residents indicated higher confidence in writing an opinion editorial and a letter of social need, although this was not statistically significant (p=0.10 and 0.59 respectively). Overall, residents viewed learning individual advocacy skills as important, especially writing a letter of social need (59%) and advocating for immigrant families (85%); notably, residents reported receiving less training in writing a letter of social need than any other topic area. A majority of residents (53-88%) intended to participate in all advocacy activities except using social media, though there was no statistically significant difference in intent before and after the curriculum. The primary limitation pediatric residents identified to completing advocacy activities was time constraints. Discussion: Pediatric residents intend to participate in advocacy activities and find these activities important but are primarily hindered by time constraints. Limited response rate affected interpretation of whether sessions improved knowledge or confidence in advocacy skills. Future studies should investigate how in-depth advocacy training enhances actual advocacy participation during or after residency.