Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Advocacy in Rheumatology: Implications for Medical Education Based on a Focused Literature Review.
Wong, Jellena, Joneja, Mala
Advocacy in healthcare is a critical element of social accountability and a key competency in physician training as defined by the CanMEDS roles. Patient advocacy can be defined as the use of the physician's resources and expertise to enhance the patient's quality of life. Few models for teaching advocacy skills to physicians in training are available. The history and development of patient advocacy in rheumatic disease can serve as the basis for the development of a teaching model for residents and medical students. With this in mind, the purpose of this review was to: 1) Review the literature with respect to advocacy and rheumatic disease 2) Describe connections in the literature with respect to teaching advocacy in medical education 3) Based on our findings, propose a model for teaching advocacy skills to medical students and residents.
Two separate MESH keyword searches were conducted of Ovid Medline. The first search used "Patient advocacy" (MeSH) AND "Arthritis/Rheumatoid/or Arthritis, Psoriatic/ or Arthritis/ or Arthritis, Reaction" (MeSH) with no date restriction. The second Medline search used "Patient advocacy" (MeSH) AND "Education, Medical" (MeSH) with date restriction from 1996 to present. Further articles were obtained from the reference lists of these articles.
Twenty-four relevant articles and one book were identified based on the two literature reviews. The review of literature on patient advocacy and rheumatic disease identified five broad themes including: 1) self-management, 2) the four psychosocial theories of chronic disease, 3) the advocacy group movement, 4) the Patient Education Model, and 5) specific areas unique to rheumatic disease. The review of the literature on advocacy and medical education identified three different themes including: 1) clinical bioethics and medical ethics, 2) social responsibility, and 3) communication. There is overlap in the literature emphasizing the importance of the role of the physician in educating patients in order to empower patients and promote the self-management of disease.
The literature addressing advocacy in rheumatic disease combined with the literature on advocacy in medical education supports a model of advocacy where the physician has a pivotal role in the education of patients about their condition and associated management strategies. Medical students and residents should be trained to speak to patients in non-medical language, facilitate patient education and provide a scaffolding for self-management strategies. Rheumatology, with its history of promoting self-management and the Patient Education Model, can be a leader in educating future physicians in advocacy in health care.
To cite this abstract, please use the following information:
Wong, Jellena, Joneja, Mala; Advocacy in Rheumatology: Implications for Medical Education Based on a Focused Literature Review. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :91