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2 Final Year Medical Student, Cambridge Medical School, UK

1 Final Year Medical Student, Kings College London, UK

Introduction: Advocacy and leadership skills enable frontline healthcare professionals to improve the systems they work in [1]. Globally these areas are neglected in medical school curricula, causing many students and doctors to feel unable to affect change [2]. The International Federation of Medical Student Associations (IFMSA) represents 1.3 million students worldwide and facilitates peer education, policy-development and advocacy. IFMSA’s conferences provide unprecedented opportunities for mutual learning in areas otherwise neglected by medical curricula. We aimed to improve medical students’ understanding, motivation and ability to undertake health-improvement activities through a 3 day training workshop.

Methods

Model of Transferring Benefits

A systematic review of both published literature and grey literature was conducted. Content relating to costs or benefits to Methods: The workshop was by aextracted group of students from the UK, America and the UK at an individual, institutional or developed system level was Quebec, and delivered prior to the IFMSA international conference in 2013 on the theme and analysed by thematic synthesis.

‘Advocacy the Physician-in-Training’. Content included introductions to key topics including The benefits and of volunteering described were mapped to the key advocacy, leadership, global health, vision-building, strategic planning and team-building and skillsoutcome indicators for five different UK professional development based training in advocacy techniques such as engaging with the media and policy-writing. structures. range framework of methodological styles were used the including peer and expert-led lectures, small group AAfurther was developed to demonstrate link interactive workshops, debates, thematic visits. Learning was then applied to outcomebetween volunteer experience within and partnerships andsite improved focussed campaigns such as changing medical school curricula and ethical student electives. UK service delivery outcomes. Pre and post-workshop questionnaires assessed impact on student knowledge, skills and attitudes.

Overview of Results

Overview of Costs

The literature review (including citation mapping) returned 9 Domain Initial Codes published papers and 32 pieces of grey literature that met all Results: 65 students from 31 different countries participated in the Financial workshop.Financial Data showed a clear increase in participants’ cost inclusion criteria. Most literature does not meet high standards of perceived knowledge desire do so. from 94%other of areas students increased Loss of Staff to Loss of staff of work,reported Imposing upon others when formal academic rigor. about advocacy; skills to carry out advocacy; and

cover,feedback Challenges ofsupported organising cover, Trained understanding of advocacy. 80% reported increased motivation to affect change. finding Student the rolestaff ofleaving peer their post following links, in equipping andandinspiring -educators 95% of sources cited benefits 32% citedthem costs. to embed learning into current and future frontline practice. More rigorous Reputational Negative perception of the UK Institution where links are run badly, evaluation covering a wider range of outcome measures is proposed for future training programmes. - 40 initial individual benefits codes were elicited.

30 20

0

1

2

3

4

5

Health and Security

Accidents/Injury, Management of security risks, Exhaustion/Burnout/Stress, Culture shock

30

Opportunity

20

- 15 initial cost codes arose, which were grouped into 5 domains: financial; reputational; health & security; loss of staff; and Understanding (out of 5) opportunity costs. 10

Desire to Advocate

Advocacy Skills

Number of Respondents

Number of Respondents

Number of Respondent s

of Advocacy - 10 Before Institutional andUnderstanding national benefits were extracted. These seem to arise both directly from the existence of links (e.g. After Improved reputation) and from workforce engagement in links.

Negative perception of the UK where links are run badly,

Staff distracted 20from areas of UK work, Neglect of relationships/Burden of Family or friends, Loss of annual leave, 10 Negative effects on career, Opportunity costs

10

0

1

Benefits to Individuals and Workforce

2

3

4

Skills (out of 5)

30

5

0

1

2

3

Desire (out of 5)

4

5

Conclusions

- The 40 individual benefits codes were grouped into 7 key There is little published or unpublished literature on the impact Conclusions: Advocacy and leadership skills are &critical to effective medical practice, and domains: clinical skills; management skills; communication of volunteering within health partnerships. The existing evidence improvement of healthcare systems. However, internationally students rarely taught these skills, teamwork; patient experience & dignity; policy; academic baseare is descriptive and focuses on the benefits. andskills; demonstrate a low baseline&level of motivation and ability to engage inwork theseis areas. and personal satisfaction interest. More required to quantify the costs and benefits of Our student-run an effective, whichwithin couldhealth be employed volunteering partnerships for individuals and - A high degree of workshop concordancedemonstrated was shown between benefits replicable model worldwide by global student organisations, healthcare bodies and medical education faculties alike. institutions, and the associated challenges and barriers. cited and professional development indicators within UK Learning from peers is aframeworks, cheap andincluding effective participants feeling inspired and suggests that skills acquired workforce development theapproach Knowledgeresulting in Despite these limitations our analysis & skills framework The NHS framework resources and empowered to put (KSF), learning into Leadership practice. Increased and through mentorship will enable further volunteering map closely to workforce development continuing professional development competencies. development and up-scaling of peer-led training programmes, andframeworks can influence students early in and can be theoretical linked to improved service delivery within the medical NHS. Benefits could be maximised by formally their profession, to create a culture embracing and leadership throughout careers. - A theoretical trajectory from volunteerofexperience toadvocacy UK embedding volunteering within health partnerships within service delivery outcomes was demonstrated in most areas, but continuing professional development processes. not all (see Model of Transferring Benefits). [1] Earnest MA, Wong SL, Federico SG. Physician advocacy: What is it and how do we do it? Acad Med. 2010; 85:63–67. [2] Duvivier R, Stull M. Advocacy training and social accountability of health professionals, The Lancet 2011; 378: 9807.

A Report on ‘Making Change Happen’ - The IFMSA Advocacy Pre-GA, New York, 5- 9th March, 2013 IFMSA Coordinators (Programme) – Felicity Jones & Dan Knights (Medsin-UK) AMSA-USA Coordinators (Logistics) – Susanna O’Kula & Riju Banjeree (Mount Sinai)

With thanks to Liz Wiley (President of AMSA- USA) & Roopa Dhatt (President of IFMSA) And Hollie Kluckewski, Genevieve Bois and Alex Lebefvre (Pre-GA Facilitators & Trainers)


Peer-led Leadership Training for Medical Students