Systems-Based Training in Graduate Medical Education for Service Learning in the State Legislature in the United States: Pilot Study

BACKGROUND There is a dearth of advocacy training in graduate medical education in the United States. To address this void, the Legislative Education and Advocacy Development (LEAD) course was developed as an interprofessional experience, partnering a cohort of pediatrics residents, fourth-year medical students, and public health students to be trained in evidence-informed health policy making. OBJECTIVE The objective of our study was to evaluate the usefulness and acceptability of a service-based legislative advocacy course. METHODS We conducted a pilot study using a single-arm pre-post study design with 10 participants in the LEAD course. The course's didactic portion taught learners how to define policy problems, research the background of the situation, brainstorm solutions, determine evaluation criteria, develop communication strategies, and formulate policy recommendations for state legislators. Learners worked in teams to create and present policy briefs addressing issues submitted by participating Illinois State legislators. We compared knowledge and attitudes of learners from pre- and postcourse surveys. We obtained qualitative feedback from legislators and pediatric residency directors. RESULTS Self-reported understanding of the health care system increased (mean score from 4 to 3.3, P=.01), with answers scored from 1=highly agree to 5=completely disagree. Mean knowledge-based scores improved (6.8/15 to 12.0/15 correct). Pediatric residency program directors and state legislators provided positive feedback about the LEAD course. CONCLUSIONS Promising results were demonstrated for the LEAD approach to incorporate advocacy training into graduate medical education.