The advocacy toolbox: medical student curriculum for integrating advocacy in surgery

Purpose Surgical providers have increasingly become aware of the importance of social determinants of health on access to surgery, disease presentation, and post-operative outcomes. However, few studies have examined the feasibility of teaching surgical students and trainees tools for social advocacy. Herein, we describe a curriculum, the "Advocacy Toolbox", tailored towards first-year medical students, focused on four practical methods of physician advocacy. Methods A surgically tailored curriculum was designed focusing on legislative advocacy, social determinants research, mobilizing professional organizations, and health journalism. First-year medical students at our institution were invited to participate. Mentorship was provided at the faculty, resident, and medical student level. Students engaged in longitudinal projects they were passionate about to practice applying advocacy techniques. Mastery of learning objectives was assessed with pre- and post-curriculum surveys. Changes in understanding were assessed using Wilcoxon signed-rank test. Results Of 12 learning objectives assessed, students showed significant improvement in mastery of five learning objectives (p < 0.05), and students trended towards significance in mastery of five other learning objectives (p < 0.10). Written feedback for the course was positive. Conclusions The "Advocacy Toolbox" is the first curriculum tailored towards first-year medical students interested in surgery to teach them fundamental advocacy skills they can use throughout their careers. The implementation of this curriculum improved knowledge of numerous aspects of advocacy among medical students. We hope that continued use of the curriculum in this group will foster a growing number of future surgeons interested in implementing advocacy in their careers.