As pediatricians we are in a unique position. We not only treat a patient’s illness, but we also evaluate the patient in the context of their home, family and community environment. Many of the issues facing children today are complex and cannot easily be fixed during a 15-minute clinic visit. By learning the skills necessary to advocate for our patients at the individual, community and legislative levels we are able to expand our influences to provide a greater impact.
The Pediatric Advocacy Rotation comprises a three year, longitudinal project as well as more intensive two week blocks devoted solely to advocacy activities during the first and second years of residency. This curriculum is designed to give residents the skills necessary to develop, implement and evaluate an advocacy activity from beginning to end. Residents will perform a community needs assessment, form partnerships with community stakeholders to impart change, and learn about addressing issues at the state and federal legislative levels.
The purpose of the advocacy rotation is to train residents to:
- Develop a tool kit of advocacy skills that can be applied in any community
- Use advocacy to advance the health of individual patients/families
- Identify and establish community based partnerships
- Describe and participate in the legislative process
- Dedicate concentrated time to longitudinal project implementation and evaluation
Specific aspects of the curriculum can be categorized at three levels: the individual, the community, and the legislative levels.
At the individual level, residents identify a need of a continuity clinic patient/family and provide individual advocacy efforts on behalf of the patient/family. These advocacy efforts may include phone calls, letter writing or provision of information on health or community resources.
At the community level, residents participate in a number of exercises designed to familiarize them with the community where most of their patients live. These exercises include windshield survey of a low income neighborhood and a “day in the life” activity in which residents must complete a number of activities that patients/families often experience (e.g. apply for Medicaid; find day care for a child with special needs).
At the legislative level, residents learn about the legislative process and the role it plays in healthcare. They have the opportunity to work with legislators during the Florida State Legislative session. Residents also meet with administrators in various Florida Department of Health divisions to assess needs, improve communication, develop programs and influence policy. Lastly residents write an opinion editorial.
The advocacy rotation curriculum is spread across all three years of residency training. In the intern (PGY1) year, residents focus on understanding the meaning of advocacy, the role of the pediatrician as community advocate, and become familiar with community partners, resources, and current advocacy initiatives. First year residents also begin work on the foundations of a longitudinal project that is based on a community needs assessment, available community resources, and a passion.
The second (PGY2) year curriculum builds upon the knowledge gained over the course of intern year. The focus of the second year is therefore the application of knowledge in the pediatrician as community advocate role. As a second year resident, you will reach out to community partners and work together to achieve a common outcome while bringing awareness to chosen population, need, and desired outcome. Throughout this curriculum you will continue to explore your community and participate in a wide range of activities that further advance your understanding of what it is to be a pediatrician as community advocate.
Each resident develops a project around an advocacy topic of their choice and is partnered with a faculty mentor to complete a needs assessment, develop a timeline and strategic plan, and see the plan actualized in the Alachua County community. Sample project s from the original curriculum are presented in the Residents in Action section.